[NICUSurvivor]

Hello All-

I am in my Senior Year (final semester) doing a Clinical of 8 hour (24 a week) with a preceptor who has been working on the Medical Surgical Unit for 20 years. I am trying my best to keep up to her standards but is really hard to get feedback from her. I can tell she is frustrated when i do not know how to so something (i.e. what and where to document (patient administered medication pump attempts etc. i.e. morphine). My main issue that i am aware of is organiziation/time management skills. I get to the unit at 630am and look over possible patients that i might recieve and make sure i understand why all the meds that are given, compatabilities, compliactions, etc. By 7am i am reading the chart and taking MD orders off the charts and transferring them to the Cardex and so forth. My preceptor arrives at 715 and we listen to report from the night nurse.

Lately we have been in a step-down unit from the ICU with vital checks q4 hours etc. I have 2 patients - generally one or both are on contact precautions (for MRSA in wounds/nares). There are generally not enough PCA (or UAP's) to work with us in this room of 4 patients. And one other nurse is in the room. I feel i get caught up in lifts, boosts, etc. and i rarely take a break/or talk to anyone except to recieve information on my patient's. I haven't taken a lunch break yet- and everytime i want to chart my assesments she points me in doing something else first (not high on my priority list). Each shift i meet with my professor to go over my patient's for a few min. She always says i'm on the right track but she wants me to get my charting done sooner. I always chart on blank piece of paper then i give it to my preceptor to review. She then gives it back to me so i can transfer it to the charts. Most shifts- i never get a chance to give report (she does it) and i am still charting at 415. I've had shifts where i am there until 615 because i am waiting for her to finish reading over my draft so i can chart it, generally she only makes a few corrections here and there about wording. Meanwhile she is kibitzing (telling jokes etc. to staff) and i have to wait. It's getting frustrating and i feel i can never accomplish my goals because i am continoulsy waiting for her or struggliling to get help so i can complete a task. I'm trying to delegate certain tasks (such as help with baths/ retreiving linens) but she gets annoyed- it's especially hard with patient's on contact precautions.

i'm starting to become discouraged that i will never get time-management down. Ive spoken with my professor about the issue but she says i'll be better when i have more consecutive days with my patients.

can someone help me have a timeline for completion of certain duties. I try to set deadlines for myself but by 1315 i'm usually running behind.

thank you

[marilynmom]

How long have you been doing clinicals there? For me it takes a couple days to totally feel oriented to the unit and really get a hand of where things are on the flowsheets and how they chart, because every place is different. I'm just starting my second week in the ICU and am just feeling like I am really getting the hang of how things flow in that unit and sometimes I have to remind the staff that I am still a student and am there to learn as well as help.

Also, there is no way a Med/Surg RN with 20 years experience should expect you to be at her level. Your STILL a student and you are there to learn still. You WILL get your time management skills down. Everyone has their own style and it simply going to take you awhile to find your style and the more you do things, get into a routine once you graduate you will do great!

I think we all feel the way you do at times in certain clinicals. And the more advanced we get and closer to graduation the worse it gets it seems!

[NICUSurvivor]

Thanks for the support! I appreciate it!