newer grad feeling inept at rounds

CaLLaCoDe, BSN, RN · Jul 2, 2008

You can always call pharmacy and find out that way, rather than trouble someone you think might not easily approachable. On my new work adventure, I've thought about bringing doughnuts to sweeten their palates ahead of beating my brow when it comes to dealing with the new person.

Sandy_dfw · Jul 2, 2008

There are times, however, when I forget where to find the info and then I get flustered.

I am only in school right now so I do not know how the system works for looking up info. If you are forgetting the links then the easiest way I know is to make a links page and copy the website links onto the page. Then anytime you need info you can go to that page and get the website very qucikly.

Where I work at now I have made a yahoo bookmarks page with all the websites I might need. I can get to that page quickly and get the answers I need.

I do not know if this will help at all.

Good luck.

Sandy

Hands and Heart · Jul 2, 2008

I would approach the charge nurse at a comfortable time to explain your desire to become more efficient and competent in your position. Ask him/her to allow you more time to find/answer the MD's question or wait for your request for help before jumping in. Also, ask him/her to not take over at that point, but to turn the reigns back over to you so that you can continue to be effective in rounds. After rounds are complete, discuss your performance with the charge nurse. Ask for criticism on what you did right, what was wrong, what was left out, and how to improve. Perhaps there is someone you can do mock rounds with as well. The only way to learn to be effective, efficient and competent in your role is to practice it over and over until it is second nature. Having someone take over constantly will stifle your growth. Good luck.

chenoaspirit, ASN, RN · Jul 2, 2008

Im sure the charge nurse was only trying to help out by easing your frustration/tension and also help the doc get the info he/she needed. The next time he/she does it, afterward ask questions so you know the next time. He/she should have explained to you why the higher dose of the drug for your future knowledge. I agree with hands/heart that the only way to learn is by practicing. It will also take time. Each time you are unable to find something on the computer, later find it and note where you found it for future reference. Good luck. It will get better, I promise.

PiPhi2004 · Jul 2, 2008

It just takes a lot of time to really get good at rounds and just be thankful that someone is there that is more experienced that can make sure pts get the meds they need. We have morning rounds in our ICU and usually one attending, the resident, the pharmacist, the charge nurse, respiratory, and the bedside nurse participate. I didnt feel comfortable in rounds for the first 6-8 months but now I feel free to address anyone as need be. In report I usually make a list of concerns about things that need to be done or meds that need restarted or abn labs that may need to be supplemented. It just takes time to recognize what your pt needs, plus it can be very intimidating as a newbie to talk to drs. Thats why the charge nurse is there, to help you. You will eventually get it and just keep asking questions when your charge isnt busy so you will be more prepared next time. What is likely is that you are right on schedule with your training and will just grow with time! Good luck!

kcalohagirl · Jul 2, 2008

Okay, someone may feel free to tell me that I am completely out of line here, so have at it.

If you are a "fairly new grad", why are the MD's asking you about the dosages that they should be giving of certain meds?

I've been an RN on my floor (cardiac) for over two years now. And it is only in the past few months that I feel comfortable making recommendations about beta-blockers, etc. . to our PAs and residents.

If I have a patient that is having anxiety issues, or can't fall asleep, or something fairly benign, I may be more agressive with my suggestions. If the residents/MDs/PAs are looking for more information about the result a patient may have had to a certain intervention, that information should be on the chart.

mpccrn, BSN, RN · Jul 2, 2008

try sitting next to the charge nurse so you can see where she goes for info.....comfort will come with confidence......stay with it! :nurse:

jjjoy, LPN · Jul 2, 2008

There's that all important time/experience factor and trying to balance the need to jump in, ask questions, be an active learner, etc and to just sit back, observe and absorb having faith that the system will work - that over time you will become more competent and comfortable - but til then it's that balancing act... ask, ask, ask, push, push, push for learning and sit back, observe, absorb, have faith, observe, absorb, have faith.

BlueEyedRN · Jul 2, 2008

I hated rounds my first year because our intensivists loved making everything a learning experiences and would ask these complicated questions that I couldn't possibly know that answer to. I eventually learned to say sweetly, "I have no idea." And of course, the more I learned, the harder the questions they would ask. I sort of appreciate it because I did learn a lot, but you could tell they just delighted in knowing so much more than me. (Oooh, big ego boost, a doctor with 12 years experience knows more than a brand new nursing grad. Ugh). I learned to really not sweat that stuff and get the focus on what I needed from them.

I don't know exactly how your rounds are done, but it seems to me that the best way to stay involved is to not look up stuff on the computer because then your focus is there instead of on the discussion. Let someone who knows the answer pitch in, but if you have questions yourself, ask them. Most people I know love to teach and you aren't expected to know everything when you are new. Have your list of concerns and make sure that you get what you need before they move on to the next person.

Keepstanding, ASN, RN · Jul 2, 2008

oh sweetie, i do hope things get better for you ! getting report and doing rounds can be fast paced and complicated, all on a limited time.

hang in there ! :heartbeat