Clinical Nursing Student Needs Advice 5 patients - page 4

by Lynn52 8,527 Views | 70 Comments

Hello All, I am finishing up my ADN with 9 weeks to go. I'm in my mid fifties. In my current rotation we care for as many as 5 patients on a cardiac tele unit. I am overwhelmed to say the least. I have to make it through 5... Read More


  1. 1
    Quote from LadyFree28
    ^How can you "hear" how posters "sound" on here???

    I'm just curious...where is this sound coming from????

    Your post can be interpreted as defensive and crabby, but I can not make that assumption because I can't "hear" you....
    Your posts make you "seem" crabby. Apologies for the word "sound."

    Look, I'm not trying to insult you all. But you genuinely sounded VERY burned out and you would do yourselves, as well as countless numbers of patients, a favor if you took a few days off work and actually relaxed!

    I'll repost my advice in case anyone missed it.

    "Do yourself a favor...take a few vacation days and take some deep breaths, have a cocktail or ten, go out and dance your butt off at a club, sit on the beach, or wiggle your toes in the grass in your backyard. Build a snowman with your children and then drink some hot chocolate with them. If you're single, make an online dating profile and chat with a few people. Go out and treat yourself to a personal toy and have fun! If you're in a relationship, sit down your GF/BF/spouse and just talk, reconnect...and then roll around in the sheets. Have an orgasm or two. Go to see a movie or stop off at Barnes and Noble and buy a new bestseller and spend the day reading. Be crazy and go buy a plane ticket and spend the weekend in a big city or a sunny place, or go on a weekend road-trip!"

    Nurses need to work together, not fight and back-stab each other. OP wants support, not words of "well suck it up, baby, welcome to the real world." Is real world 5 patients and a crazy shift? Most likely yes, but OP should be eased into it, not thrown to the wolves. That is all I would like you guys to realize!!
    Last edit by chrisrn24 on Feb 23, '13 : Reason: added in advice!
    onewill likes this.
  2. 0
    " A new grad nurse gets a few day of orientation and then they are on their own with a full assignment" ??? So glad where I work they give even experienced nurses aprox 7 shifts of orientation on the floor, a new grad would get 4-6 weeks on med-surg tele. Just learning the Ins/Outs of a particular institution takes time, the type of charting they use, the layout of the land.

    8-9 tele patients per nurse very unsafe. There are shifts that having just 4 patients kicks my butt. I'd really love to know how the patients differ in a facility with 8 patients per nurse vs 4 patients per nurse, or do they differ. If they don't differ how does the nursing care differ? How many corners are being cut, how much overtime just to get charting done after the next shift takes over.

    3 patient's per nurse in ICU. Standard is 2 patients per nurse, occasionally 1:1, and in certain cases 2 RN's per patient. Never 3!
  3. 5
    Quote from chrisrn24

    Your posts make you "seem" crabby. Apologies for the word "sound."

    Look, I'm not trying to insult you all. But you genuinely sounded VERY burned out and you would do yourselves, as well as countless numbers of patients, a favor if you took a few days off work and actually relaxed!

    Nurses need to work together, not fight and back-stab each other. OP wants support, not words of "well suck it up, baby, welcome to the real world." Is real world 5 patients and a crazy shift? Most likely yes, but OP should be eased into it, not thrown to the wolves. That is all I would like you guys to realize!!
    Lol...I don't know how long you've been in this arena, but I've worked a little more than 30% of my projected 30 year nursing career. I can honestly say I NEVER experienced burnout... I have been a preceptor, an orientee, and a consistent team player. My point is to not make assumptions about who we are, just like I don't do to you, THAT is disrespectful. Look at my posts...If anything, I am passionate, but LOVE being a nurse. I'm even returned to new grad status, but I have PERSPECTIVE as well.

    No one can "throw you to the wolves" if you learn to advocate for yourself...If you can't advocate for yourself, can you honestly say you can advocate for your patients, function when pts are at a high acuity??? And they are getting HIGHER, and our responsibility is expanding as more sicker pts are going to be coming through the door, as well as our communities.

    I have been a HUGE advocate for myself, in turn, my patients and my practice has been very competent and respected, as well as my relationships have been between my team, whether it be Drs, Nurses, Therapists, and Techs, and everyone in between.

    I've had 98% thankful days compared to the 2% thankless days in my profession. I attribute to the fact of what I am capable of doing, soliciting help, and enlisting advocacy as my mainstay.

    So, please, spare me what you think when we don't know each other, nor have ever ask me for help, or PM'd me for advice or have communicated with me on posts...you haven't walked in my Danskos. I will do the same for you, and I suggest you do the same for these posters. They are being HONEST, and for me, that is FAR GREATER than the "poor baby" path...it doesn't serve the empowerment that we have as nurses. Just my opinion, and my experience, of course.
    Rose_Queen, Halcyonn, poppycat, and 2 others like this.
  4. 0
    LadyFree28, I'll just leave you with this quote from up thread which I think is well spoken.

    Quote from Bezoars
    It's NOT SAFE for a student to have that many patients, not knowing the unit, or where stuff is, or being able to do anything without an instructor there.... That's crazy. What they are asking you to do is CRAZY. Sure we handle a lot of patients in "the real world", but common... this is a nursing student with no real world experience. Did they hand YOU 8 patients your first day on the job and say "have at it"? I sure hope not. Typically you go through a training time or preceptorship where you learn the floor and how to be a nurse... THEN they can load you up with patients. Let's have a little compassion. Do you remember how you felt when you were out there the first time on your own?
    That is all I am asking. Remember your first days of nursing and have some compassion for OP.
  5. 1
    Quote from chrisrn24
    LadyFree28, I'll just leave you with this quote from up thread which I think is well spoken.

    That is all I am asking. Remember your first days of nursing and have some compassion for OP.
    I'm doing my first days of nursing AGAIN!!!

    Lol, I just said I was a NEW GRAD.

    How about AGAIN, YOU having not only compassion, but RESPECT to other posters and their opinions. Not everyone is jumping on the OP, and certainly not me.

    I have her my perspective. Nursing is hard. Not going to give the warm milk treatment does not make me more or less empathetic. I have her tips, techniques, which are FAR more USEFUL than stating, pat "Nursing is rough, tsk, tsk" statements.

    I rather benefit from REALITY than pat statements; pat statements insult my intelligence and the reality of how complex nursing truly is.

    That's my perspective, and I am sticking to it.
    Again, you don't know my posts, nor my perspective, because you HAVE NOT walked in my Danskos...try them on...when you do, you will understand my perspective...until THEN, agree to disagree and RESPECT my opinion, as I do yours.
    loriangel14 likes this.
  6. 1
    Quote from LadyFree28

    That's my perspective, and I am sticking to it.
    Again, you don't know my posts, nor my perspective, because you HAVE NOT walked in my Danskos...try them on...when you do, you will understand my perspective...until THEN, agree to disagree and RESPECT my opinion, as I do yours.
    Agree to disagree it is.
    onewill likes this.
  7. 2
    On my surgical rotation (which was before my final practicuum), you had to be able to handle a five patient assignment. Help was there if we needed direction. We had to be able to demonstrate time managment, prioritization and knowledge. You couldn't manage five, well you were held back, given another chance and if that didn't work, you were then asked to leave.

    As a new grad, I had three day shift and two evenings for orientation. The rationale being, we are all locally trained, worked in the facilties that hire us, and have some knowledge of what we were getting into. Orientation isn't for consolidating your skills, it's to learn the unit routine, paperwork, etc.

    Employers shouldn't have to provide new grads to surgery, medicine and LTC units with extensive orientations, that's what nursing school is supposed to teach you. The basics of patient care and management. CNEs are their to provide more indpeth skill based knowledge.

    I was in my 40's when I went through school. There seemed to more pressure on the more mature students. Depending on the instructor they either wanted to fail us because of our "advanced age" or expected to much from us because we'd lived in the real world.
    onewill and loriangel14 like this.
  8. 1
    Quote from Fiona59

    Employers shouldn't have to provide new grads to surgery, medicine and LTC units with extensive orientations, that's what nursing school is supposed to teach you. The basics of patient care and management. CNEs are their to provide more indpeth skill based knowledge.
    Practicing your skills in the lab and on an actual patient are night and day. It is good to be refreshed on them. Even if I learned a skill in lab, I still ask for assistance my first time doing it. I don't often deal with PICCs but I did recently and I asked my fellow nurse, "Will you come and make sure I'm setting this IV tubing up right?" Even though I practiced it a million times in lab, and did it fine straightaway, I just like to be comforted that it is okay.

    I had a one month orientation at my LTC facility, and so does everyone regardless of experience. For both refreshing skills and learning the routine. There should be absolutely no shame in asking for help with things you are unfamiliar with.
    onewill likes this.
  9. 1
    Quote from Fiona59
    On my surgical rotation (which was before my final practicuum), you had to be able to handle a five patient assignment. Help was there if we needed direction. We had to be able to demonstrate time managment, prioritization and knowledge. You couldn't manage five, well you were held back, given another chance and if that didn't work, you were then asked to leave.

    As a new grad, I had three day shift and two evenings for orientation. The rationale being, we are all locally trained, worked in the facilties that hire us, and have some knowledge of what we were getting into. Orientation isn't for consolidating your skills, it's to learn the unit routine, paperwork, etc.

    Employers shouldn't have to provide new grads to surgery, medicine and LTC units with extensive orientations, that's what nursing school is supposed to teach you. The basics of patient care and management. CNEs are their to provide more indpeth skill based knowledge.

    I was in my 40's when I went through school. There seemed to more pressure on the more mature students. Depending on the instructor they either wanted to fail us because of our "advanced age" or expected to much from us because we'd lived in the real world.
    Well said.

    I actually had no orientation when I was hired because I had done a placement there. I just showed up and picked up my 5 patient assignment.Of course I was able to ask for help if I needed it ( I still can ) but I was able to manage a regular assignment because my preceptor had made me carry five by the end of my placement.
    Fiona59 likes this.
  10. 2
    You all must be crazy perfect! OMG I would be terrified if I got on the floor my first day and they gave me a full assignment!!! That is absolutely crazy. I am so thankful I got proper training.
    onewill and ama3t like this.


Top