Clinical Nursing Student Needs Advice 5 patients

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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 more of these shifts and should be home free as my last rotation will be less intense. We are expected to do two assessments per patient, IV assessments every two hours,start IVs, all skills, and pass all meds. The med orders change frequently on this unit and there are many unstable patients with codes etc.

I don't mind working very, very hard and forgoing a break but as a student this is a bit much. If we make a mistake depending on the severity we are out of the program :( . My first concern is for my patients I'm just not sure I can do this and am looking for any advice that anyone would kindly share.

Some of the challenges are we do not have immediate access to the med room, have to wait for our instructors for IV pushes and skills, we have not been orientated to the floor...this is tough!!!

Thank YOU!!!

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.

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.

Specializes in Acute Care, Rehab, Palliative.
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.

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. :)

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. :)

Are you saying we weren't trained properly?

Are you saying that generations of nurses before you that were hospital trained were poorly educated because they went from student to staff without an orientation?

No wonder American healthcare is so expensive! Double nurses for how many months until the new hire feels confident!

Specializes in Acute Care, Rehab, Palliative.

I was SO nervous but I had done a placement there.I didn't say I was perfect. lol I'm just saying that I wasn't coddled.But they were kind and supportive. I had been taking care of 5 for the last 2-3 weeks of my placement so I was used to it.School is your training.

Are you saying we weren't trained properly?

Are you saying that generations of nurses before you that were hospital trained were poorly educated because they went from student to staff without an orientation?

No wonder American healthcare is so expensive! Double nurses for how many months until the new hire feels confident!

Oh no, not saying that. Just saying that hospital training and in class training are 100% different and so if you are classroom based you need a good orientation onto the floor. Now that training is more classroom based expectations need to be changed as well.

Yes, nurses need to be trained and confident. Some nurses it will only take a few days, others need a little more time and an extra push. But no one should be thrown the wolves on day one. If you did tons of training in that hospital you were hired in, expectations are quite different than someone who shows up there day one without having stepped foot in the hospital besides their interview.

Specializes in Pediatrics.
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 more of these shifts and should be home free as my last rotation will be less intense. We are expected to do two assessments per patient, IV assessments every two hours,start IVs, all skills, and pass all meds. The med orders change frequently on this unit and there are many unstable patients with codes etc.

I don't mind working very, very hard and forgoing a break but as a student this is a bit much. If we make a mistake depending on the severity we are out of the program :( . My first concern is for my patients I'm just not sure I can do this and am looking for any advice that anyone would kindly share.

Some of the challenges are we do not have immediate access to the med room, have to wait for our instructors for IV pushes and skills, we have not been orientated to the floor...this is tough!!!

Thank YOU!!!

Wow they r really preparing u for the real deal! Be thankful. Every day in nursing is what you described. There is always going to be obstacles, you will always have a million things to do, and there is never enough time to get it done. Welcome to nursing. Good luck

Specializes in Intermediate care.

Depends what year you are. When i have students with me, i think one patient is enough for them. Sometimes they have a buddy system where its 2 students to one patient. Which is fine. But junior year, you should take 1 on your own FOR SURE. End of your junior year, you need to be taking 2.

My senior students, i expect alot more from. Beause the reality is this...you NEED to be challenged in nursing school. I would have learned nothing had i taken 1 patient my entire time while i was in nursing school. Prioritization and time managment is key!! What things need to be done now? what can wait until later? You have 4-6 patients in a day. It is essential to get practice with this. When you graduate they are not going to take sympathy on you being new. The second i was off orientation i was expected to be able to do what every other nurse did on that unit. If one nurse could handle 4 patients it was expected that i should do the same. Nobody took sympathy on me being new. Yea it sucked for about a year and many nights i spent in tears. But i got over it, i learned many lessons and im doing great. I feel im a good nurse. I'm not a warm/fuzzy nurse. I'm an "all business" type of nurse, but i'm good at what i do. This is becuase i was FORCED to do it.

Specializes in Pediatrics, Emergency, Trauma.
Depends what year you are. When i have students with me, i think one patient is enough for them. Sometimes they have a buddy system where its 2 students to one patient. Which is fine. But junior year, you should take 1 on your own FOR SURE. End of your junior year, you need to be taking 2.

My senior students, i expect alot more from. Beause the reality is this...you NEED to be challenged in nursing school. I would have learned nothing had i taken 1 patient my entire time while i was in nursing school. Prioritization and time managment is key!! What things need to be done now? what can wait until later? You have 4-6 patients in a day. It is essential to get practice with this. When you graduate they are not going to take sympathy on you being new. The second i was off orientation i was expected to be able to do what every other nurse did on that unit. If one nurse could handle 4 patients it was expected that i should do the same. Nobody took sympathy on me being new. Yea it sucked for about a year and many nights i spent in tears. But i got over it, i learned many lessons and im doing great. I feel im a good nurse. I'm not a warm/fuzzy nurse. I'm an "all business" type of nurse, but i'm good at what i do. This is becuase i was FORCED to do it.

^AMEN!!! :Whoop:

In my experience, "all business" was not only good, but better for my patients. My competency allowed them to trust me, and they saw me as empathetic.

Like the saying goes: Forewarned is Forearmed!!! Take advantage of the opportunity, OP :)

Specializes in ICU.

Ya'll must have forgotten how tough it is to wait for your instructor to come around and supervise your med pass. Obviously it's going to put you behind especially when you and all your classmates have 5 patients. In the real world, you can just give the meds yourself and be on your merry way. Making comparisons between the OP's current predicament and real world nursing is not fair at all.

Lynn52, reading your post brought back memories of my final semester med-surg rotation. New hospital, hardly any orientation, straight in with four patients, and team-leading. Our patients had their assigned nurse but we were to do everything we had been taught and practiced previously. This was the first semester we didn't do total care. Our instructor was with us for IV pushes. The whole rotation was hair raising and enormously stressful. Thankfully my patient's nurses were for the most part very supportive (not all, but the majority), as was my instructor.

I think the people on this thread who recommended working on organization and using a worksheet gave very good advice. I would add doing your best to prioritize your care based on the seriousness of your patients conditions: Who is your most unstable patient? Does he/she need immediate medical/nursing interventions? What is important and must be done but can wait a bit? What is not time-sensitive?

As far as patient safety: If there is something you are concerned about I would not hesitate to check with your patient's nurse and/or your instructor. Patient safety is critical. Hopefully, even though you have five patients you are receiving support from your instructor and your patients' nurses. Good luck.

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