Clinical Nursing Student Needs Advice 5 patients - page 5

by Lynn52 | 8,644 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


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    Quote from chrisrn24
    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!
    elkpark, GrnTea, and applewhitern like this.
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    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.
    Fiona59, GrnTea, and applewhitern like this.
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    Quote from Fiona59
    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.
    onewill likes this.
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    Quote from Lynn52
    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
    elkpark, GrnTea, Fiona59, and 2 others like this.
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    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.
    GrnTea, Fiona59, applewhitern, and 1 other like this.
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    Quote from Jenni811
    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
    GrnTea, Fiona59, and loriangel14 like this.
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    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.
    snowwhite2002, onewill, netglow, and 1 other like this.
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    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.
    Last edit by Susie2310 on Feb 24, '13
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    The real issue, as few others have pointed out, is that the OP has to wait for the instructor to be present in order to pull/pass meds and perform all skills. This is the same scenario for me during clinicals, and we usually have a group of 8 students to 1 instructor. We can't do ANYTHING but assessments and documentation without our instructor present. We have 2-3 patients assigned and of course we always get ripped a new one for "poor time management". I think I could handle 5 patients just fine if I didn't have to either wait in line or actively seek out my instructor to supervise me every time I need to give a med or perform a procedure. I try to cluster care and catch up on documentation while in line, but this scenario isn't the same as it will be in "the real world".
    netglow likes this.
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    Thank You for your comments....I will read and reread them as I finish up this rotation. The nurses on this floor never have more than 5 pts so this is a full pt load.....before you can work in this hospital you are required to go through an orientation that lasts at least 6 weeks so we are handicapped in that way. We were shown nothing absolutely nothing didn't know where anything was. We do have to wait for our instructor to do some procedures which slows us down. We also have a shorter shift making it harder to get it all done we have to attend a meeting before the end of shift. The full pt load is new to us this semester last semester we had 2-3 pts but were able to get all our pt info before we hit the floor ......look up drugs, diagnosis's etc. so this is tough. The other night I had late night clinicals and then early morn the next day slept a few hours and by the grace of God only got two pts ,was assigned to charge nurse, otherwise it wouldn't have been pretty. I would have cried uncle before I would have allowed harm to anyone though. I personally think it is too much if I have 3 pts I get to delve in deeper and understand everything better....or 5 but let me get my info ahead of time to compensate for the fact that we have less time to get it all done and far less experience. I do appreciate the comments and will work on memorizing any meds Idk well, improving my organization (although I think it is pretty good), and praying like crazy Let's face it at this age you don't go to school to be a nurse unless you really want it bad and think you'd be darn good at it!!!
    Halcyonn and nursel56 like this.


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