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!!!

Specializes in Pediatrics, Emergency, Trauma.

NURSING is TOUGH; nursing school PALES in comparison. When you get your first job, you have sometimes only 10 WEEKS to be on orientation, and then you are on YOUR OWN.

It is up to the person to accept the challenges and go forth...No one is being mean, forgot where we came from, etc, etc. Every chance I get, I add to my experiences from my orientation. IT IS A HUGE LEARNING CURVE; yet, I decompress, look things up, and become more forearmed and things click together. I can see the difference of when I graduated as a new grad LPN having a large load, where I was able to get on a floor and take on a patient load, compared to a new grad RN. I was able to take on a good amount; however, I'm able to put it together, but I would've WISHED for this type of load be side it gives you a great assets of a nursing skill to anticipate while you assess, as soon as you get on that floor. I don't always have that luxury until after the fact, which, for me and my nursing practice, is not always best; I don't like to play catch-up when my patient needs me there in the now, not later.

Again, OP, glad you were able to gain insight on looking things up, being your best advocate for asking for help, delegating to others; skills that sometimes a new grad feels hesitant to utilize, putting them at risk for burnout in the first year. Hope you are doing well...this experience will allow you to grow LEAPS and BOUNDS...you will see when you get that first job, promise!!

Specializes in Acute Care, Rehab, Palliative.

10 Weeks? That's a lot.Our new grads get 2.

Specializes in Pediatrics, Emergency, Trauma.
10 Weeks? That's a lot.Our new grads get 2.

^ *Shrugs*... My first job as a LPN I got 12 weeks, along with an additional 3 months of resource nursing if needed; got reviewed at 6 months. This organization has a new grad residency program, which is 18 months, which I'm in; maybe that is the difference?

If the OP were to get hired at your organization, then this is what she needs then; this experience is beneficial!

Specializes in ED.

It's scary and stressful to have that many patients...but you will be better prepared when you graduate. My first job out of school, which I'm working now, is in an ED. By my fourth week I was expected to take four patients on my own. Four patient isn't a lot, but in an ED where you have a lot of unstable patients, patients needing IVs, blood draws, EKGs, etc, and you're getting a new one every few hours...it's a lot. Your first job won't care how new you are. You have an orientation period, and then you are cut loose. And the scariest part of it is that YOU are the nurse. As a student, it seems like a punishment, but you will eventually be thankful that your program expected that much of you. I remember it used to take me 20 minutes to do a total assessment on one patient...you better believe my first RN job taught me to cut that down to 2 minutes, lol (although in the ER we do focused assessments). I know you're just a "student", but you are close to graduating, and the job market is fierce. Being able to handle a normal patient load will only help you. This coming from someone who was a student three months ago and is now handling 3-ish critical patients at a time on their own. See what I mean? At nine weeks till graduation, you're only 12 or so weeks from having a heck of a lot more responsibility. At least in school you are not yet really the RN for these patients.

Lynn52, I'm so sorry your clinical experience is like this. Hopefully you are even closer to being finished and this will all be behind you. In my clinicals, we are assigned to nurse and we work with her. She may have 5 or 6 patients, but they are not our sole responsibility. I've read some of the other posts and know they don't agree with me, but I feel they've thrown you in like a fish out of water. Hold on...it'll be over soon. lol. I know that is like telling you to hold your hand on a hot stove. Keep us posted.

Specializes in Nursing Education, CVICU, Float Pool.

Congrats on your coming graduation!!!!!

OP, it sounds like you just need some methods to help you manage your patient load more effectively. I'm graduating from an ADN program too! In 5 weeks!!!!!!! We are taking between 4 to 5 patients now, and have been since fall semester. I didn't think that I could do it, but surprisingly I maintained. You can do it too! There are some in our class that can handle 3 a lot better than they can 4. In school we usually get an assignment/patient-load that Has mixed acuity patients. Our instructors never gives us more than 2 high acuity patients at one time. It can be difficult working on a cardiac/telemetry unit, I did my preceptorship in the CVICU, the typical patient load is 3 patients there, unless there is a fresh CABG, then that's one on one. The telemetry unit at the hospital where we do clinical, generally, has higher acuity patients admitted mostly.

Around here, Patients on floors like CCU and telemetry usually have multiple comorbidities and multisystemic issues that require I higher level of critical thinking, attention, and care. That being the case, when on that floor we typically won't have more than 3 -4 mixed acuity patients. We still do most of our ADLs and take our own vitals. We help with baths and must chart a full shift assessment and a "mini-asseesemt"/nursing notes every 2 hours in each patient we have. We call the docs, pharmacy, central supply, nutrition, respiratory, and PTwith our primary nurse or instructor nearby for reference if we need it. We give our own meds individually, which the instructor or prinary nurse must sign off on each time. That process can slow you down tremendously bc we also don't have access to the Pyxis, but somehow we manage, and we most meds on schedule too!

I believe that once you find a time management plan or nursing brain sheet that works for you, you will do great!

I think it sets up a student for errors and patients for harm to expect a novice to manage such a load safely.

Apparently some nurses think it's ok to eat their own young. Mentor and support the new ones for the very reason that it IS a tough profession! Someday they will be taking care of YOU - why make them bitter!

Amen.

Oh gosh do I feel your pain!

Agree to disagree it is.

I believe you have been honest as well as very respectful. Thank you for advocating for new nurses...it enhances patient care in the long run.

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