First week as a nurse (LPNa)

Published Jan 19, 2008

1 Article; 2,043 Posts

Specializes in ICU, Telemetry.

I know when I was in school (graduated Dec. 19th) I always wondered what my first week on the floor (after orientation) would be like. Setting: Small rural hospital in the south. Time period: on my ATT, waiting to take the boards on the 29th. The floor: ICU stepdown. So, if anyone else would like to know, here goes....

My preceptor, who is GREAT, walked up, and said, "First, forget everything you learned in school. This is the real world." Not comforting. She sat me down and we tore thru the hospital training on IV starts, administration of blood products, and all the other things your instructors tell you "LPNs never do." First day, the plan was I would shadow her, and then gradually get assigned patients where I was the nurse and she would shadow me, until we both were comfortable.

The plan lasted about 5 minutes. The schedulers assigned us each patients like I was a "real" nurse, and we couldn't get anyone to come in. So, first day, I've got two going to SNFs that we have to get ready for discharge, a post CVA, and two pneumonias. These folks, it would have been easier to have wheeled them to the dibold, told the machine to dispense one of each, and do the med pass that way, since they pretty much had the entire alphabet soup -- CHF, DM, RF, RA, etc. The first day, I gave more injections and hung more piggies than I did the entire time I was in school, including platelets. It seemed like if you weren't getting platelets, you were getting heparin / coumadin. We worked almost 14 hours on what should have been a 12 shift. My preceptor was great, and never let me feel like I was as clueless as I actually am. I mentioned to her on the way out (since we'd dealt with projectile stool and I hadn't even blinked) that crap, vomit, and suctioning trachs doesn't bother me...but stinky smelly feet make me want to puke. Keep that in mind....

Same thing second day, except someone who was supposed to be going home had a CVA. Nicest guy you'd ever want to meet, and the family was present, asking "what's going on / what's that you're giving him / he's never had that before" -- nice, concerned, and I'm trying to hang IVs, etc. Patient was awake and his eyes were flying around the room and he looked terrorfied, since by this time the MD had come in and said he was having a CVA. I leaned over to make sure he could see me, and told him, "Mr. X, I know you're scared. It's okay to be scared. We're going to take the best care of you that we possibly can." Maybe he couldn't understand, but I know if it had been me, I'd have wanted someone to talk to me. He went off to the ICU. Now, remember the feet? I get a homeless guy with necrotic feet from DM, who's going to need amputations and was taking swings at the CNAs. Wound vac, necrosis, a smell that made us open the window and turn the heat all the way up. Preceptor is happy, I think I'm never going to get the smell out of my hair...

Third day, I'm supposed to get 2 patients and my preceptor shadow me. We get an new admit, have to get a psych consult to try to figure out if the homeless guy can give a valid, legal consent, I'm hanging potassium, looking at labs that show a LOL had an MI, and generally thinking, "dear god, please don't let them code, don't let them code..." Luckily my shift ended before the Friday night gun and knife club started up...the ER was getting slammed as I left, and we are probably completely doubled up over there today.

So, in short -- got to do a lot of the things they said LPNs never do without "extensive training from their employers" on the first day. Had a patient have a CVA, had really really bad feet, hung all kinds of drugs and did platelets.

I am HAVING THE TIME OF MY LIFE!:w00t:

I must be demented....