nurse671 8,539 Views
Joined Oct 19, '08.
Posts: 386 (24% Liked)
Just the barebones
1. State (city would be nice)
4. Perks if any
1. Northern California
3. no health benefits
4. company cellphone & tablet
Being a new nurse is a emotional experience and I remember confidence being a fragile thing.
I had a preceptor like the one you describe, but I thought of her a little differently. Her style was direct with little fluff. In communication, she was more like a man-straight up and to the point. If I wasn't doing something well, she told me. However unpleasant it was to hear the truth, she gave me honest feedback, and that is what I needed. Her job was to teach me how to be the best nurse I could be; my preceptor figured I was strong enough to handle the truth.
I also had a second preceptor who was warmer and more nurturing. Being one of the more timid nurses, my second preceptor helped me get over my fears and get on with business. I learned that confidence would have to be earned through hard work one day at a time.
Between the two of them, I had an excellent orientation, and I am grateful to them both.
Best of luck to you getting through this growing phase.
I'm sorry you're going through this. I just had a similar experience, doing my final placement in school on a busy surgical floor. I felt like I was doing really well and my preceptor really liked me...then a week before the end of my placement she gave me her full assignment to handle and I got really overwhelmed and made a med error, and she had to help me with care on 2 patients (4/5 were total cares...they were going to split the assignment but assumed that since my nurse had me with her it would be fair). I felt terrible, made a learning plan, explained several times that I realized the seriousness of my mistake and what I learned from it. I tried really hard to improve my practice in the last week and felt I did really well...I wanted the job so badly. She gives me my final evaluation and rips me apart, saying I was awesome in the beginning but went downhill after she gave me the full assignment, that she doesn't think I'm cut out for fast-paced surgical nursing (when it is in fact, the kind of nursing I want to do). She compares me to her other students, saying that they never had any problem, and that she won't be recommending me for a job. Because I was overwhelmed on the first day on my own, and made one mistake. I'm still a student! Needless to say I told her that I respected her opinion and would take everything she said into account to make changes to improve my practice....but that I disagreed with her that the surgical floor wasnt for me and that it was what I wanted to do and will do it.
So, I know exactly how you feel. I would take your preceptors critiques into account, let her know you respect her opinion, try to make changes to your practice...and prove her wrong.
All the best.
I feel like I made a bad choice now. It bugs me that I felt confident in my decision until it was challenged.
Well, you're generally wise to follow protocols because that's what they're there for... and you're going out on a limb if you disregard them.
That said, you're always better to feed people for hypoglycemia than to hit their poor veins with the very acidic D50.
Of course, you had a central line so the acidity and veins weren't an issue (and stopping the abx for a couple of minutes won't hurt anything).
Be careful about some of your assumptions:
- "I'd be in the room with him the whole time." --- yep, right up until something unexpected came up (code, fall, and you ended up being gone for 30 minutes
- "Has a history of tolerating it (low BS)" -- yep, right up until he doesn't... and that would be the time that you discovered that your lines were crapped out and there was no glucagon to be had...
You could do that 1,000 times and be fine but it's number 1,001 that will get you and your patient into trouble.
When the BS was 60, it was time to deal with it as a high priority because swings in blood sugar are detrimental to the patient over the long term (that is, correlated with poorer outcomes).
Whenever you deviate from the physician's orders, you're taking a risk. In this case, the risk was rather small but also completely unnecessary (though not worth 'flipping out').
Thanks...I have a report paper we use to take notes on to help with report. I constantly take notes. If time allots, I like to jot down things I will pass along. Invariably I am always asked a question about a patient and left feeling "duh" for not knowing.
I used to feel like you do all the time. This may not be a popular answer, but I think that knowing a patient's entire history is not really an important part of being a good nurse. Some nurses really get involved in their patient's pathophys and want to talk all day about the intricacies of their disease process....but how does that help your patient care? Many of those same nurses suck at patient care, keeping their work space clean, cleaning the patient, developing a therapeutic relationship, etc. You need to know what is normal and what is not depending on your patient's diagnosis, but you don't need to know that they had a lap chole in 98. I get annoyed when I get report and nurse goes on and on and on and on about their history. I want to know what I need to know, if that makes sense. So don't be so hard on yourself. You are probably doing a much better job than you think. Nursing is an inherently tough position....so don't be so tough on yourself. GL honey!
As an RN with seven years in the field, I can empathize with what you're saying. I often still feel that way -- like I somehow could/should have done more for my patients. Keep in mind that you can only do the best you can do. It's not your job to fix every patient's problems, or make everyone better. I often have to remind myself that I can't fix in one night a problem that the patient took ten years to develop. As time goes on, you'll get smoother and more confident doing nursing care, which will leave you more time to collect information on the patients. In fact, you'll look back one day and say to yourself, "Wow, I'm good at this! How did that happen?" Good luck to you, and don't lose heart.
I just have to say, that last final on Monday was a make it or break it moment for me. I took off from work on Friday and Monday to have 4 full days of studying - didn't shower, wore the same clothes, pretty much didn't move from my desk. I was super nervous but ended up turning it around and I passed! so I'll be getting pinned on 6/3 and have a summer internship in the ER of a local hospital as well - I'm so happy!
Don't stop working hard for it, guys - it's tough but 100% worth it!
I guess you're right. Although I haven't gotten anything to show for the 5 years I've been in college, I do have two beautiful children. One of which has cancer, so I can't really put all the blame on myself. Haha, I wish I had the LPN to gain some confidence! The most I did was part of a medical assistant program and I absolutely adored it. That's when it dawned on me. Two years later I'm finally able to go in the right direction! lol.
I started nursing school at 38. What is your point?
They may have become friends and are talking about their families or something else they wouldn't share with a relative stranger. I remember my first nursing job where two of the nurses talked only Russian when they were together. When I had been there about three months, they began to smile at me and, shortly thereafter, they switched to English. Remember though, if you aren't as close as the other people, they may still stop talking and that's ok. It isn't for any bad reason. Yes, you're being too sensitive.
Our lab drives me crazy, too. We once had a guy who would call and argue over every single order. "Why do you want a potassium level? He had one this morning." Yes, and it was 2.7, treated it, now need to re-check. This same guy had long hair and a beard. I had a patient say that he woke up and Jesus was standing over him! He thought his time had come.
Can we pretty please not make this a floor vs. ED situation? That is nurse on nurse hating!
Let's get back to hating on pharmacy.
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