GoldenFire5 3,893 Views
Joined Sep 22, '05 - from 'San Diego, CA'.
She has '5' year(s) of experience and specializes in 'ICU'.
Posts: 249 (15% Liked)
When you come off orientation, you're not expected to know everything. Your charge nurse and resource nurses will expect you to ask questions. If your patient is crashing, they will want to know about it.
At the beginning of your shift, take 5 minutes to think about worst case scenarios. What is the worst thing that could happen to your patient? What would the beginning signs of that look like? What would you do? If you are still on orientation, you need to ask your preceptor about worst case scenarios *now*. Review them with her for each patient. When something unusual or terrible happens on my unit, I still ask - how did you know it was happening? What were the early signs?
So when your patient takes a turn for the worse, don't panic, get a set of vitals while you're thinking about what could be happening. Think of urine output as a vital sign, too. Do you have protocols for standing orders? Know them cold when you come off orientation. Review what's going on with another nurse.
How was the urine output? Did it drop off when the night shift nurse put the cuff on the leg and stopped the pressors?
You have a great opportunity for a fresh start. You should receive some sort of orientation at your next hospital to learn the flow of how things work and how the RNs interact as a team.
>She told me that I should have taken charge of my patient care and directed them to what needs to be done.
I would take this advice to heart and become more assertive and directive at your next job. You're presenting yourself as having 3 years of experience... the nurses at your next job will expect you to know what you're doing.
And take the phrase "I don't care" completely out of your vocabulary. It will almost always be misinterpreted.
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