Help with multidisciplinary communication

Nursing Students Student Assist

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In school and clinical, I usually can communicate just fine! However, I just started my ICU preceptorship, and my words are not coming out normal.... Everything that I want to say is getting mixed up when it comes out, and I have sounded so stupid in front of my preceptor and doctors. For example, when providing the Dr. a history of the patient: I said the patient was on a Lasix drip to restore his/her intravascular volume. WHICH IS PLAIN WRONG. DUH!! :( It makes me so frustrated because I have worked so hard to understand the physiology and the medications (which I do know!!).... and then I have to lose it in front of everyone. I don't normally have a problem talking to other nursing students in other classes, so why am I struggling so much now? I also love public speaking and do well at it.... so why am I stumbling all over the place when doing multidisciplinary rounds?

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Could you just be nervous? Preceptorship is scary! You don't have an instructor with you, and while you have your nurse, it's just different! Take a moment if you mess up, joke about your nerves and move on. Doctors scared me until my ER preceptorship when I was expected to handle my own load and just do it. LOL. "Sandwich Doctor" made it much easier for me! (That obviously wasn't his name, but he was eating a sandwich the first time I met him, so that was the nick name I gave him, he loved it! LOL)

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Thanks for the feedback - yes I am definitely nervous!! I'm also trying hard (probably too hard) to not act like a "know it all" with my preceptor as I heard that preceptors do not like this.... BUT it's hard to find a balance. If I just be myself and stop censoring everything I want to say, she may not like it either.... So until I find a better solution, I'm sounding stupid...

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

It's nerves. Before you talk to the MD.....get everything you want to say ready. Make notes of what you think they want to know and what you want to say/ask for. Most of the time the MD's don't want the extras......especially at 3am. They just want to know what the patient is on.....and not why they are on it and who ordered it. Be careful of "knowing" why a patient is on a drip for there maybe many reasons the MD prders something. Ask you preceptor why they are on the gtt.......instead of telling them why they are on the drip. Example: Is Mr STEMI on the lasix drip becasue......blah, blah. blah? What made the MD choose that treatment? Would xyz be beneficial as well? How do you know the treatment is effective?......

To call the MD Example: "HI! Dr.Crabby, This is Newbie from St. Mary's CVU calling about Mr. STEMI CABG in CVU 4. He is post op day #2 and He is having 4-6 beat runs of V-Tach. His potassium just came back as 2.3, his Mag is 1.5. H/H is 29.0 and 9.3. He remains on a Lasix drip, the dopa is at 5mcg/kg/min, Nitro at 6cmg/min, Lido is at 2mg/min.........Ok, so....You want the Lido increased to 3mg/min and IV KCL 20meg piggy back repeat times one as per policy.........do you want a repeat K after second K piggy back? You want me to Leave the Lasix drip as is?.......Ok. Lytes 2 hours after potassium is infused and leave lasix gtt as is lido at 3 mg/min....thanks Dr. Crabby."

You need some brain sheets.......here are a few.

doc.gif mtpmedsurg.doc doc.gif 1 patient float.doc‎

doc.gif 5 pt. shift.doc‎

doc.gif finalgraduateshiftreport.doc‎

doc.gif horshiftsheet.doc‎

doc.gif report sheet.doc‎

doc.gif day sheet 2 doc.doc

‎critical thinking flow sheet for nursing students

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Specializes in Hospital Education Coordinator.

I believe this will improve when you gain more confidence. Meanwhile, go by the SBAR report sheet and do not volunteer more than that unless asked.

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