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- by sophie<3 Jan 2, '11I just accepted a job as a PCT in a large hopsital. I have no prior PCT experience but am going into my 3rd semester of nursing school so I do have some clinical experience under my belt. Unfortunately, PCTs and student nurses have a different scope. I know that in nursing school I can do more invasive procedures that as a PCT I cannot (foleys, medications, IVs, etc). The position I acccepted is a float tech so I will be floating to different floors all the time. I was told the floors I would be working on are ICU, Tele, and Med/Surg floors...which is fine but I am pretty nervous about it. Does anyone work as a PCT on any of these types of floors? If so, can you give me some duties or a quick run through of your day just to give me an idea of what to expect? I will be working PRN so I pretty much make my own schedule...I think I will be working 7p-7a because I'm more of a night owl anyway and I've heard ( I don't know if it is true) that 3rd shift tends to be a little quieter than other shifts and I feel like that is a good way to start out a new job. Also, my orientation starts tomorrow..it is Monday, Tues, Wed, and Friday of this week....so after that, will they just let me out on my own? Or will I follow a tech around until I feel comfortable? I'm just a little confused...I want to have a good learning experience and a 4 day orientation doesn't seem like very much to me!
- Jan 6, '11 by turnforthenurseRNYour scope as a PCT is different from my scope as an NT, because I can do foleys, blood draws, dressing changes (both sterile and non-sterile!), start IVs, even give enemas! (thankfully that experience hasn't presented itself yet but I don't want to be the nurse who has never and doesn't know how to give an enema!)
Anyway, I have an assigned unit, but I do pick up and float throughout my hospital. I've floated to other med-surg units, telemetry, the ICU and ICU stepdown. Most of them are the same but the ICU/ICU stepdown units are a little different.
I typically work 3-11p, occasionally 3p-3a and I also work 11p-7a. I rarely work at 7a, mainly because I'm not really a morning person. Anyway, my typical 3-11p shift:
3pm: get report, start vitals. I only do Q4's.
4pm: put in vitals (oftentimes I'm done before 4pm, but not always)
4pm: get blood sugars on patients who need them
5pm-6pm: basically help the nurses/patients with whatever they need and answer call lights.
6:45-7pm: start vitals. This is when the Q12's need to be done, too (those are done once/shift, so at 7am and then again at 7pm)
8pm: put in vitals...I also take my break at this time
9pm: get HS (bedtime) blood sugars on patients who need them.
10pm-11pm: again, just help then nurses/patients with whatever they need and answer call lights. At 11pm I give report to the oncoming aide/tech.
If blood needs to be drawn, I will do that...same with dressing changes, foleys, etc. If patients are being discharged, sometimes they will have me wheel them downstairs to their destination. If patients are being transferred to different units, sometimes they will have me bring patient belongings to their new room or help transport the patient over to their new room. Sometimes they will have me go down to the lab to drop off blood cultures (because those are glass bottles and can't be tubed down to the lab, too much risk of them breaking) and also to stock up on blood culture bottles. I will also be sent to other units to get things, such as a bladder scanner or other supplies. If we have sitter cases that can't be covered, then I am the one who has to cover them, either on my floor or I will get sent to the floor that needs me.
Here is my typical 3-11p day on the ICU stepdown:
Vitals and urine outputs are done Q2, so at 4pm, 6pm, 8pm & 10pm. Temperatures are only done Q4, so at 4pm & 8pm. We empty all of the foleys at 5pm. For blood sugars, it depends on if the patient is on an AC/HS (before meals/at bedtime) or Q6H schedule. If they are AC/HS, then we get them at 4pm and 9pm and if you're working night shift, again at 0600. If they are on a Q6H schedule, this particular unit gets them at 4 & 10. Everything else is answering call lights, helping the nurses/patients with what they need and doing the other things I mentioned above.
I occasionally float to the ICU, but there I usually work mornings, either 7a-3p or 7a-7p. Techs do not do vitals or UO's in the ICU but sometimes I will go ahead and get them for the nurses if they are busy or if I'm not doing anything.
In the morning I gather all of the glucometers and do the quality control checks because in that unit, they are always done at this time. I then go around to all of the patients who have tube feeds (which is pretty much the whole floor) and prep all of the bags (filling it with the tube feed solution and then letting the solution flow all the way through the tube) and hang them on the side for the nurses. Blood sugars again depend if the patient is on an AC/HS or Q6 schedule. The AC/HS schedule is still the same (11am, 4pm, 9pm, and if you're working night shift, again at 0600) but in the regular ICU, the Q6 schedule is 12 & 6 (not 10 & 4 like in the ICU stepdown). I answer call lights, help the nurses/patients with their needs (oftentimes it takes 2 people to bathe a patient and most of the baths in the ICU are done at night but some nurses prefer to just do in the morning) and again do the things I mentioned above. I round frequently on all of the units I work on but I round even more so in the ICU due to all of the invasive lines and high use of restraints. Plus, nurses will appreciate it when you tell their vented, restrained patient with a bunch of lines that their bottle of propofol is empty and the patient is starting slowly awakening
I know it sounds like a lot, but TRUST ME, you will get everything down as you work. When you float to your units, introduce yourself and make yourself known. Tell them you're new and ask questions - they'll tell you what needs to be done and when and what to expect on the unit. Don't take what I said as a guide to what needs to be done because every unit and different hospitals function differently, but I hope it kind of gives you an idea Personally I love my job and I love my home floor, but I also love floating to different units because you really gain some experience! I think it makes you more well-rounded because you have exposure to different nursing units, both med-surg and critical care, which are two completely different (but very interesting!) realms of nursing. Good luck to you!
- Jan 7, '11 by sophie<3thank you! and you are right, it sounds like A LOT. after my orientation time i did realize i can draw blood..but i know that i cant do foleys, dressing changes, etc. we do get seperate 12 lead EKG training this summer so that will be an interesting experience and skill to have! i don't know how you keep everything straight on the different floors though! i hope to be organized and deligent about my charting...i have never been a tech before so this is a brand new expereince for me! i also hope my orientations go well and they show me the ropes, or at least have mercy on me for being new how long did it take you to feel "comfortable" on the units or to get your own pace/schedule down of doing things? also, what is your opinion on working nights?? is it more difficult than working during the day?..i plan on working 11p-7a at first and then possibly do 7p-7a...maybe with some experience i will do 3p-11p but for now i want to try to bypass some of the adminstration, doctors, family situations until i know what i'm doing (if that makes sense). Anyway, thanks for the advice Definitely helped a lot!
- Jan 7, '11 by Bruce_WayneQuote from melosaur♥Please excuse me in advance and I'm not trying to be rude, but if I were you I'd double check your state's nurse practice act about the enemas and sterile dressing changes. I'd hate for a fellow PCT to be lead astray by a nurse manager that has a misconstrued interpretation of the nurse practice act and YOU wind up getting in trouble for practicing without a license. For offenses that involve a CNA, PCT, PCA, or UAP practicing without a licenses that's a special case where YOU get in trouble and not the RN or physician responsible for you. Their license only covers you up to a certain point.Your scope as a PCT is different from my scope as an NT, because I can do foleys, blood draws, dressing changes (both sterile and non-sterile!), start IVs, even give enemas! (thankfully that experience hasn't presented itself yet but I don't want to be the nurse who has never and doesn't know how to give an enema!)
About the enemas, I'd check on that too and be extremely hesitant and cautious of giving medicated enemas until you get a clarification. Non-medicated soap-suds enemas on the other hand are fair game a lots of fun! But in your post you didn't say if you were talking about medicated enemas or not.
Again I'm not saying this to try to dis you or anything, and I may be wrong, or you may have special certifications and training available to PCTs in your area and not mine.
Edit: I just re-read and you're a NT and not a PCT. SORRY! I'm going to leave my post up as a warning to others though....
- Jan 15, '11 by turnforthenurseRNQuote from sophie<3It is a lot, but honestly, once you work the floor a couple of times you begin to establish your routine That's nice that they train you to do 12 lead EKGs! That is one thing that I never learned, but hope to some day. The hospital I work at has EKG techs who come up and do 12 lead's...I only know about the 5 lead ones (with the colored wires..."snow over grass, smoke over fire, chocolate in my heart" stuff lol)thank you! and you are right, it sounds like A LOT. after my orientation time i did realize i can draw blood..but i know that i cant do foleys, dressing changes, etc. we do get seperate 12 lead EKG training this summer so that will be an interesting experience and skill to have! i don't know how you keep everything straight on the different floors though! i hope to be organized and deligent about my charting...i have never been a tech before so this is a brand new expereince for me! i also hope my orientations go well and they show me the ropes, or at least have mercy on me for being new how long did it take you to feel "comfortable" on the units or to get your own pace/schedule down of doing things? also, what is your opinion on working nights?? is it more difficult than working during the day?..i plan on working 11p-7a at first and then possibly do 7p-7a...maybe with some experience i will do 3p-11p but for now i want to try to bypass some of the adminstration, doctors, family situations until i know what i'm doing (if that makes sense). Anyway, thanks for the advice Definitely helped a lot!
As for charting, we don't really do much...vital signs are put in the computer on med-surg floors or on the critical care flow sheet on the critical care units (which is a paper tri-fold, I honestly like those a lot better) and the only time I ever make a nursing note is when I do a dressing change or insert a foley or something that NEEDS to be documented. We also have hourly rounding forms that we have to fill out.
It honestly didn't take me long to get used to everything. I worked in a hospital as a PCNA so I was already used to the hospital routine...everything pretty much stayed the same, but skill-wise, I can do a lot more as a tech than I could as a PCNA.
As for nights, I love them! It's a different pace compared to days - much more quiet and laid back, but that doesn't mean that night shifters are lazy and do less work. That's a common misconception that day shifters have. Night shift can be busy too...like I said, it's just a different pace. You'll also get shift differential on nights, and the amount varies depending on the hospital. When I worked as a PCNA, I got $1...as a tech (I work at a different hospital now) I get $0.50. I also get shift differential for working evenings (3-11p). Oh, and the only thing about working nights is that you have a messed up sleeping schedule...it takes some time to get used to and your first couple of nights will be rough if you've never worked them before (because you're not used to the sleeping schedule!) but after that I think it's easy to adjust to. I primarily work evenings and occasionally work nights and I never have a problem adjusting to the night shift schedule now...but I don't know, that's just me
If you have other questions feel free to ask me!
And CNA_in_ADN, we don't give medicated enemas I don't know what my hospital does to allow us to do all of this stuff...but I am thankful because the experience is invaluable. I'd like to add that at my hospital, all NT's are either in nursing school or just graduated from nursing school (oftentimes those NTs have an RN position pending with the hospital). Also, when I started, I had to kind of "gain the trust of the nurses" before they let me do everything (IV's, blood draws, foleys, dressing changes...)
- Mar 28, '11 by sophie<3so just a quick update..i've been working about 3 months and things are going great! this first few times working on a unit can be a little confusing but so far i have worked on almost all of them at least once and each time the routine gets easier i really enjoy it now and you are right, when written out the schedule seems so confusing of when to do Vitals, I&Os, etc but it just takes time to get your own thing down. I am really enjoying ICU nursing though..i worked Saturday night and only had 4 patients which really lets you focus your care instead of running ragged. Seeing the different units has really helped me see what I might like to do as an RN (less than a year away!) Thanks again for the advice
- Mar 29, '11 by turnforthenurseRNGlad to hear that you're doing well and you're liking your job as a PCT float!