Re: Shakin' in my boots!!!
Congratulations on getting your dream job! I'm also a new pediatric nurse, 9 months into my first job. Here's a few things that helped me:
-- develop a "brain" that works for you -- no, not the one between your ears (though that's important too!), but that little piece of paper that many RNs use for taking notes throughout the shift. Mine is two-sided, and has 4 columns on each side; one for each pt (our max ratio is 4:1). There are lines going across for each hour of the shift (from 1500 to 2300), and I write what medications/tx's, etc each pt needs to get at each hour -- that way I can look across and immediately see if I have, for example, a whole lot of meds to give at 2000, or an albuterol tx that needs to be given right before end of shift, and plan accordingly. On the back, I write my notes from the report I get at the beginning of the shift, and also notes on what info I need to pass on to the next shift -- like, the fact that I gave one pt tylenol at 2245 for a temp of 38.7, or that another needs to be NPO after midnight for surgery tomorrow.
-- work on developing a routine that works for you. As much as possible, try to do the same things at the same time in your shift -- this won't always be possible and sometimes you need to "go with the flow", but having a routine really helps me to remember things as well as do them more quickly, even if the routine sometimes gets interrupted.
-- understand the roles of everyone else on the health care team, and what you can reasonably expect them to do. This is especially true of CNAs. Do you have CNAs, do they cover all the pts or just some (and which ones), do they only do vitals or do they do I/O, hygiene, meals, etc? Don't be afraid to ask a CNA to do something for you as long as it's in their job description -- just be sure to ask politely! (I always ask our CNA's if they're "available" for a particular task -- even if it's in their job description, they may be too busy doing something else to get to it right then).
-- start memorizing info about meds you give often -- what they do, why they're given, most common side effects, and safe dosage (generally expressed as mg/kg/day for most pedi meds). This will save you from looking them up each time you give them.
-- think about how you can cluster tasks. If you have meds due at 2000 and 2100, can you give them all at 2030, or do they really need to be given one hour apart? Did the parent have a question for which you need to look up an answer the last time you were in the room? What supplies do you need for any given task? (so you don't have to run back and forth to the supply room several times).
-- understand what your preceptor's expectations are of you, and check in with her/him often. If there's specific skills you'd like to focus on, let them know.
-- don't beat up on yourself for being way slower than everybody else. It takes time, and eventually you'll be doing things as quickly and efficiently as everybody else.
-- BREATHE! If you're starting to feel overwhelmed, stop and take several deep breaths, and just think about what you need to do next.
-- Have faith! You can do it! Others have, and you will too!
GOOD LUCK!
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