I've been working in a SNF/ subacute rehab for 2 years now and landed my first travel nurse agency position at a medsurg tele in a community hospital. yes, community meaning barely any nursing aides and no phlebotomists! only 4 hours of orientation and I was on my own on DAYS! biggest mistake since its so busy. I thought i was very confident with my skills, assessments, labs, etc.
1st day, i had one patient that started on amiodarone drip fixed rate that was already hung, plus x2 IV ABX going on multiple iv sites d/t incompatibility. he had to go down for TEE to check for vegitation ( which I had to look up). 2nd pt went down for an angiogram and I was still getting used to their paper charting and orders since im use to using PCC that I missed having to notify the pt's team when pt arrived back from surgery.
2nd day was a little better in getting orders done and carried. except for no nursing aides and I had two patients total assist and on restraints. still learning their policies and documentation on restraints but I felt i hurt my back providing pt care bc it was so hard to find and extra hand to change pts. especially when an orthopedic surgeon decides to come in at 1830 end of my shift to remove a cast from a RBKA revision and blood soaked everywhere on the bed sheets and I had to change pt and bed all by myself even when I asked the charge nurse for help.
3rd day was the worst! 4 patient load 2 total cares and 2 patients on the call light, no nursing assitatnt. One patient was going crazy tachy 150- 170s d/t to his afib and tried paging the team numerous times, was able to get help in drawing cardiac enzymes did a 12 lead provided stat digoxin extra dose after am dose, IV lasix (my first time) d/t possible fluid retention. WORST THING- order to start on amiodarone titrate with loading dose ( i have never done) , another nurse ended up hanging it up for me close to end of shift because I was catching up with my other orders and medications and STAT lab draws. when giving report realized amiodarone drip was running at the wrong rate ( lower dose) and labs were not drawn prior to giving amiodarone. the nurse who hung it was not able to clarify with me on what she did before she left. luckily patient was okay, no adverse reaction but I am soo scared of losing my license. to ADD on I didnt have time to follow up on labs bc I dont have access to the computer and have to wait for everything to fax back from lab.
I know I always try to ask for help and I am contracted at the hospital for a couple more weeks. even though I cried every day since I started, I have learned so much in those three days and am willing and eager to learn. I always try to be safe and look up everything before giving medications but because I am unfamiliar with some of the meds and procdures, i fall very behind. I need advice on what to do, stick it out or break my contract ?
