Any tips for acute hospital setting and preceptorship?

[bigboy18]

Hi all, I'm an Student Practical Nurse and I was just wondering if any of you have any tips on working in these settings. I have 2 more months to go before I graduate. 5 weeks for acute and 5 weeks preceptorship (My school instructors decide where I'll be placed either LTC or acute). Somewhat nervous but I feel I can make it. The acute hospital I'm at has A LOT of elderly patients. I felt like I was back to geriatrics..but this is only because of the location the hospital is in (A lot of retired old folks live in this area where the hospital is in)

Today was my 2nd day there and it was boring. A girl from a different class got sent home today cause she screwed up on her charting and flow sheet record. She also misspelled a lot of things and didn't have some of her prerequisites completed (she seemed a little too hyper..so I'm glad she's gone) and she tried blaming the clinical instructor by telling the director of the school that she didn't need to check the charts so it was okay for her to chart.

The setting felt really.. laid back and it was not what I was expecting for an acute hospital. I was expecting something more like the TV shows you see on TV (ER, House, greys etc) But nonetheless, I have to pass it.. and I can't fail!!!

I MUST pass...last semester's clinical, I made a huge med error which almost set me back another semester but luckily with a lot of convincing, they passed me. So far so good. I haven't made any errors nor have I shown any nervousness.

So any tips would be appreciated!

[Fiona59]

I don't know which province you are in, so I'll be general.

Are you on a medicine or surgical unit? Hate to tell you this but the bulk of surgical patients are usually over 50.

So, having watched the SPNs on my units over the last couple of years, I'll give you what your preceptor wants from you.

Be interested in your work.

Don't decline any opportunity for any skill. Yes, you may have inserted a foley but grab every chance you get to insert another!

Observe any procedure that a resident performs on the unit. You might only get to open sterile packages but you will learn by watching.

Don't tell your preceptor that you are "going for the BScN as soon as I get my hours in".

Your preceptor is ultimately responsible for everything you do to their patients (yes, they are the preceptors patients as well). So don't be offended when your preceptor rounds on your patients and checks their dressings, drains, etc. Their license is on the line.

When in doubt, ask. If you have time look up the information yourself and bring what you've learnt to the preceptor.

Go with the flow of the unit. Don't compare how they work with other units you've been on.

The reality of nursing is nothing like what you've seen on TV. Yes there are codes but it's not an everyday event. In a decade at an inner city hospital, I've never had a patient code on me (knock wood), whereas my friend who precepts about four students a year has had three patients code on her watch in the last 18 months and this is on the same unit.

The residents don't want to flirt with the nurses, they want to know if we have any food to spare in our fridge. Most of our surgeons don't have attitude like their TV counterparts. Good unit managers won't tolerate them belittling their nurses. I've only ever met one doctor with a "House" type personality and he works in the community.

Go with the flow and you'll do fine.

[bigboy18]

I don't know which province you are in, so I'll be general.

Are you on a medicine or surgical unit? Hate to tell you this but the bulk of surgical patients are usually over 50.

So, having watched the SPNs on my units over the last couple of years, I'll give you what your preceptor wants from you.

Be interested in your work.

Don't decline any opportunity for any skill. Yes, you may have inserted a foley but grab every chance you get to insert another!

Observe any procedure that a resident performs on the unit. You might only get to open sterile packages but you will learn by watching.

Don't tell your preceptor that you are "going for the BScN as soon as I get my hours in".

Your preceptor is ultimately responsible for everything you do to their patients (yes, they are the preceptors patients as well). So don't be offended when your preceptor rounds on your patients and checks their dressings, drains, etc. Their license is on the line.

When in doubt, ask. If you have time look up the information yourself and bring what you've learnt to the preceptor.

Go with the flow of the unit. Don't compare how they work with other units you've been on.

The reality of nursing is nothing like what you've seen on TV. Yes there are codes but it's not an everyday event. In a decade at an inner city hospital, I've never had a patient code on me (knock wood), whereas my friend who precepts about four students a year has had three patients code on her watch in the last 18 months and this is on the same unit.

The residents don't want to flirt with the nurses, they want to know if we have any food to spare in our fridge. Most of our surgeons don't have attitude like their TV counterparts. Good unit managers won't tolerate them belittling their nurses. I've only ever met one doctor with a "House" type personality and he works in the community.

Go with the flow and you'll do fine.

I'm on a medical floor basically. My instructor will be sending 2 of us slowly to med-surg floor and having us experience that. Everything's going fine with my acute clinical and our instructor is making sure we are not making any mistakes by having us go slow.

As for preceptorship, thank you for the advice. Hopefully I get acute again, but I wouldn't mind giving Long term care a shot. I already only have 4 more weeks left of acute (It's going by so fast) and than I go straight to preceptorship. I'm excited and nervous at the same time.