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Discussion

can i do this (is this for me)?

Hey i need some advice.

Situation: im not sure if im cut out to be a nurse. Im in a 2 yr program with 3 terms/yr. Right now im in my second term (2wks left). We only have one patient now but its a lot to do and know. We do vitals, assessment, and give meds (if we know why they're being given, how they work, and labs/vs we need to check before giving them). I have trouble with the meds but i guess it takes time to familiarize yourself with them. I know as a nurse we will most likely have techs to take signs and do i&o but its a lot to know. Today my pt said she had a headache of 5 from 1-10. First reaction, i'll tell the nurse. I found my instructor and she was like did she want anything can she get anything....i was like i dont think she has anything ordered i was going ask the nurse...big turn around she says you are the nurse.....im not sure if 2 yrs will prepare me to work as a nurse...its nice having a orimary nurse or instructor to go to. Once im in the field i cant be checking with other nurses for small things all the time bc their busy.

Background: i've always had a love for animals and steve irwin is my idol. I studied bio and got a bachlors in preprofessional. I wanted to work with animals but all throughout school i couldnt get a vet tech job. I volunteered in the pacu of a hospital to see what it would be like. My mentor was awesome and very experienced (he made it look so easy) yet even he made simple mistakes and had questions. Figuring there were not many animal jobs i would be able to find in addition to paying well (bc i hear many stories of ppl working with animals and the pay and scheduling is brutal). I decided to go to nursing school, get a decent job(with good intentions and pay(not that im all about money but i want to live decently). I went through first term and it wasnt too bad. My clinical instructor was really nice and taught us a lot. The one i have now is a bit more strict and intimidating. What she expects is reasonable but still a lot.

Assessment: im confused and not sure what to do

Recommendation(s)?

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    • Featured Replies

    i was scared and unsure when i first started nursing school. its so overwhelming and stressful, but i promise you, it will get better. It's about repetition. meds, assessment.. etc. of course, you cant anticipate EVERYTHING, but once you start doing skills over and over and give meds over and over you remember what type of patient gets that med, what reactions to look for... you get the idea. Many hospitals have externships for new grads so they can be shown the ropes. you will be fine!

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    We're all scared and forget to ask things or don't know how to think things through. It's a process, and your instructor is trying to make you think. Everyone says you really learn the most when you actually ARE the nurse- meaning AFTER you've graduated and passed the NCLEX. Don't assume you'll have techs for anything. Expect that it will be on YOU, and if you have a tech, bonus! These things ALL take time, and you'll slowly build up your comfort.

    Let's say you have a patient tomorrow who's IV fluid beeps that it's complete. What do you do? Think it through. Is more ordered? Do they have any IV meds that need to be hung? Where would you look for all of this? What is their diagnosis- do you need to listen to their lungs or check for edema (ie dx of heart failure)? How is their IV site doing? If you need to disconnect it, do you have a plug with you, and maybe a flush? This is why critical thinking is SO important as a nurse. BUUUUUUUT- NO ONE expects you to know everything. Your instructor is challenging you, with a goal of making you BETTER. Assume the best from her, and take on the challenge! Never answer a question with "I don't know" unless you follow it up with "Let me get back to you," then go RESEARCH the answer.

    Be patient with yourself, and know that EVERY nursing student feels this way at least some of the time!

    Now, about being a vet tech- only YOU can decide which path is right for you. Follow your heart. The RN market isn't great right now in most areas, either.

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    In nursing school, you are learning so many new things from critical thinking to knowing skills. Being a novice (think of Benner's Stages) can be an uncomfortable feeling. I know I don't enjoy feeling so new with everything I do in clinical. But do not let it sway you because even veteran nurses need help sometimes.

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    Do you think that every nursing student knows everything they will ever need to know by graduation? You are not expected to know everything, only know where you can get the information. Even experienced nurses have their moments when they can't figure out what to do in a situation and ask their co-workers for help.

    If your patient is complaining of a headache:

    1) ask the patient to scale the pain from 0-10.

    2) find out their PRN pain med orders

    3) determine when they last had pain med and when they can have more

    4) give the information to the nurse ( Mrs. Jones in room 2015 is complaining of a headache of 5 out of 10, she has tylenol PRN pain med order, she last had a dose 4 hrs ago).

    If it is your patient, you should know everything about the patient you are taking care of. When we go to clinical, we are given about 15 minutes to review the chart and electronic medical record (EMR). After that time, the instructor will take notes from the chart and EMR and say "tell me about your patient" We should know why they are there; past medical history; meds currently on and what the meds are for; any pertinent labs, whether they are high or low, and what is causing them to be high or low. You are only in your second term and not necessarily at that level, but you need to know as much as possible about your patient. This is your opportunity to be "the nurse" without actually being truly responsible for the patient. Like your instructor said "you're the nurse" you should know about the pain meds that can be given to her.

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    • Author

    Thanks for the feedback. I did ask the pt to rate her pain and if she had any pain meds prior to her stay. She had a hydromorphone pump and odansetron prn. Then when my instructor asked me to look again the physician recently put in pain meds. I get fustrated because i research my pt and meds and i still am asked questions from my instructor that i do not know. I almost feel like i should knkw the answer most of the time but its only my 18th or so week. I also feel like i let my instructor down bc she'll either sigh or say u need/should know this or say go look it up and come back. I guess if i was really that horribke of a student she would say so

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