Clinical Nursing Student Needs Advice 5 patients

[Lynn52]

Hello All, I am finishing up my ADN with 9 weeks to go. I'm in my mid fifties. In my current rotation we care for as many as 5 patients on a cardiac tele unit. I am overwhelmed to say the least. I have to make it through 5 more of these shifts and should be home free as my last rotation will be less intense. We are expected to do two assessments per patient, IV assessments every two hours,start IVs, all skills, and pass all meds. The med orders change frequently on this unit and there are many unstable patients with codes etc.

I don't mind working very, very hard and forgoing a break but as a student this is a bit much. If we make a mistake depending on the severity we are out of the program . My first concern is for my patients I'm just not sure I can do this and am looking for any advice that anyone would kindly share.

Some of the challenges are we do not have immediate access to the med room, have to wait for our instructors for IV pushes and skills, we have not been orientated to the floor...this is tough!!!

Thank YOU!!!

[Bezoars]

Wow... that's tough, and it sounds a bit unsafe. I would think three patients would be good, NOT 5. Sounds like they are setting you up for failure. I can only hope that they will give you the most stable patients on the floor. The IV assessments are easy, take no time at all... just a quick look at the site and touch to make sure all is well... make sure the fluids, etc., are running correctly. You shouldn't have too many skills to do, actually. Most days you will only have maybe one NG to do on one patient, or one cath so it shouldn't be too bad. For meds, get started early and get organized. Make sure you have everything you need and make lists. Start with the easiest pt to give too and move on... do hardest last. IV pushes aren't bad and you may be starting a couple of IV's but YOU CAN DO IT! Just remember, it's a lot for anyone. No one will sail through without a hiccup. Remember to be safe first with your patients. If you don't feel comfortable, ASK.

[chrisrn24]

5????? In nursing school we had one and we ran our butts off. Or we shadowed a nurse with 4-5 patients herself.

[ChristineN, BSN, RN]

Sounds like you are doing your practicum. When I did mine on a med-surg floor I started out slow with 1-2pts and by the end of the 8 week period I was taking a full 5 pt assignment and doing all skills that were within my nursing student scope for them. I think it is wonderful your school is expecting you to take 5 pts as it will help you with your time management and knowing what to expect after graduation. Hopefully you were not started out on day 1 with 5 pts but were built up gradually. Ask your instructor or the nurses for any advice they have for making your day go smoother. Hopefully you are at least able to delegate vitals and ADL's to a nursing assistant so you can focus on nursing tasks.

[nurse4sale]

Do you carry a sheet of paper with all the systems? At the top of the sheet put the patient's name, room number, A/B bed, and allergies written in red and diagnosis, then write your systems starting with neuro, resp, cv, gu/gi, etc. and ending with labs. Unless, however, everything is electronic in the hospital, but still you may need to do this. It helps with identifying your patients at a glance. Once you write all info about the patient from the previous shifts report, you go right in and do your assessments first. Here you will find out who has an IV, Foley, oxygen, etc., don't forget to write all vitals. Vitals are essential. Then jump over to the meds and pass them asap. If you have to wait on your instructor, do other things in the interim like looking up meds to see if they're compatible, etc.

You do have it tough, but you've come this far to let anything get in your way, so take a few deep breath and remember that it's all in your organizations skills, so keep that in mind. Good Luck, Lynn52!

[nurseprnRN, BSN, RN]

Sorry, OP. You are very near the end of your education and this is make-or-break time. This is actually less than you may be expected to do in your first job. I don't see this as being "set up for failure" at all, unless you enjoy the victim role, and you don't sound like the type.

Esme has some great "brains" sheets that may help you get organized. Good luck!

[BSNbeauty, BSN, RN]

Welcome to the real world of nursing my dear, except you have less work than clinical. More nursing schools need to be like this instead of painting the picture of roses and rainbows. If you feel overwhelmed always ask for help. In the real world help is always there.

[applewhitern, BSN, RN]

I agree with Crazy%cuteRN~ more nursing schools should be like this. Mine was! So many new grads today expect a long, lengthy orientation. The point of nursing school is to learn nursing. Your job will likely be much worse than this. At my hospital, the floor nurses take 8 patients, and ICU nurses take 3. Nursing is a very hard job. Eat a good breakfast because you can't count on lunch.

[netglow, ASN, RN]

OP, I agree that is a tough deal.

Still having your instructor as a "ball and chain" is what your issue is, am I correct? Your last rotation would be better on a floor being assigned to an RN. Waiting in line for your instructor, to get meds and for pushes, skills etc. will not work out well at all.

[winddrinker]

And what is your point? In the real world you will work much harder than this. If you think this is too much for you, maybe you should have pursued a different career....and you're not even working nights, weekends, and holidays for 12+ hour shifts yet, as ou will do as an RN. My first job with a BSN was on a cardiac/tele floor, and I had 12-14 patients.

[blondy2061h, MSN, RN]

In my area tele units are routinely staffed 1:7-9. I never took more than 3 patients in clinical except for during my practicum (which was 12 hour nights and 9 patients was the norm, plus admissions) but wish I would have to better prepare me for the real world. I take 3 patients typically at my real job, but they're more critically ill. Utilize your resources you have now and learn from the experience.

[chrisrn24]

Wow some of you guys are not nice...that is a lot of work for a student. When I started my first job it was a struggle.

OP, it will be easier once you get into a job where you actually start to know the people, the place, where supplies are, what supplies you have, how to use them, etc.