Clinical Nursing Student Needs Advice 5 patients

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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!!!

I think having a feel if the floor will decrease your anxiety once you get onto the floor as a licensed nurse. I don't agree with the "pass/fail-yourrrre OUT!!!" mentality, especially when you are this close. I say advocate for yourself if you need help, are swamped, etc...find out if you can delegate and collaborate if you have techs on the floor, especially if you have a big patient who has a mental status change and on a bed alarm. You have help and you are on a team! :)

Oh, I absolutely agree that having a feel for a floor is a great idea. But OP shouldn't be the sole provider for these patients. She is essentially being thrown to the wolves. In my program, during practicum, students in hospitals shadowed for a few days, and then were allowed to take over care of ONE patient with the patient's nurse watching over them, meaning that nurse allowed them to be the patient's nurse, but checked their medications, IV pushes/insertions/medications/fluids, treatments, etc and was the one ultimately responsible for the patient. Students were allowed to do charting, etc but it was checked by the nurse.

Then the student was allowed two patients, three, etc. BUT a primary nurse was assigned and they were always watching over and making sure everything was okay. That is how it should be. Not going from none to five patients and being absolutely responsible with only a clinical instructor to help.

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Specializes in Acute Care, Rehab, Palliative.
If any new grad thinks he or she is ready to function on the floor after nursing school, I would be severely worried for their patients. Nobody should be that cocky. New grads need proper support and training. They have the tools, they need to learn to utilize them but in a safe and proper manner (starting slow, plenty of help, etc). You learn these things in theory, you need to learn to use them in real life, but at a reasonable pace.

I think you all need to remember what you felt like the first days on the floor and then read my above post and take a vacation somewhere and remember that we're all in this together.

I never said they shouldn't have support.

Why on earth do you think we need vacations? That has nothing to do with this at all.

When I did my final placement I was expected to care for a full assignment. If I needed my preceptor she was there but I still had a full load.When I was hired at the same place after graduation I had no orientation days at all. I had a full load from day one

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Sounds really intense, you've gone this far, hang in there!

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I never said they shouldn't have support.

Why on earth do you think we need vacations? That has nothing to do with this at all.

When I did my final placement I was expected to care for a full assignment. If I needed my preceptor she was there but I still had a full load.

I think you all need vacations because frankly quite a few people on AN sound very, very crabby and need to take a break. I often think that people on here sound miserable in their jobs and wish that on others when in fact many of us have jobs we like.

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Specializes in Gerontology, Med surg, Home Health.

Bezoars,You're right...I wasn't handed 8 patients on my first day as a new grad.....I was handed 10. We all made it through.

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Specializes in Pediatrics, Emergency, Trauma.

I think you all need vacations because frankly quite a few people on AN sound very, very crabby and need to take a break. I often think that people on here sound miserable in their jobs and wish that on others when in fact many of us have jobs we like.

^How can you "hear" how posters "sound" on here???

I'm just curious...where is this sound coming from????

Your post can be interpreted as defensive and crabby, but I can not make that assumption because I can't "hear" you....

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^How can you "hear" how posters "sound" on here???

I'm just curious...where is this sound coming from????

Your post can be interpreted as defensive and crabby, but I can not make that assumption because I can't "hear" you....

Your posts make you "seem" crabby. Apologies for the word "sound."

Look, I'm not trying to insult you all. But you genuinely sounded VERY burned out and you would do yourselves, as well as countless numbers of patients, a favor if you took a few days off work and actually relaxed!

I'll repost my advice in case anyone missed it.

"Do yourself a favor...take a few vacation days and take some deep breaths, have a cocktail or ten, go out and dance your butt off at a club, sit on the beach, or wiggle your toes in the grass in your backyard. Build a snowman with your children and then drink some hot chocolate with them. If you're single, make an online dating profile and chat with a few people. Go out and treat yourself to a personal toy and have fun! If you're in a relationship, sit down your GF/BF/spouse and just talk, reconnect...and then roll around in the sheets. Have an orgasm or two. Go to see a movie or stop off at Barnes and Noble and buy a new bestseller and spend the day reading. Be crazy and go buy a plane ticket and spend the weekend in a big city or a sunny place, or go on a weekend road-trip!"

Nurses need to work together, not fight and back-stab each other. OP wants support, not words of "well suck it up, baby, welcome to the real world." Is real world 5 patients and a crazy shift? Most likely yes, but OP should be eased into it, not thrown to the wolves. That is all I would like you guys to realize!!

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" A new grad nurse gets a few day of orientation and then they are on their own with a full assignment" ??? So glad where I work they give even experienced nurses aprox 7 shifts of orientation on the floor, a new grad would get 4-6 weeks on med-surg tele. Just learning the Ins/Outs of a particular institution takes time, the type of charting they use, the layout of the land.

8-9 tele patients per nurse very unsafe. There are shifts that having just 4 patients kicks my butt. I'd really love to know how the patients differ in a facility with 8 patients per nurse vs 4 patients per nurse, or do they differ. If they don't differ how does the nursing care differ? How many corners are being cut, how much overtime just to get charting done after the next shift takes over.

3 patient's per nurse in ICU. Standard is 2 patients per nurse, occasionally 1:1, and in certain cases 2 RN's per patient. Never 3!

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Specializes in Pediatrics, Emergency, Trauma.

Your posts make you "seem" crabby. Apologies for the word "sound."

Look, I'm not trying to insult you all. But you genuinely sounded VERY burned out and you would do yourselves, as well as countless numbers of patients, a favor if you took a few days off work and actually relaxed!

Nurses need to work together, not fight and back-stab each other. OP wants support, not words of "well suck it up, baby, welcome to the real world." Is real world 5 patients and a crazy shift? Most likely yes, but OP should be eased into it, not thrown to the wolves. That is all I would like you guys to realize!!

Lol...I don't know how long you've been in this arena, but I've worked a little more than 30% of my projected 30 year nursing career. I can honestly say I NEVER experienced burnout... I have been a preceptor, an orientee, and a consistent team player. My point is to not make assumptions about who we are, just like I don't do to you, THAT is disrespectful. Look at my posts...If anything, I am passionate, but LOVE being a nurse. I'm even returned to new grad status, but I have PERSPECTIVE as well.

No one can "throw you to the wolves" if you learn to advocate for yourself...If you can't advocate for yourself, can you honestly say you can advocate for your patients, function when pts are at a high acuity??? And they are getting HIGHER, and our responsibility is expanding as more sicker pts are going to be coming through the door, as well as our communities.

I have been a HUGE advocate for myself, in turn, my patients and my practice has been very competent and respected, as well as my relationships have been between my team, whether it be Drs, Nurses, Therapists, and Techs, and everyone in between.

I've had 98% thankful days compared to the 2% thankless days in my profession. I attribute to the fact of what I am capable of doing, soliciting help, and enlisting advocacy as my mainstay.

So, please, spare me what you think when we don't know each other, nor have ever ask me for help, or PM'd me for advice or have communicated with me on posts...you haven't walked in my Danskos. I will do the same for you, and I suggest you do the same for these posters. They are being HONEST, and for me, that is FAR GREATER than the "poor baby" path...it doesn't serve the empowerment that we have as nurses. Just my opinion, and my experience, of course. :)

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LadyFree28, I'll just leave you with this quote from up thread which I think is well spoken.

It's NOT SAFE for a student to have that many patients, not knowing the unit, or where stuff is, or being able to do anything without an instructor there.... That's crazy. What they are asking you to do is CRAZY. Sure we handle a lot of patients in "the real world", but common... this is a nursing student with no real world experience. Did they hand YOU 8 patients your first day on the job and say "have at it"? I sure hope not. Typically you go through a training time or preceptorship where you learn the floor and how to be a nurse... THEN they can load you up with patients. Let's have a little compassion. Do you remember how you felt when you were out there the first time on your own?

That is all I am asking. Remember your first days of nursing and have some compassion for OP.

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Specializes in Pediatrics, Emergency, Trauma.
LadyFree28, I'll just leave you with this quote from up thread which I think is well spoken.

That is all I am asking. Remember your first days of nursing and have some compassion for OP.

I'm doing my first days of nursing AGAIN!!!

Lol, I just said I was a NEW GRAD.

How about AGAIN, YOU having not only compassion, but RESPECT to other posters and their opinions. Not everyone is jumping on the OP, and certainly not me.

I have her my perspective. Nursing is hard. Not going to give the warm milk treatment does not make me more or less empathetic. I have her tips, techniques, which are FAR more USEFUL than stating, pat "Nursing is rough, tsk, tsk" statements.

I rather benefit from REALITY than pat statements; pat statements insult my intelligence and the reality of how complex nursing truly is.

That's my perspective, and I am sticking to it.

Again, you don't know my posts, nor my perspective, because you HAVE NOT walked in my Danskos...try them on...when you do, you will understand my perspective...until THEN, agree to disagree and RESPECT my opinion, as I do yours.

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That's my perspective, and I am sticking to it.

Again, you don't know my posts, nor my perspective, because you HAVE NOT walked in my Danskos...try them on...when you do, you will understand my perspective...until THEN, agree to disagree and RESPECT my opinion, as I do yours.

Agree to disagree it is.

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