Feeling so stupid

[kistigirl84]

I'm a new grad/new nurse and I'm am currently on my 7th day of orientation. I have a great preceptor but she moves a little to fast for me and sometimes she makes me feel embarrassed to ask questions. And most of the time it's simple question related to things I should no but when I'm overloaded with info that day I tend to forget things or I think too concretely (if that makes since).

We haven't went over the pt admission to the unit process in detail so I'm really confused as to how it works in out Peds unit.

How does it work at your workplace.

All I know is the pt will more likely come from ER. ER gives report to us about the patient. Patient comes to unit and we do an assessment and admission paperwork is completed. My thing it at what point do we notify the physician. Do we notify the hospitalist pediatrician or the patients pediatrician? Who notifies the MD, the unit nurse to where the patient is admitted or the ER. What happens after that? Does the MD give verbal/telephone orders? Or do we wait for him to arrive the next morning (I work night shift) to do a written order? Or does he/she enter them through computer (CPOE)? I'm sure it depends on the status of the pt as well.

How does it work on your unit?

[kiszi, RN]

I'm sorry you're having a hard time. It's important that you find your voice and ask your preceptor these questions. You're a new nurse on orientation-- you're supposed to ask questions!

Generally the floor nurse will notify the MD of a new admit. Find out who the admitting doc is and notify him/her. At my facility we only have hospitalists that see patients while in house, but yours may be different. There must be some kind of protocol on your floor for receiving admit orders (does the doc enter them into the computer? Do you use standard order sets that the doc can check off?) Again, a question for your preceptor. The next time you have an admit, jump in and observe carefully. Look at the admit orders for existing patients to see how they are set up.

I do find it a bit troubling that you've been in orientation 7 days and don't seem to know how orders get put in the system. Be observant of all that happens around you. I think you can acclimate in time if you are proactive.

[BonnieSc]

I'm sorry you're feeling overwhelmed. I wouldn't try to find out what people do at other hospitals; it can only confuse you. Is it possible to take a few minutes with your preceptor, get out a pen and paper, and say "I'm just trying to get the admission procedure down, can we go over it again?" And then WRITE DOWN the steps. I think almost all preceptors would understand and respect that. Don't wait for when you have an admission coming, do it first or when you have a little bit of downtime. You should also be able to ask another nurse or the charge nurse. Anywhere I have oriented, I've had most of the nursing staff say "Let me know if I can help you, I remember what it's like to be new!" Take them up on it.

New admissions are one of the most confusing things about being new because the procedure varies so much. You WILL get it down, don't worry. I'm an experienced nurse and it's still a little overwhelming every time I try to learn the procedure at a new place.