Final Fourth Year Practicum

[CJ2831]

Hi everyone!

I am a fourth year RN student and am seeking some advice. I recently started my final practicum on a med/surg floor that often has very acute patients. As this is my final practicum, I am expected to eventually take on 100% of the RN's role, under the supervision of a preceptor. My preceptor has told me that this is an important time to move away from doing all of the "extra student steps"and start to face the reality of the workplace (fast paced and time crunched). Although I understand this reasoning, I am finding it challenging to take my preceptor's advice for speeding up my work, as I am worried (esp with med admin) that this will lead to missing important things or making mistakes. As students we are taught to be very thorough and due to the extra steps/care we are encouraged to take, providing care may take longer. I want to learn how to increase my organization etc, so I am prepared to work alone when I graduate, but I also dont want to adopt bad habits or unsafe shortcuts just to get everything done faster. Does anyone have an experience with anything similar to this???

[hallcrest]

I would talk with your clinical instructor about specific tasks and duties that you are responsible for week by week as you progress. That way you can know ahead of time what to expect and avoid some of the on-the-unit insecurity when you feel that it is all piling up.

Also, you can just tell the RN assigned to you that you are feeling a little overwhelmed and could they keep an extra eye on you today.

That might not be the coolest thing to have to do, but in terms of patient safety it needs to happen. And if your teacher gets wierd on you about it - tell em straight up - you were feeling a little overwhelmed and you knew that your patients safety was 1st priority. So you asked for help.

[Schweet]

I am sorry to hear you are having this dilemma (mind you, we all go through it at some point in nursing school and after school). One thing I have heard which really rings true is, "Accuracy before speed, speed will come in time." Remember that you have dealt with a lot of these medications previously which means some increase in speed will occur automatically. Certain practices should never be shortened such as always going through the 5 (or 8) rights of medication distribution.

I had a lot of trouble during the beginning of my 4th semester with time management but I kept reminding myself that I had already done many procedures before. I could now remember that last time I forgot an extra IV cath and this time I'd bring one so that if I didn't hit the vein, I'd have a spare. Getting all your supplies before going to the room is a good way to improve time management at clinicals.

Another thing I did each night was write 3 things I'd done right and 3 things I will do to next time correct what I did not so right. This helps lessen the likelihood of making the same mistake. I also made a list (because lists and me get along) of what supplies I needed for more complex procedures.

Hope that helps a little and don't forget accuracy before speed.