First day off of training...nervous!

[aviaa]

So I am going to be off of training starting tonight. I just found out cause I thought it was going to be the 8th. Anyways, I am super nervous! I am at a nursing home. I worked last night as well. It was a hard night, but I did learn a lot. I feel kind of stupid though cause I didn't recognize that the changes in vitals on a pt vomiting coffee ground emesis with a GI bleed was possibly becoming septic. We sent her to the ER. I feel like I can't remember anything I have learned in nursing school! This is my first job as an RN and I want to do a good job! Also, what would be the lowest BP for giving a BP med? I have heard 100 for systolic and 60 for diastolic. Any thoughts? How do I stay confident and be a good nurse? I studied like crazy throughout nursing school and for nclex! Any advice is very much appreciated! Thanks!!

[darkangelRN]

Good luck, I hope it went well! My first day on my own is coming up!

For BP meds, my preceptor told me (this just happened today) to look at the patients trends. See what the BP was yesterday before and after meds. Are they normally low? High? Is this new for the patient? Some meds on my floor actually have parameters set by the physician in the patients MAR. Today, we held the BP med and the patient was 113/50. So I wouldn't base it on one specific number. Use your critical thinking skills. I have noticed that nothing is ever black and white.

If you are really unsure, I would ask someone else on the unit.

Let us know how your first day went!

[DisneyNurseGal, BSN, RN]

I too am a new nurse, and at first I was so desperate for the hard and fast "cookie cutter rules" I could apply to everyone. Like the previous poster said, you need to look at the big picture... if the patient is 100/60 and they always get their BP meds then it is safe to give. How is the patient feeling? I had a patient due for BP meds. Her BP was 135/90, but she was reporting feeling very dizzy. I held the medication as to not make the situation worse. I monitored her, and ended up giving the med four hours later when her BP was the same but the dizziness had subsided.

Critically think through every problem. No two patients or even situations are the same.

You will be fine, take your time, just know this isn't like school or the NCLEX. these patients are fictional scenarios.

Good luck!