First LPN job....VERY STRESSED OUT!! HELP!

danfif · Mar 18, 2006

All right, Stop, take a deep breath,,,,,,now let it out.

You are a new nurse, relax, give yourself a break for a minute. Nobody expects you to know everything the first minute that you hit the floor, cause if you did, you would not need orientation, now would you.

You graduated from nursing school, you passed the dreded NCLEX licencing test, now you will learn what it is you need to know on the floor. You have the knowledge to do the job, you have proven that. Now is the time to learn from your preceptor how to do the job. How and when to apply the things you have learned, and to continue to learn more and more each and every day.

I know exactly how you feel, I was there just over a year ago, but I can tell you that it does get easier as the shifts go by. It takes time though, and to be really honest, there are times when I still question what I am doing, but that is just natural.

The one word of advice that I might give you is this, If you don't feel comfortable doing a specific procedure then ask for help, or ask a question to clairify what you are doing. Remember, there is no such thing as a stupid question.

You will be just fine!

Peace Out,

Dan

Daytonite, BSN, RN · Mar 18, 2006

only your 7th day and you're not running the place yet. jeez!

you are expecting too much of yourself. you have set expectations that are too high for you to achieve. you are going to make mistakes--fact of life as a new nurse. it's what you do with the mistakes. it's the debriefing you do with yourself. go over (in your mind) what you didn't do, what you will try to remember to do next time. that is how you improve. it take months (as in 12 or so) to become proficient, not days. you can expect that much of your orientation is going to be like this. if you allow yourself to become so emotional everytime you make a mistake you will stress yourself out and want to quit before you even start. what you will find later when you are more seasoned is that many of the errors you make are really not that important. did the patient get injured? did the patient die? then, there is always room for the nudge factor. don't beat yourself up. vow to improve. hang in there.

here's a couple of web sites you can check out to read up on blood transfusions and blood banking.

http://teach.lanecc.edu/nursingskills/blood/blood.htm -- transfusion procedure

http://teach.lanecc.edu/nursingskills/blood/transfusionproducts.pdf -- a list of the different blood products available for transfusion

http://medstat.med.utah.edu/webpath/tutorial/bldbank/bldbank.html - tutorial on blood banking and blood transfusion. includes discussion on compatibility, crossmatching and transfusion reactions

i did a search on the compatability of iv unasyn and iv potassium and as you can see the return is that there are no known incompatabilities between the two medications. i don't know what that nurse was talking about. guess she was having a bad hair day. you always have the option to stop the main iv was dripping while you infuse a piggyback med.

http://www.drugstore.com/pharmacy/drugchecker/interactions.asp?drugs=unasyn+i.v.%7c119137%3bpotassium+chloride%2fsodium+chloride+i.v.%7c104397&patientdrugs=&x=50&y=9

knx0224 · Mar 18, 2006

thanks for the encouragement guys! any tips on how to make the most of my orientation??

MoriahRoseRN · Mar 18, 2006

Hi,

keep your head up,you sound like a winner.

I was just wondering, I don't mean to sound dumb, but I thought LPN's could not hang blood products. Maybe it's different in your state.

Good Luck!

alpine76 · Mar 18, 2006

just a quick question what state are you in? im only asking because i have been a lvn in the state of california and if you have IV cert you can hang blood, iv fluids, but never any antibiotics. The rule to remember is that you can hang anything that the body makes naturally. But if that is ok in your state what do RN's do?

knx0224 · Mar 18, 2006

I am in NC. The only thing clinically we can't do is work with unstable pts, such as in ICU, ER, or NICU, etc... We cannot do care plans either, but on a med surg floor we do the same things as RNs clinically. Our hospital trains us to do so....HA!

alpine76 · Mar 18, 2006

I am in NC. The only thing clinically we can't do is work with unstable pts, such as in ICU, ER, or NICU, etc... We cannot do care plans either, but on a med surg floor we do the same things as RNs clinically. Our hospital trains us to do so....HA!

That sucks to do all the work like an RN and get paid LVN salary.

DallasRN · Mar 18, 2006

Chill. Any new job you have - nursing or otherwise - is going to require a period of time to become comfortable and reasonably proficient. Not one of us came out of school knowing everything we needed to know, and most of us will admit to learning new things all the time. They say you have to be in any new job a minimum of 6 months before you begin to feel reasonably comfortable. That's been my experience.

As for the nurse that yelled at you in front of a patient. Bad news. I've precepted probably hundreds of new grads over the years and I've never found it necessary to yell at or belittle anyone in front of anyone else. Not once. And I won't let that happen to me, including doctors. On a few occasions, I've had people come close but I will immediately say something to the effect, "This is a discussion we need to have in the staff lounge." And if necessary, I'll leave the room. I would strongly recommend you discuss this other person's behavior with the manager, with this other nurse present. If for no other reason than that sort of stuff is a hospital liability. Beyond that, you have the potential to become a valuable employee and I bet they don't want to lose you in the first few weeks.

Now as for getting what you need from orientation...you need to remember that your orientation is for you. Be proactive. I've always require my orientees to keep an ongoing list of things they feel they need to accomplish and things they aren't yet comfortable with even tho' they may have done them. I ask them to talk to other nurses to see if a skill/procedure on their list is being done on another pt. and if so, try to arrange their participation. When a pt. is going to surgery, I do my best to arrange to have the orientee accompany the pt. so he/she can learn the flow and the reasoning behind the numerous forms, the need for positioning, the need for pain control measures, the opportunity to talk with the anesthesiologist during the procedure to learn the effects of anesthesia, etc. All of this is real different in the real world vs. reading from a book. (I never understood why pt. with open gallbladder surgery required so much pain med until I actually observed the surgery. Good lesson for me!)

Use your resources. Drug question? Call the pharmacy. Diabetic question? Call the diabetic educator. Nutrition question? Call the RD. Don't know what the prep is for a radiology procedure? Call the radiology dept. Search out these answers on your own and they seem to stick better.

For years, I carried a pocket-sized notebook with me constantly. I would write down things...normal lab values, supplies for different procedures, drug compatabilities, frequently dialed phone numbers, etc. You might try this, customizing to your needs. That little notebook got me through many stressful times.

And finally, familiarize yourself inside out with the hospital policy/procedure manual, and particularly the one specific to your unit.

Once again, remember your orientation is for you. Not only does the hospital have a responsibility to orient you, but you have a resposibility to tell the hospital what you need. We aren't a one-size-fits-all group of people. :)

knx0224 · Mar 18, 2006

Thanks!!!!

bullcityrn · Mar 18, 2006

Chill. Any new job you have - nursing or otherwise - is going to require a period of time to become comfortable and reasonably proficient. Not one of us came out of school knowing everything we needed to know, and most of us will admit to learning new things all the time. They say you have to be in any new job a minimum of 6 months before you begin to feel reasonably comfortable. That's been my experience.
As for the nurse that yelled at you in front of a patient. Bad news. I've precepted probably hundreds of new grads over the years and I've never found it necessary to yell at or belittle anyone in front of anyone else. Not once. And I won't let that happen to me, including doctors. On a few occasions, I've had people come close but I will immediately say something to the effect, "This is a discussion we need to have in the staff lounge." And if necessary, I'll leave the room. I would strongly recommend you discuss this other person's behavior with the manager, with this other nurse present. If for no other reason than that sort of stuff is a hospital liability. Beyond that, you have the potential to become a valuable employee and I bet they don't want to lose you in the first few weeks.
Now as for getting what you need from orientation...you need to remember that your orientation is for you. Be proactive. I've always require my orientees to keep an ongoing list of things they feel they need to accomplish and things they aren't yet comfortable with even tho' they may have done them. I ask them to talk to other nurses to see if a skill/procedure on their list is being done on another pt. and if so, try to arrange their participation. When a pt. is going to surgery, I do my best to arrange to have the orientee accompany the pt. so he/she can learn the flow and the reasoning behind the numerous forms, the need for positioning, the need for pain control measures, the opportunity to talk with the anesthesiologist during the procedure to learn the effects of anesthesia, etc. All of this is real different in the real world vs. reading from a book. (I never understood why pt. with open gallbladder surgery required so much pain med until I actually observed the surgery. Good lesson for me!)
Use your resources. Drug question? Call the pharmacy. Diabetic question? Call the diabetic educator. Nutrition question? Call the RD. Don't know what the prep is for a radiology procedure? Call the radiology dept. Search out these answers on your own and they seem to stick better.
For years, I carried a pocket-sized notebook with me constantly. I would write down things...normal lab values, supplies for different procedures, drug compatabilities, frequently dialed phone numbers, etc. You might try this, customizing to your needs. That little notebook got me through many stressful times.
And finally, familiarize yourself inside out with the hospital policy/procedure manual, and particularly the one specific to your unit.
Once again, remember your orientation is for you. Not only does the hospital have a responsibility to orient you, but you have a resposibility to tell the hospital what you need. We aren't a one-size-fits-all group of people. :)

What awesome advice, I think that this is one of the best responses I've ever seen here on any forum. I'm not a nurse yet but when I am, I will remember what you said! I just wanted to comment on what you wrote.

knx0224 · Mar 18, 2006

Hey all

I started a group

http://health.groups.yahoo.com/group/brand_new_nurse/

PLEASE JOIN

I hope this isn't against the rules, if so please forgive me!

:uhoh3: