Any tips? I take 2 patients. We don't have the luxury of being assigned a patient ahead of time. We get our assignment the morning we arrive on the unit. I've had patients with 15 meds to look up in addition to my other patient's 8. If you know you have to do your assessment, bathe your patient, look in the chart, look up things you need to know before you give the meds, address people who stop and ask you for help and various things......hooooww do you do it all? I'm getting a headache just thinking about it. I know it takes time management, but........................................
Jun 25, '09
I am not assigned a patient ahead of time, however, you have to develop a plan to cope for the day. First, I take my reports, then I go in to say hi to my patients to see if there is any thing they need or any emergencies. I quickly make up a table of all my medication and do side effects and nursing considerations all at the same time...while considering my next medication administration. I quickly breeze through my charts, looking at the H&P, and progress notes and the most recent orders quickly, then I start my care...while doing my am care, I do my assessments head to toe. You have to learn to multitask or else you might end up in deep trouble..I learn how to do this well...I do vitals in less than 5 minutes for my two patients.
Jun 25, '09
If my instructor approaches me and something isn't done, I always make sure to point it out and acknowledge it. Most instructors will understand that things pop up (I once had a patient code right during morning med administration) so they won't pick on you as long as they know that you are competent and know what needs to be done and plan to do it. When something isn't done and you don't point it out to them, they may assume that you don't know it should be done, which makes you a scary nurse to have on the floor.
Just my two cents.
Jun 26, '09
You need to establish a timeline before you even get to clinicals. I don't know my pt. assignments either but I still have a plan for the day. For example:
From 8am-10am- do you am care, am vitals, assessments, and am meds.( before going to your instructor make sure you jotted down what the meds does and side effects and etc.
10am-12noon- Checking the chart for updated orders, rounds
12:30-2:30- Vitals, meds, rounds
2:30-3:30- Final rounds and etc.
Jun 27, '09
I generally check the chart first before it is even time for report. I like to see the current labs and see what's going to need watching or is concerning, and check the meds so at least I had an idea. then I would get report on each patient - if the nurse was late with report, I'd at least go in to see the patient tell them who I was and that I'd be their student for the day- if it was really bad (once got report and hour and a half late!) I'd do my assessment and vitals. I'd get more info on the labs and tests and any new ones they needed at this point. Then AM care on one patient, meds for both (rechecking if too much time on certain vitals of course). Then AM care for the other patient. I usually had time to go back in and check on each of the patients and then get onto lunchtime vitals, accuchecks and then meds for lunch.
I had a a little schedule that one of the newer grad nurses had given me that worked really well. Ask your instructor, and the floor nurses how they like things set up. Know what you have to accomplish by what time, but to be honest like someone else said, when someone codes, or has explosive diarrhea across the entire room and accidentally rips out their IV, your schedule goes straight to he double hockey sticks.
Jun 27, '09
Another hint I can give is, if you know you are giving a medication that messes with the heart, electrolyte levels, or clotting time; make sure you have the values of the tests that need to be monitored before the teacher comes to you. For example, if giving Lasix, make sure you have the most recent Potassium level off of the chem panel. That shows the teacher you are ahead of the game.
Must Read Topics