Help me please...I need help from an experienced nurse

when you take report write down what you will need to do and check off each one as it is finished

also write down any observations that you notice

i hope someone else can add help in your situation...clinicals are rough but everyone goes through them and they are runing in circles also

I'm not an experienced nurse, but I did finish nursing school and had some of the same feelings that you describe, so hopefully I can help.

As a student, most everything you learn is new, and its not enough to understand just the diagnosis and nursing treatment, but you also have to learn facility policy, logistics of the unit, charting, etc...and about the time you get comfortable with one facility you are whisked away to another clinical rotation. Alot of times you feel like a chicken running around with its head cut off....lol...or a dog chasing their tail!

So here are some tips that may help...

*Get as much information about your pt as you can

During our first two semesters, we were encouraged to go the night before to look through our pt's chart for their diagnosis, hx, labs, treatments, procedures, meds, and careplans. That allowed us to research everything the night before and anticipate what things we would be doing for the patient the following day or possible complications. If this is not possible, show up early that morning/afternoon and do the same thing. You can never be too prepared...especially when you're a student and everything is so new

*Make an hour by hour schedule and do your best to stick to it!

Type it up and make copies! Keep it on a clipboard, handy. For example; 0645 get report and give my pt(s) a quick look to make sure they are alive

0700 check my chart and mar, collect vitals, do assessments

0800 meds and bed baths

0900 check chart for new orders, meds (*good idea to leave space to write the specific meds that you need to give at these times)

....you get the picture

*If there is something that needs to be done, do it NOW! don't wait until later because you never know what will happen! This is frustrating for students because you have to wait for they dynamap/thermometer, wait for the instructor to give meds or perform procedures, wait for the nurse or doc to finish with the chart...and then when you get what you need you feel that you are constantly trying to play catch up! Just remember to breathe, prioritize, and work at a steady pace...there is always something to do!

*Keep clutter out of your pockets...I saw some students who would go to pull out a pen, and everything but the kitchen sink came out with it...alcohol wipes, extra gloves, flushes, cell phone, scissors, tape, chapstick, make-up compact, gum or mints, notecards with study material...some of these things ARE necessary and some aren't...use common sense!

*Keep your items together and in a place that is easily accessible!

You don't want to spend half the shift running around looking for your drug guide, your clipboard, a pen, your paperwork, etc. Nor do you want to wait outside a breakroom for a staff meeting to end when you really need your textbook to look up a lab value that was just called on your pt.

*Evaluate yourself when you go home!

Clinical does not end at 0230 or whenever you get off! Its a learning experience. You prepare, you perform, and you evaluate! This helps you learn and not make the same mistakes again. What things went wrong today? What factors contributed to the problem? What can I do differently next time to experience a better outcome?

*Ask others!

Don't be afraid to ask other students, nurses, or your instructor what they do to keep on top of things! You would be amazed how many ideas you will get that you never would have thought about on your own.

I'd suggest that if you cant figure out how to solve the problem on your own very quickly, you bring it up one-on-one with the clinical instructor in post conference. Express your concerns, and how you feel, and ask for suggestions from the instructor to improve in this area. Better to bring it up yourself first, and show the instructor that you recognize a problem area and want to fix it, rather than have an instructor bring it up in a final eval as something you were poor at. Just my

what wonderful advise, these folks have already said everything I was thinking. I do think it would be good if you could talk to your instructor. If you don't feel comfortable talking with this instructor (I had one of those once! Asked for her help and input and got a blank stare) then find one you can talk to. ask for tips/timesavers/etc. Once you get enough input you can formulate your own plan. You'll find your groove. Just keep at it!

Thank you so much for the advice everyone...soldiers wife...I have thought about typing something up...I might actually try that tonight and see what I can come up with tomorrow. I am afraid to talk to the instructor. She's a bit intimidating. (really I'm sure I'm just really easily intimidated!! ) I will try this out and see what happens. Thanks for your help.

Do you have a preceptorship semester with your nursing program? When I was in school we had one semester that we followed a RN (always the same one). This is where I learned organiZation by following her. Each hospital and each unit has their own routine so no matter where you go initally you will have to learn it. Right now just try and focus on learning skills and make yourself as available for whatever pops up.

I totally agree with making a check list. This past semester I was the reverse of you- an evening clinical, then day clinical the next.

Prior to each clinical, I would brainstorm all interventions/treatments we learned all semester- ie., vitals (ie., q4, q8), finger sticks (ie., tid, qid), dressing changes, I&O's, O2 management, meds (ie.,what time given pertaining to hospital policy), assessments, basically anything we learned how to do.

Once I got to see/read about my patient I would then conform my list into one that was appropiate for my patient. I would then write down in order, specifically things I would do (view previous shift notes, vitals/general assessment, glu, check results for morning draws, meds, vitals again (maybe), breakfast, assessment, bath, dressings, glu, lunch..) and then just crossed off what I did.