HELP! Preceptor pb + time list.

[CSNS]

I am a new grad on a onc/med surg unit. I just started orienting two days ago and I am already sinking. I am not sure if it is the preceptor or just the beast that nursing is. My preceptor intimidates me. She is good at what she does but I feel like I am bothering her. An example, she will be charting, once done (which BTW she hasn't explained a thing about what she was doing) she just stands up and goes to the patient's room to go do something. Or go to the med cart and pull meds and go hang them, or goes and chart...and I am following like a puppy. She doesn't just say "hey come with me I am going to do this" or "let's go do this. I know I should approach her but I am not sure what to say, I don't want her to get mad and make it worst. Or maybe I am the one wrong, but I am scared that after my 6 wks orientation like that I will be lost taking care of 5 patients! HELP! My anxiety is going awire so much that I think about it constently spoiling my time off.

Also, has someone developed a check list of different tasks to do during the day? Or could you tell me what your organization is?

Thank you so so much.

[SoundofMusic]

Ask for another preceptor ASAP. This is not precepting what she's doing to you. She doesn't want to work or teach.

Tell your manager what is going on and that you want to learn and want someone who takes time to teach you, or you're leaving the unit.

These hospitals do this, and then charge US new grads for these orientations. It's crap. They need to provide people who can teach and train -- not dolts who do stuff like this.

Find one now. It's your preceptorship and the ONLY time you've got to learn. It needs to be worth your while. I had one like this and got a new one within a few weeks. Went much better after that.

Good luck.

[SoundofMusic]

Wanted to add -- here is an outline of a daily schedule one of my preceptrs gave me -- can be adapted to your unit and really keeps you organized. Just make it your own and tweak it to your day. Helps to get the time management thing down first.

SCHEDULE:

0700 - 0730

VC and handoff, consult with techs on accuchecks, total care pts, labs, baths, etc.

0730-0800

VS

Pt. assessments

Check labs

Review prior shift's 12-hr chart

Verify AC's

0800-0820

Enter VS and assessments into IDX

Chart assessments, record neuro assessments in chart

0820 - 0930

Check orders

0800 meds

0930-1100

1000 meds

check orders

Round at 1100

1200

VS if not a total care pt. and enter in IDX

chart/neuro checks

verifiy ac's

Round

1230

Lunch -- tell all pts. and handoff to another nurse

1300

Return from lunch and watch other nurse's pts/Round

Check orders

1400

Round/Meds

Catch up on work

Take off orders

1500

Check orders/Round

labs if any

Take off orders

1600-1700

Round

Write progress notes on all pts, record changes/updates only

V care - updates only

Meds if any

Record neuro changes in charts

1800

Round/meds if any

confirm rounding papers signed in each room

stock rooms for next shift

Catch up

1900

Round

12 hr chart checks

I's and O's in IDX

Hand off report

[sediaz]

I love SoundofMusic's schedule!!!!!!!!!!!!!

I'm going to copy it and use it.

I hope it will help me "anchor" the shift. There's so much going on during the med surg day shift and this schedule beats what I was using to keep me on track.

What I seemed to have missed during Nursing School was all the "interruptions" that seem to mess up "my" schedule. I guess part of this was due to the time of shift that I had clinicals.

An example of this would be yesterday. I had my pt assignment and was receiving report when I got a call that I could bring up two of my pts that were scheduled for hemodialysis. I"d rec'd report on one of the pts and had been told to order her an early breakfast tray because the departing nurse hadn't been able to get thru to the nutrition dept. I hadn't had a chance to meet much less assess these pt. It was crazy but I got through it. Turns out the dialysis doctor wanted all the pts done early so he could leave early----bending the schedule to fit his needs.

Getting report and having to lightening fast get someone's trifold done so that they'll be ready for early morning surgery was another "interruption" to my plan. That trumps other stuff I need to do.

Getting 2 post ops (within 20 minutes of each other)and needing to do discharge teaching for another patientis yet another challenge to maintaining some sort of plan for my shift.

My preceptor told me that as I learn to prioritize I 'll start thinking of situations in a sort of "although that XXXXX is important and needs to be done this XXXXXX trumps that XXXXXX" and it will keep my priortizing more fluid. My so called plan has to be flexible.

I tell myself that I am a novice nurse and that this time of my practice is to be used to transition into a med/surg nurse. I will be awkward at times and make goofs in prioritizing and be incredibly stressed.

It is hard and scarey but I love it. I look forward to the day when I'm not new at nursing and I can relax into my profession.

Thanks for the helpful bits of info.

[SoundofMusic]

Ugh, having all that stuff as soon as you come onto your shift is just INSANE. I don't understand the powers that be that allow it to happen, knowing full well it's change of shift time for nurses.

I should probably have this list copyrighted or something - it is so good -- and it's not mine -- it was written up by my preceptor and now she gives it to all the new nurses. She is great.

Not that it helps at all when you've got that kind of mess going on at shift change ...but it DOES help you to get your brain back on track once the "storm" has passed.