How My Orientation is Going

Nurses General Nursing

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I'd say it's going ok. I have high expectations of for myself so when I mess up I'm really mad at myself.

I think the most trouble I'm having is with the Pyxis. I've never had to use anything like it so it has been difficult to get use to it, scanning the patient's bracelet & then the meds. Then dealing with the narcotics. Oy! That's a whole other story! Have to have a witness to get them out AND to waste them. Holy hell. I'm trying to get use to that! I'm not use to that. I'm use to working in corrections so nurses didn't pass meds & the inmates rarely if ever got narcotics.

When I worked in nursing homes it was all on paper & we didn't have to go through so many steps like this. It's a whole new world to me. I feel bad & mad for messing up. I should know better but it's all so new.

I also feel kind of bored, it seems all monotonous. Go in, get report, pass meds, lunch, pass meds, give report. Blah. Same thing day in & day out. Maybe it will be different when I'm off orientation but man, I feel so bored with it. There aren't any codes or anything exciting that happens. I can see why no one stays in med/surg departments for long. I already want to bridge & move to the ICU or ER after I get RN med/surg experience.

Oh I know! Every time I make a slight mistake, my stomach drops to my ass. Lol.

Pyxis is a special kind of nightmare. I have worked with several . Not one of them required a witness to sign OUT narcs. Consider why your facility has that requirement. As a traveler at the Mayo clinic, I had to print out my narcotic administration and coordinate it with the patients MAR... to make sure they jived. Apparently my thumbprint was not enough evidence.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Sometimes nurses who are orientating (and therefore their orientees) get the more stable assignments so there is time available for the orientee to get a good routine down and also time for available education (policies, procedures, equipment etc). Typically the goal is for the assignment to get more complex, but well, it just doesn't always work out like that.

Right now, it sounds like you have identified the things that you haven't mastered yet. I know the Pyxis was my nemesis the first couple weeks at my new job... I'm finally competent at it!

Good luck!

We do a group shift report over everyone's patients before everyone splits up & do bedside shift report. We discuss who is on what precaution, who doesn't get out of bed, so on & so forth. Not many require full turn teams, a lot are up ad lib, not many have PICCs on our floor. It's a pretty stable floor.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Pyxis is a special kind of nightmare. I have worked with several . Not one of them required a witness to sign OUT narcs. Consider why your facility has that requirement. As a traveler at the Mayo clinic, I had to print out my narcotic administration and coordinate it with the patients MAR... to make sure they jived. Apparently my thumbprint was not enough evidence.

If I am not giving the full amount of a narc I need a witness but then my preceptor told me to do something to by pass that. I don't even remember what she told me to do to by pass that. When she told me to do that it caused me to eff something up with the Pyxis which got me in trouble. I.Wanted.To.SCREAM!

I hate the Pyxis. It will forever be my nemesis!

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Specializes in as above.

orientation if calm, means your not learning. Ask questions! It not good to feel too safe. If something in reality suddenly appears, your screwed!

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
orientation if calm, means your not learning. Ask questions! It not good to feel too safe. If something in reality suddenly appears, your screwed!

I don't understand, how so?

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If I am not giving the full amount of a narc I need a witness but then my preceptor told me to do something to by pass that. I don't even remember what she told me to do to by pass that. When she told me to do that it caused me to eff something up with the Pyxis which got me in trouble. I.Wanted.To.SCREAM!

I hate the Pyxis. It will forever be my nemesis!

Either you and /or your preceptor is incorrect. You need a witness for a waste.

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Such a pity that the health and well being of millions of human lives is left up to some greedy, for profit mechanism. Works like a charm for those who are not affected by it, really stinks for the 99% who have to wait and suffer because those who stand to profit from this 'your money or your life system' make you waste untold hours punching everything in from an insulin syringe to a dressing. Next, I expect them to keep track of toilet paper usage. How much longer is a dying middle class who just had 25 billion stolen from medicare going to put up with this selfish, greedy, and immoral system that dictates that access to healthcare is some 'luxury' and that if you can't pay you go without? Enough is enough

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Either you and /or your preceptor is incorrect. You need a witness for a waste.

I know that now (after I got chewed out). I had to pull out whatever narc it was but because I wasn't going to give the full amount I needed a witness. I went to go get my preceptor, she told me to bypass that, but because I bypassed that it wouldn't let me choose the option to witness a narc to be wasted. *sigh*

Also, she had me pull out another narc to give to a patient when he didn't ask for it (all shift) but then I couldn't return it to the Pyxis because it thought I gave the full amount or wasted it.

Two very important lessons learned.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Such a pity that the health and well being of millions of human lives is left up to some greedy, for profit mechanism. Works like a charm for those who are not affected by it, really stinks for the 99% who have to wait and suffer because those who stand to profit from this 'your money or your life system' make you waste untold hours punching everything in from an insulin syringe to a dressing. Next, I expect them to keep track of toilet paper usage. How much longer is a dying middle class who just had 25 billion stolen from medicare going to put up with this selfish, greedy, and immoral system that dictates that access to healthcare is some 'luxury' and that if you can't pay you go without? Enough is enough

What is this about?

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I know that now (after I got chewed out). I had to pull out whatever narc it was but because I wasn't going to give the full amount I needed a witness. I went to go get my preceptor, she told me to bypass that, but because I bypassed that it wouldn't let me choose the option to witness a narc to be wasted. *sigh*

Also, she had me pull out another narc to give to a patient when he didn't ask for it (all shift) but then I couldn't return it to the Pyxis because it thought I gave the full amount or wasted it.

Two very important lessons learned.

Your preceptor is misinformed and not teaching you correctly. Incorrect narcotics documented via PYXIS will bring you down.

I would ask for personal pharmacy instruction and management direction.

Protect yourself, not only your job, but your license could be on the line with this.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Your preceptor is misinformed and not teaching you correctly. Incorrect narcotics documented via PYXIS will bring you down.

I would ask for personal pharmacy instruction and management direction.

Protect yourself, not only your job, but your license could be on the line with this.

Yeah, I realized that when *I* got in trouble for the way SHE taught me. That's why the Pyxis scares me so much! I can pull out the regular meds just fine, but pulling narcs make my heart drop to my ass.

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Yeah, I realized that when *I* got in trouble for the way SHE taught me. That's why the Pyxis scares me so much! I can pull out the regular meds just fine, but pulling narcs make my heart drop to my ass.

No problem. If you have to get a witness to sign out narcs (never heard of that) and a witness to waste, take your time and find somebody to do it. Sadly, the patient will just have to wait. CY your A.

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