Published Sep 12, 2005
ArmyWife,RN
25 Posts
Hi All!
I'm new here and to nursing (obviously, I'm posting here :) ) and I am looking for some support.
I work in a small (12 bed) ICU. I have been off orientation for a few weeks now and I still don't feel like I'm "getting it".
Yesterday, it was me and another nurse (experienced) with 4 pts - all of them "IMC" status. At one point the more experienced RN looked at me and said "I have to go up to Med-Tele to start and IV" and left. So, I was alone with four patients for around 15 - 20 minutes (it seemed like hours). As soon as she was gone, ER called with an admission so I had to assign the room (pick a room, any room). Also, one of her pts called (he doesn't like the call light, so he just yelled) for his pain med (he's a frequent flyer and watches the clock for it). After she got back, I was trying to get myself together to do my 2000 assessments on my two pts (still hadn't opened my notes yet) and she tells me "ER is calling to give report on that admission, you need to take it" (huh! can't you see I'm flopping around like a fish on the deck already?) So I get report from ER LVN (who happens to be a friend of mine) and ask her to give me 20 minutes. I then hurry through the assessments and give one pt meds (he threw 1/2 of his potassium chloride pill at me but he's a sundowner and there was no reasoning with him) but before I can give the other pt his meds, the admit comes in. I haven't had time to set up the room, so I'm completely unprepared for him. I get him settled in the room with the help of the other RN take the 1st set of vitals and leave him to give the meds to the other pt. I get back to the new pt and find out he is deafer than a post so I'm yelling at him to get his health hx info from him while the other RN is putting the orders into the system for me. (Thought she was being nice, found out later that she "had to do it" because she was the charge RN.) So, now I'm behind even more and the next shift RN comes on. I told her I could give her report, but I would need to finish the charts before she could have them.
Now, I know all that sounds like a typical evening, but here's the part where I don't feel like I'm getting it. In the ER, they started 2 grams Rochephin on my new admit pt and the doc wrote for him to then have 1 gram qd IVPB and 750mg Levaquin qd IVPB daily. When I give report to the oncoming RN, I said, we could probably time the Levaquin for the AM after the pharmacy opened (we don't have a pixus on our unit) since he just had the Rochephin. I'm thinking that in order to make the oncoming shift easier this is a good thing - otherwise, she has to go to ER and get the Levaquin from their pixus which means time off the floor and finding someone in ER to get into the pixus for her. I'm then informed that "he needs it now". Why? This is the part that I don't get. Really, if anybody has an answer, let me know.
So, this is how my shifts go. I don't feel smart enough, good enough, or fast enough and at this point I don't think I'm ever going to.
Thanks for letting me vent.
Gail-Anne
97 Posts
How long was your orientation? Did you do any percepterships in an ICU setting?
Is there someone you can speak with to help with your organizational skills, like a Clinical nurse? Maybe you just need a few more days with a well-organized nurse, one would hope that your institution would be willing to give you more assistance than have you leave. They've already spent quite a bit on you, whats a few more days!
Don't give up on nursing altogether. ICU (or emerg) is not for everyone. Often you will hear us old nurses say that it's best to get a year or two of med/surg before working critical care as it does help with handling things.
Thank others for their assistance but don't feel that you have to apologize all the time as you're not up to their level yet. We were all new at this once.
Get a good nights sleep. Best of luck.
sbic56, BSN, RN
1,437 Posts
I'm then informed that "he needs it now". Why? This is the part that I don't get. Really, if anybody has an answer, let me know.
Whenever an antibiotic is ordered, it needs to be given asap to start battling the infection. Both antibiotics were ordered, as it was not yet know what antibiotic is the best one for the infection as the culture results were not known as yet.
Be good to yourself...nursing can be very unnerving until you get your feet under yourself. Take a deep breath, learn from your mistakes and keep up the good work.
sirI, MSN, APRN, NP
17 Articles; 45,819 Posts
Hi All!I'm new here and to nursing (obviously, I'm posting here :) ) and I am looking for some support.I work in a small (12 bed) ICU. I have been off orientation for a few weeks now and I still don't feel like I'm "getting it".Yesterday, it was me and another nurse (experienced) with 4 pts - all of them "IMC" status. At one point the more experienced RN looked at me and said "I have to go up to Med-Tele to start and IV" and left. So, I was alone with four patients for around 15 - 20 minutes (it seemed like hours). As soon as she was gone, ER called with an admission so I had to assign the room (pick a room, any room). Also, one of her pts called (he doesn't like the call light, so he just yelled) for his pain med (he's a frequent flyer and watches the clock for it). After she got back, I was trying to get myself together to do my 2000 assessments on my two pts (still hadn't opened my notes yet) and she tells me "ER is calling to give report on that admission, you need to take it" (huh! can't you see I'm flopping around like a fish on the deck already?) So I get report from ER LVN (who happens to be a friend of mine) and ask her to give me 20 minutes. I then hurry through the assessments and give one pt meds (he threw 1/2 of his potassium chloride pill at me but he's a sundowner and there was no reasoning with him) but before I can give the other pt his meds, the admit comes in. I haven't had time to set up the room, so I'm completely unprepared for him. I get him settled in the room with the help of the other RN take the 1st set of vitals and leave him to give the meds to the other pt. I get back to the new pt and find out he is deafer than a post so I'm yelling at him to get his health hx info from him while the other RN is putting the orders into the system for me. (Thought she was being nice, found out later that she "had to do it" because she was the charge RN.) So, now I'm behind even more and the next shift RN comes on. I told her I could give her report, but I would need to finish the charts before she could have them.Now, I know all that sounds like a typical evening, but here's the part where I don't feel like I'm getting it. In the ER, they started 2 grams Rochephin on my new admit pt and the doc wrote for him to then have 1 gram qd IVPB and 750mg Levaquin qd IVPB daily. When I give report to the oncoming RN, I said, we could probably time the Levaquin for the AM after the pharmacy opened (we don't have a pixus on our unit) since he just had the Rochephin. I'm thinking that in order to make the oncoming shift easier this is a good thing - otherwise, she has to go to ER and get the Levaquin from their pixus which means time off the floor and finding someone in ER to get into the pixus for her. I'm then informed that "he needs it now". Why? This is the part that I don't get. Really, if anybody has an answer, let me know.So, this is how my shifts go. I don't feel smart enough, good enough, or fast enough and at this point I don't think I'm ever going to.Thanks for letting me vent.ArmyWife,RN
Hello, ArmyWife, RN,
I know you feel overwhelmed, but, you really did a good job juggling the admit and assessments, meds, etc.
As for the Levaquin. As the above member stated, it needed to be started ASAP. The offending organism/s is/are hopefully eradicated with the combined use of Rocephin and Levaquin.
I think, with time, you will be even more confident. Hang in there......