Oh my! I'm on week 7 of my RN orientation, & today was the first day I had 6 patients. It was nutty-one patient was going to the OR, another to the cath lab, and two more to CT. So I'm trying to do all that & prep them & assess them & give meds (if they could get them) before they went down-& then assess & give meds to the others & was getting so many calls from docs, family, etc! Sheesh! but despite all of that, I felt like I was doing pretty well & on top of things as best as I could. Around 1 PM, my preceptor asked is she could do anything & I asked her if she could hang two IV antiobiotics on one of my patients, cuz I had to give meds to two others at the same time. So then after that we looked at a patient's bedsore, checked to see that a wound nurse consult was put in, cleaned her sore, & put on a new dressing. Then I went to lunch (finally!!!) at 1:50-2:20 PM. (my only break) Then after lunch I recheck all the patients who were there, assess the one who came back from the OR, assess the one who came back from the cath lab, count up the Is & Os, hang up some new IVFs that ran out, etc. Then it was 2:55 PM & I went to look for my clipboard to give report on my 6 patients to the next shift. I COULD NOT FIND IT ANYWHERE!!!! Needless to say I started to get really nervous & freaked out. I looked in every patient room I went into, all over the nurses' station, the med room, the break room, the hallways, the pull out tables outside of patient rooms that we write on, everywhere I went-& could not find it! I looked for 10 minutes-my patients must have thought I was nuts cuz I went into their rooms like 50 times in 2 minutes looking for the darn clipboard. So then I'm thinking, ok, I'll just look at the assessment notes I wrote & put in their charts-but all the charts were gone-docs had them & were writing in them, etc! AUGH!!! Meanwhile my preceptor knows I lost it & tried to help me look for it, but then she says I should just try to give report from memory & to just visualize my patients in my mind & that that will help me give report. The only problem with that was that my mind was totally fried by that point from having 6 patients for the first time ever, & trying to do everything on time-I could not even tell you MY middle name if it wasn't on my clipboard at that point! Then another nurse said "Hey-I saw it on the waiting room." Yep-it was mine! But guess what? I was never even in the waiting room! Someone must've walked off with it by mistake & just left it there! That is so not right. It had ALL my assessment notes on it, all the order changes, any pain-SOB complaints they had, the tests they went to, etc....in other words EVERYTHING! So when I got it back (it was 3:15 by this point-I was so behind!) I started to cry a little & of course everyone is looking at me-I couldn
't help it I got so scared thinking how am I supposed to just give a full report on 6 people on my first day having 6 when I can't remember anything right now. But then once I got it back & calmed down a bit-I gave report. Has this happened to anyone else before? So now I'm trying to see if I can remember everything on my patients off the top of my head-& I can remember more than I thought-except I cannot memorize/remember who had clear lung sounds, who had wheezes/diminished sounds; who had edema in their legs & who didn't, the types of IVFs they're all getting, that kind of stuff. I mean how can you with that many patients? So of course I need to write it down to remember. My brain can only hold so much info at one time! Tell me what you all think. But seriously, other than my lost clipboard freaking out episode, I felt like today was not that bad at all. I will just bring in my roller skates for tomorrow to move faster! :)
Good for you christvs!! A gentle reminder though, make sure all the abbreviations you use are "legal" abbreviations and not just some of those in your facility use.
For instance in my facility some were using CTM for continue to monitor,, it isnt a legal abbreviation so they shouldnt have been using it. We have a doctor no less that seems to think it ok to make up his own, doesnt inform us and we have to call him about what his intent was. Who knows what RTC means,, "return to clinic",, only in his world!!!
Glad to hear you had a better day. Perhaps you should talk to this person who's precepting you and then talk to your UM about continuing with this person precepting you.
Glad to hear you had a better day. Perhaps you should talk to this person who's precepting you and then talk to your UM about continuing with this person precepting you.
I agree. Not only to maybe stay with this preceptor, but also to give recognition where it is due. Your preceptor deserves a pat on the back from her boss too. :)
Yes! I definitely want to stay with this preceptor-she is really awesome. :) And I am only using legal abbreviations in my charting-I am doing everything "by the book." :) I know, it is crazy when you're trying to figure out someone's made up abbreviation for something!
Specializes in PICU, Nurse Educator, Clinical Research.
Thank you everyone for all your advice. I'm happy to say I had a much better day today-especially thanks to my preceptor at work. I've been shuffled around with 9 different preceptors & I think the one I had today is in the top 2! :) She REALLY helped me stay on track, helped me see how I should organize things, prioritize, not fall behind, things like that. I walked away actually smiling at the end of the day! :) Woo-hoo! Even though I had 6 patients once again! :) She let me know I was very attentive to my patients, and very thorough & careful & commented how it was good that I looked up all unknown meds before giving them & also that I never do something I don't know without asking for help first. So then we both agreed that I pretty much just need to focus on my time management skills! :) I took her advice & changed a few things around & noticed the difference today already. I'm working with her again this weekend, so I'm happy about that. It is so nice to actually work with the same preceptor for more than one time-what a concept! I think I really needed some structure & guidance, cuz honestly, the other "preceptors" I've had were all very nice but really did not guide me much at all. So I'm happy I had the one I had today-I feel so much better just in one day-cuz it never dawned on me to do things the way she suggested.
-Christine
Doesn't a helpful preceptor make all the difference in the world? I had my sixth preceptor in eight weeks this past week, and she was fantastic in teaching me time management strategies- not just chastising me for not staying on top of things. my 'primary' preceptor is a very caustic person, and she would just get exasperated and take over when i did things wrong...she also would just say things like, 'you need to tighten up your time management.' um....time management in nursing isn't like time management anywhere else, y'know? in the other careers I've had, I had a lot of autonomy over what i did when. but in this one, things are governed by schedules beyond my control, so i really need someone who can teach me *specific* techniques to use for time management as a nurse.
i will say that it's nice to know someone's going through some similar stuff, and it's good to hear things are improving for you!
my 'primary' preceptor is a very caustic person, and she would just get exasperated and take over when i did things wrong...she also would just say things like, 'you need to tighten up your time management.' !
I hate this. When I first started working my preceptor was bad about doing this. I say show me once and let me try on my own. I lost alot of valuable IV starting experience this way.
The suggestion about putting your notes in your pocket was excellent. I have a pocket sized notebook that goes in the side pocket of my scrubs pants. I'm open to changing formats but it has to fit in a pocket. I can't find it if it's not there, and I never know when I'm going to waltz into a patient's room and need to stay there 20 minutes taking notes and giving care during their emergency.
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meownsmile, BSN, RN
2,532 Posts
Good for you christvs!! A gentle reminder though, make sure all the abbreviations you use are "legal" abbreviations and not just some of those in your facility use.
For instance in my facility some were using CTM for continue to monitor,, it isnt a legal abbreviation so they shouldnt have been using it. We have a doctor no less that seems to think it ok to make up his own, doesnt inform us and we have to call him about what his intent was. Who knows what RTC means,, "return to clinic",, only in his world!!!
Keep up the good work.