Reebles 3,210 Views
Joined: Apr 8, '10;
Posts: 89 (24% Liked)
; Likes: 42
first year nursing student... extremely nervous as it was my first day on clinical.. first time alone with a doctor and a patient (i was to just observe and get V/S once he finished his assessment) i felt like i should be doing something so as he was asking her questions I proceeded to get a blood pressure... he then lifts his hand high in the air so my fist reaction was to give him a HIGH FIVE. Little did i know that he was actually telling me to STOP... not telling me I had done a good job (perhaps i was distracting him?). awkward doesnt even cover it... he didnt have much of a sense of humor either so he just looked at me with a strange look on his face..
I always "frisk" myself when I need a pen. Then remember I'm not wearing scrubs with 10 pockets. LOL
My 5 yo granddaughter washes her hands like a nurse and I love it. After using public BRs she also asks for Purell because..."maybe someone didn't wash her hands and got poop on the door". I love that kid!
trying to swipe my badge on our bedroom door, the bathroom door.. & it's usually when I don't even have my badge on! Also at work, trying to swipe my badge on doors that don't require badge access.
I am a new grad RN. I was just hired into a new grad program on a med surg fllor with a ration of 1:5 patients. I have advice based on my preceptorship on a med/surg floor. MAKE YOUR OWN shift report or brain sheet or whatever you want to call it. If you make your own it's much easier to organize your patients info quickly during shift report. A good start to the day makes the rest of the day go smoother. This was my work flow when I got to the unit in the morning:
1) FInd out your pt's and rooms number - get stickers for each, arrange room number in sequential order
2) If using an electronic medical record system open up each patietns chart so you can access each quickly
3) Start with first patient: read H & P, write down admitting daignosis. Read their history - write down co-morbidities. Write down most recent vitals. Look at labs - write down the abnl lab values. Are they DNR or FC? write down IV sites, foleys, drains, tubes they may have - this way when you go into patients room you know what to look for. write down their Doctors name/ team name, or whatever. If your struggling with your beginning preparations ask your preceptor how they start out. everyone's different. Now during shift report you already know a lot about the patient and you'll have time to think about what questions you may have!! yay!
4) Most important part** Look at the MAR or Mar summary. I write down PRN meds seperate from scheduled meds. Write down scheduled meds and when they are due - if you have time write down dose so when you go to the pixis/med removal machine you have more confidence.
For the PRN's write down whether they are Q4/Q6/Q8 or whatever and when the last med was given - this way when your in the patients room and they say their pains a 7, you can look at your notes and see what pain med they can have when. Saves time!! I wirte down PRN meds in a different color ink so they stand out. Buy one of those pens that can switch from red,blue, black. Consider writing all patients scheduled meds on one page you can look at, that way you can look ahead and go ok and noon so and so, and so and so have meds due, so I should do this first. or whatever... you get the idea.
5) Go meet the patient with the nurse that your relieving. Have them come into room with you. Introduce yourself and ask them if they need anything rt now and tell them you have to go see the rest of your patients, and that your still getting report and you'll be back soon. Look around the room where are there IV's? do they have a folley? see somehting you'll need to fix soon? are they in pain? write it down so when you come back after report your prepared!
6) After reports down and you have all your patients data. med time! remember your 5 rights of med passing. dont rely soley on your notes you have to recheck MAR again. but you'll have more brain material from writing things down already. Makes it go smoother, and you'll feel more confident. Practice IV piggyback whenever you can, seems simple but unless you practice you wont have confidence. do everything. volunteer! ask other nurses if they have a skilll to do if you can do it. practice makes perfect and build confidence.
7) If you have down time play with patients charts so you can familiarize yourself with where certain info is contained. Explore away! ask questions about new things you discover!
8) Do a good assessment! look at dressings - don't chart on something you never asked about or looked at. if you forgot something go back to patients room - be bold - there's no shame in learning. Don't worry about what other ppl think - they probably arent even thinking about you. so relax take deep breaths and blow off anxiety. live and learn live and learn! woo!
Thats all i can think of for now. good luck! oh and ask about pain - have them rate it and describe it... some nurses dont - but you have to chart that you asked these things - an dpt's can get copies of this - and they wont be happy when they see things you quoted them as saying that never happened.... shame!
It's very normal to feel this way. Nursing school prepares you for the NCLEX more then working the floor. Getting a decent orientation is a must.
The thing I always suggest new nurses to do is keep a journal. Every day after work write down something you need to learn and something you did really well that day.
When the day is extremely hard and you feel you have learned nothing... you can go back and look at what you've written. You will be buoyed up by the daily I did this well to help keep things in perspective and you'll notice that somewhere along the way you've figured out some of the things you once felt unsure of.
I'm not saying your wrong, but I'm pretty sure they can't put a stipulation like that on an application. There's something illegal sounding in there for being equal opportunity employers. You can *prefer* to have people from your area but it can't be a requirement.
I hear what you are saying but I have an ipad with skyscape and it is the real deal!! I have the 3g unlimited version and there all all kinds of GREAT nursing apps on the app store.. I plan on using my ipad for note taking in class(which works great!!) and buying an ipod for clinicals.. I know this gets pricy but this way I can fit everything I need for a full day away from home in the front flap of my backback..
PS.. My ipad works perfect.. There are no bugs from what I can tell and they are releasing the new os soon so don't be afraid.. I LOVE mine...
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