I'm a senior doing my capstone within a level III trauma ED. My first day was yesterday and 7 hours into my shift I started crying!!! I was only supposed to "shadow" my preceptor but I jumped into things and started taking other nurses patients, stocking supplies, starting IV's, really taking initiative!
Then we had a code...my preceptor yelled at me to grab supplies (I've only been in the supply room twice to grab ice for a couple of patients) one of the things she wanted could only be found in the Pixxus (sp?) which I don't have access to. I took so long that she threw a fit, grabbed a zillion supplies threw a bag of NS on a desk and told me to prime the tubing stat. Which I did. When I got in the room to attach the tubing, I realized she didn't grab a butterfly clip (am I supposed to be psychic?) and the whole team rolled their eyes b/c she made it sound like I'm the one that forgot it. Now I'm the unit idiot that forgot an alligator clip.
Was your first day this hard? I was looking forward to capstone and now I'm dreading my second day. A monkey can go fetch this stuff, but come on - how am I supposed to memorize an entire stock room on my first day?
I don't like the sound of that ER much. The time for grabbing supplies is not when a code comes through the door. As some one else said, thats what crash carts are for or prepared resus rooms. That she was running around flapping about getting supplies, suggests to me that she is either inexperienced with codes (??????) or is working in the wrong enviroment and suggests that the ER is disorganised. When a code comes through the doors, the resus room should run like a well oiled machine with no frantic running around, nobody in a a panic (as that is what your preceptor was doing!)and definitely nobody yelling! All you should hear is the handover from the paramedics (or someone giving medical hx), the voice of the ACLS leader giving instructions and the teams responses as appropriate. If this isn't the scene you are witnessing, then you are learning how NOT to do things.
Also, as a student, you shouldn't have been asked to get involved anyway and afterwards, you should have been taken aside by your preceptor to see if you understood what was going on and to see if you were ok, had any questions, etc....
I think that you need to give your preceptor another try (might of just been a bad day!) but if this type of behaviour continues, you might want to ask for a different mentor.
And, also it is great to be eager but perhaps you should take a step back and as someone else said orientate to the department and to the patients before you start taking other nurses patients, etc.. You need to learn to walk before you can run. Be patient with yourself and you may find it all slots into place.
Your preceptor should have had you stand back and watch, especially if this is your first experience with a code. Having a well-synchronized team is a benefit for the patient, and it is in no way your responsibility to participate in the code. Doing some chest compressions would be fine too, but you shouldn't have been asked to do anything except to watch what happens, observe how the team interacts, and gain familiarity with the controlled chaos.
I'm so sorry that you left the ED feeling so down...not your fault. It's great that you took the initiative to get experience, but don't forget that you are there to learn.
I really dislike the mindset that students "need to just jump in and do it" because it sets them up to fail. Getting IV supplies for a 20-year old abdominal pain patient is one thing; asked to get supplies during a code is an entirely different matter.
Don't feel like an idiot, you're not a nurse yet. Your preceptor let you take on too much and perhaps that's a lesson within itself. You can only do what you can do. Some people like making others feel dumb, but guess what? You don't have to accept that role! You did nothing wrong. You are supposed to be learning, that's your job now, to learn. Learn not to take responsibility for something that you didn't do. Codes make people get testy because there is so much at stake, we always want them to go perfectly and they never do. If I were your preceptor I would have told you to stand back and watch, after it was over I would have asked you questions about the code and given you time to ask me questions if you didn't understand something. When precepting a future nurse, I do not ask them to do my job for me. I am there to help YOU, not vice versa. I'm am there to allow you to get some experience without taking on all the respnsibility. I'm there to let you make small mistakes so that you can learn from them. Ultimately, the responsibilty of the patient's care falls on me, not you. Try to think of it like that, she's responsible and YOU are NOT! :)
scattycarrot, BSN, RN
357 Posts
I don't like the sound of that ER much. The time for grabbing supplies is not when a code comes through the door. As some one else said, thats what crash carts are for or prepared resus rooms. That she was running around flapping about getting supplies, suggests to me that she is either inexperienced with codes (??????) or is working in the wrong enviroment and suggests that the ER is disorganised. When a code comes through the doors, the resus room should run like a well oiled machine with no frantic running around, nobody in a a panic (as that is what your preceptor was doing!)and definitely nobody yelling! All you should hear is the handover from the paramedics (or someone giving medical hx), the voice of the ACLS leader giving instructions and the teams responses as appropriate. If this isn't the scene you are witnessing, then you are learning how NOT to do things.
Also, as a student, you shouldn't have been asked to get involved anyway and afterwards, you should have been taken aside by your preceptor to see if you understood what was going on and to see if you were ok, had any questions, etc....
I think that you need to give your preceptor another try (might of just been a bad day!) but if this type of behaviour continues, you might want to ask for a different mentor.
And, also it is great to be eager but perhaps you should take a step back and as someone else said orientate to the department and to the patients before you start taking other nurses patients, etc.. You need to learn to walk before you can run. Be patient with yourself and you may find it all slots into place.