Need advice working on ortho.

[iliket0fuu]

Hi everyone! So I'm a student precepting in an ortho unit and so far I just got through my 4th day. My preceptor is nice, but yesterday she sat me down after our shift and told me I was unfocused and disorganized and to work on it for next time. She said I shouldn't be asking her about how to work the IV pump (when hanging piggybacks) or EPIC system already since it's my 4th day. I actually knew how to work them both, but I looked to her because I thought she wanted to confirm I was doing everything right... plus, students aren't allowed to do anything with IVs on our own.

She's given me one patient to start off with, but she won't let met have total care of the patient. She'll talk to the patient and tell me what to do in terms of caring the patient, but I kind of want to practice talking to my patient too since patient communication is something I suck at...

Anyways, this is a long post but I wanted to ask advice on many things. What's the best way to hang IV fluids (without getting the cords all jumbled up)? When to clear the IV pump to document I&Os? How to approach your patient during start of shift? Also, for those who use EPIC, how do you look at active orders? There's orders that overlap sometimes and it gets confusing.

[mmc51264, BSN, MSN, RN]

First of all, your preceptor should be watching you set up IV lines. It is just a skill to learn, What you need to be careful of is compatible meds. Always double check compatibility. No matter how long you work, you cannot remember them all.

Second. You should have an EPIC super-user to go to. Ours version of EPIC, you can look at order history, orders and look at dates (I wish they woudl drop off when completed) there are also many other screens to tell, we have nurses that were oriented at different times, so they learn their instructors preferences. I use my worklist and the protocols for our floor.

I&Os are going to be unit, hospital specific. Usually we chart Q4H, regional pumps and PCAs are usually Q2H.

You will get a chance to talk to your pts. Give it time. If you go in to give a bath, that is a great time to have a conversation. We chart int he rooms, so if it is appropriate, I chat with pts then.

Try not to rush anything. It will come. :)

[chiromed0]

That's funny. Four days on the job and you shouldn't be asking questions. Are you a travel nurse? Otherwise, any student shouldn't be expected to just know what to do. I'm in ICU stepdown and I forget stuff all the time and relearn. Your preceptor is just being picky. On the other hand if you don't step up and get quicker YOU will become frustrated b/c more often than not you will be working with picky people who want things done NOW. So it's just part of learning and I wouldn't sweat it. Just do the best you can and it normally is enough. This too shall pass. And you will NEVER be an expert in EPIC...EPIC makes sure of that every update. Just get through your assessment documentation and know your MAR. All else just wing it as you go til you know.