I am looking for advice. I am working on a brain injury floor as a new grad. Words cannot describe how happy it makes me to see patients progress, BUT it's my fourth shift training and I felt so incompetent today. The first couple of days I got a feel for the unit and the procedures. (I am explaining this as I have a few more questions). I have serious OCD and check all meds and procedures three times. Having said that, I have to give a patient insulin and I'm very nervous about it. My preceptor thought I was
overthinking it.
My questions are:
I thought insulin had to be signed off by two RN's? This hospital only requires one nurse. I've just not heard of that from any other RN friends I have.
Is it possible on my fourth day of training(my preceptor worked on other things "because she was bored") that I had a hard time getting everything done within a 12 hour period? . ALL meds, assessments, documenting, assisting with the nursing aides(gosh they are all blessings) AND make sure the unit is safe.
Maybe this profession isn't for me or I'm not smart enough. What has been everyone's expiernce witj insulin and training?
I used to work at two hospitals as a unit secretary before I decided I wanted to be an RN. They had the barcode system and 2 RN sign off on insulin, heparin, blood transfusions etc. So, it was new to me. You are right about having confidence. She did tell me I need to be more confident. I gave the insulin's for breakfast and lunch, but by dinner I felt myself becoming exhausted. I was about to give all meds to each patient and I told myself I needed to slow down a little. This is when errors happen and I asked her to just watch and make sure everything was right. She got irritated and I understand. It was about 20 meds plus insulin's so I didn't think it was to much to ask. I am confident once I have a few more days I'll be alright.o shadowed a couple of days and then she said do everything on your own and she will check. I was excited but I felt it was a lot to learn in three days. Or maybe I'm just complaining. Documenting is huge for me. The nurses that I work with don't really listen to lungs as it really is a neuro unit. She will document lungs are clear. I refuse to do that. If I didn't do it, it's not getting documenting. I mean do I have time to document every detail? All RN's I have ever talked to said I'll be lucky if I got to go to the bathroom for a 12 hour shift. You are were so right lol.
What happens when you have a brain injury patient that requires a 1:1 sitter? Does the tech get pulled to sit with the patient leaving you to fend for yourself with the rest of the patients? Brain injury patients can be extremely unpredictable; throw a psych diagnosis on top of that and things can go downhill fast. You'll get the med pass down eventually; what you should be concerning yourself with is how safe you're going to be once you're off orientation. Do you have previous experience working with brain injury patients? It's not really something you can pick up in only three weeks. Is there a system in place for you to call for help if necessary? I don't mean to be negative, I'm just thrown off that a brain injury floor is only staffed with one licensed person.
I completly agree with you. I think it's so unsafe to have two staff for a unit like that. However, yes there is help that can come quickly if an emergency comes up. If there is a 1:1 sitter, someone would be called in to help. So it would still be myself and the nursing technician. I'm not exactly sure if it has anything to do with being a state hospital, but I would have thought if it's a full house, 2 RN's and a technician would be staffed. Falls are more common than violance, so my focus was more on doing my best to make sure no one falls. My thinking tends to be worst case scenario. I think experienced RN's would be fine with such a situation, as they know what they are doing. Maybe I'm putting to much worry into it. Thank you very much for your reply :)
No, I am very cautious with HIPPA info. I meant what I did during the day as far as RN skills. If someone has a specific diagnosis, I printed out a care plan for it. I don't see anything wrong with that as millions of patients has different type of brain injuries. The computer system is at work so it wouldn't be possible to print it out at home. Plus, it's myself and my dog so he wouldn't be able to read the top example. Thanks for your concern though.
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Ilovenursing3
38 Posts
I used to work at two hospitals as a unit secretary before I decided I wanted to be an RN. They had the barcode system and 2 RN sign off on insulin, heparin, blood transfusions etc. So, it was new to me. You are right about having confidence. She did tell me I need to be more confident. I gave the insulin's for breakfast and lunch, but by dinner I felt myself becoming exhausted. I was about to give all meds to each patient and I told myself I needed to slow down a little. This is when errors happen and I asked her to just watch and make sure everything was right. She got irritated and I understand. It was about 20 meds plus insulin's so I didn't think it was to much to ask. I am confident once I have a few more days I'll be alright.o shadowed a couple of days and then she said do everything on your own and she will check. I was excited but I felt it was a lot to learn in three days. Or maybe I'm just complaining. Documenting is huge for me. The nurses that I work with don't really listen to lungs as it really is a neuro unit. She will document lungs are clear. I refuse to do that. If I didn't do it, it's not getting documenting. I mean do I have time to document every detail? All RN's I have ever talked to said I'll be lucky if I got to go to the bathroom for a 12 hour shift. You are were so right lol.