New grad struggling with receiving/giving report

[dann023]

I am a old 'new grad' graduated last year May. Recently started on a stepdown med/resp floor. lots of unstable/critical patient. I get 3 weeks of orientation, and I am really struggling right now.

one big problem I having trouble is remembering reports and getting a big picture together after receiving reports. I feel after received report, I should be able to retell the report to another nurse right after or give the CNA a brief report but I can't!

often I feel I am barely having time to writing down report, and after report is done I still don't really know why the patient is here, what has happened, etc. All I can remember is the not-so-important things such as pt has a PIV at left hand, family was at bedside..uggh! but the big picture - why was the patient first admitted, why is pt still here? what are we treating? what's the plan of care? I can't remember them!!!! I am so frustrated with myself. And after getting report I actually feel MORE anxious & panic. I know I can read up H&P, but I really want to be able to just get a big grasp of patient during report, and use the H&P to fill in more detail information.. not the other way around. I know you can ask the nurse to repeat, but I feel I literally need them to regive the whole report.

The inability to put a big picture of my patient together stop me from prioritizing things I need to do for the rest of the day. I am really worried and wonder if I really gone through nursing school at all..

I tried to communicate this problem to preceptor a few time, but she doesn't seem to understand what I mean, I guess no one else had the problem before..

I was mostly an A student in nursing school, I have struggled with report before in school, but never this bad. I could at least give a little bit of the story after getting report. I wonder if it's because I just need to adjust to the clinical more? Even though I graduated last year, my last actual Adult med surg was 3.5 years ago.. Because I did my preceptorship in Pediatric and my last 1.5 year of school we were doing community health and Ped/OB, etc. many terms, dx, medication, treatment are all so new to me.

I feel so overwhelmed, and out of place. Any tips/advice?

[threebrats46]

Do you use report books? We write in report books and basically copy patient's name,age,diagnoses and history and then add -on what every happened during shift ( last vital or any abnormal vitals and which MD is aware,what was done,drops/rises in labs,pain,bleeding, where the medlock is,etc...) I think every new grad has problems with report,once you get a system down you will be fine!

[studog12, BSN]

i'm in a similar situation as you, my friend. I am a new grad nurse working in a cardiac intensive care unit, and the learning curve is overwhelming, yet exciting. And you know what I probably have the most anxiety about? Giving report. I am a very detail oriented guy, and I have made my own SBAR sheet, structured the way I want it so I will be able to reference and use it in the manner which suits my brain. This means that I organize it in such a way wherr the little details of patients that are nice to know are included, too, simply because I want the next nurse to be as prepared and have as smooth of a start to his/her shift as possible. So I go through my routine...patient's name is so and so, he or she came in with this, has as history of that, etc., only to have my preceptor jump in, say I am a new grad, and start giving report. I wasn't mad at her or anything, but it perplexed me why she thought I was going about it the wrong way...doesn't one begin with the patient's name and then move to the more pertinent information such as diagnosis, history, and treatment? I guess I am just more of a step-wise person, and I don't do well with jumping from this bit of information to that bit about the patient when giving report, as I simply can't remember without looking at my cheat sheet and following my routine. My preceptor is kind of like that, and I plan on talking to her about my difficulty with report, explaining my vision for going about it, and asking for her advice on my thinking and what I could change to make it better. Anyway, I want you to know that you are not alone, my friend, and that even though giving and taking report may seem easy to some nurses, it is not as easy for those who are more inclined to detail in their communication and the more linear thinkers. Trial and error will help get us where we need to be; that and time. Let's hang in there and keep learning!