new nurse needing guidance

[Katt505]

Hello all....I'm a new nurse, RN, working in a residential treatment facility for children ages 6-13 who have been sexually, mentally, and physically abused. I work in the clinic, and my primary responsibilties are to deliver medications and treat minor injuries that the children come in with. A good deal of the time, the children are looking to "get out of school" and so they "make up" injuries to come down to the clinic.

I have to just say, I'm so insecure about my assessment skills. This is so much of what nursing is...assessment, and I feel like I have NO CLUE what I'm doing. Literally no clue. You can ask me the theory behind anything and I can tell you what I'd do...but put a patient in front of me and I just don't know, and the simplest things evade me. I just don't know whats wrong with me, and I was wondering if anyone had any words of advice or guidance.

This is my first job, and its a very good one. It's not testing any of the skills that I've accumulated in school. Co workers call this the job you "end up at," as a nurse with many years experience, but it's my first and it's so cushy...but I can't get a job right now in my area in med-surg.

ugh! I just feel so frustrated with myself. maybe there isn't anything to assess a good deal of the time, but I don't want to treat the situations that are presented as being made up just to get out of school. Help!

Kurt

[nurseprnRN, BSN, RN]

Do you have protocols for assessment and when to call for back-up? Consider calling your equivalent at another facility and asking to see theirs; discuss with your medical control (MD or ANP) if there aren't any and see if you can help develop them. Call your pediatric faculty and collaborate-- just because you're out of school doesn't mean you can't talk to them anymore :). Find your local nursing association and hook up with their pediatric special interest group for mentors and collaborators.

Take VS and do a quick survey. Chart everything and be sure to communicate in writing (a copy of your charting, for example) with the teacher or residential supervisor. For any kid with an invisible boo-boo and no history of injury (no fight, no fall, etc.), a bandaid and "RTA" (return to activity) is is always good. :) Follow up to see that everything is OK.

In time you'll learn to ask the right questions about what really brings them in.

[mariebailey, MSN, RN]

What was your orientation like? Do you have a very detailed job description? Request some clarification on your functions as a nurse in their organization or ask for additional training if you feel like you need it. Some suggestions: do some continuing education activities related to your job, get familiar with your scope of practice & your state's nurse practice act. It may assist you in developing a knowledge base & help you learn how you can apply what you learn.