New nurse

[leaRT]

I have been a LTC/rehab LPN for a year now, I worked as a tech before I went to nursing school. I have been gaining confidence working this past year but sometimes I feel like I still don't know anything. For example, a few times I have assessed a patient/resident and when I go and get the charge nurse or another nurse for their opinion and they disagree, I called to get an order for a stool sample for C-diff because it smelled just like C-diff but it came back negative, I sent a pt out to the ER for high BP, a headache and change in MS, they get to the ER, and they end up coming back with a UTI. (Which UTI's are still important but we can treat that easily in the facility). I'm good with med pass and the time management but I feel like my assessments are still not good

I try to do my best for my patients, overall I have learned so much in this past year but there are days I am just blank and have no idea.

How long does it take to get comfortable and what can I do to improve my assessments, i have been looking at my books recently.

Any insight would be appreciated... Thanks :)

[needlesmcgeeRN, ASN, RN]

With your pt. with the UTI - did you reassess the BP? Did you assess the whole patient or just look at that group of symptoms? Same with the patient for whom you suspected c.diff. Did the patient have abdominal pain, diarrhea, fever? Any of other common symptoms of c.diff? Or were you only going off of the smell of the BM? Why are you asking for advice from others with potentially more experience and then disregarding that advice?

[leaRT]

Thanks for the response -

And I think my post was not written the best... when I say I ask for advice, I pretty much always take the older (or more experienced, etc) nurses advice if I am not sure.. What I meant was before I go to them and ask them for advice, I already have an idea of what I should do or what is going on in my head, and when I go to ask for a second opinion I find sometimes their opinions or assessments are different than what I originally thought - Im not saying i don't take their advice, I usually always do, but I notice what they tell me to do is not what I originally would've done. I can't think of an example at this moment...

The UTI and C-diff instances were different

With the UTI - yes I took the BP multiple times and it was elevated every time. And no I think I was mainly focused on the symptoms - not the whole patient

And the pt I thought could have C-diff - they had diarrhea all shift with abdominal pain but no fever. And yes the diarrhea did smell like c-diff and thats what made me think C-diff and thats why I called and asked for a stool sample.

[leaRT]

This in not an everyday issue for me either, I have definitely seen a change this past year (especially in the last 6 months) in the way I approach certain situations and I have gotten more confidence as well. I know I can't know everything but I still feel like my assessments can definitely be better, and I want to be better at assessments so I can provide better care to my patients