Final semester preceptorship in AS program

Ruby Vee, BSN · Jan 12, 2018

I am in the final semester of my AS program and we are doing 12 hour shifts in the beginning then we are starting classes. I chose the Med Surg floor and I got Med Surg/Neuro which has been awesome so far. One thing that has been bothering me though is how nurses know exactly when to talk and what to say to their patients and other members of the healthcare team and they are so knowledgable on what to say to them. I feel so useless because I can barely remember my patients name and I feel like I'm failing. I really want to succeed as a nurse but I don't think that my skills are adequate. Has anyone ever felt like this. Any tips for a future murse?

Very few of us were born knowing how to talk to patients, visitors, colleagues, other health care team members or management. It's an acquired skill, just like placing a Foley or starting an IV or time management or . . . you get the picture. One habit you can get into how that will help you later on -- carry a "Brain Sheet". There are various examples of brain sheets -- a poster called Esme has authored many of them.

You'll want your patient's name, DOB and medical record number (I used to just stamp a blank sheet of paper with the addressograph plates of my patients -- and then made sure I deposited the brain sheet in the Shred bin at the end of my shift.) Diagnosis, room number and physician's name are also very important. You'll need that information when you call the lab for results, the physician or her partner for orders, the Cath Lab to see when the test is scheduled. Write down any pertinent information -- if you're calling the physician about a K+ result of 1.9, write down the K+ and when it was drawn, for example. If you're calling to see with the heart cath is scheduled, you'll need to know the name of the physician requesting the test. Etc.

Keep in mind that you are not communicating with friends at the local pub -- you'll use more formal language. If you're having difficulty remembering the medical term for something you'll need to communicate, write it down on your brain sheet -- both the correct spelling (for your charting) and the phonetic pronunciation for when you talk to the patient and his family about it. Speak more slowly and distinctly than you would if you were having a coffee with a friend -- older people who are starting to develop hearing loss lose some sounds and many are embarrassed to stop you and ask for clarification. (This pertains to colleagues and anyone with whom you're speaking on the phone.)

Most of us have felt totally inadequate at times. If it makes you feel any better (and it SHOULD), experienced preceptors don't really expect you to know anything but your OWN name your first few shifts as an RN. As a student, your skills really are NOT adequate. That's OK. We don't expect new grads to have adequate skills -- and even if you've got tons of experience as a CNA, you'll still have a ton to learn.

What your education and license grant you is a license to LEARN. You will learn so many things as a newly graduated nurse -- many things that you didn't even know you would need to learn. When you're about to start your first job, PM me or start a new post about how to succeed as a new grad. I'll be happy to help.

Here.I.Stand, BSN, RN · Jan 13, 2018

Spot-on advice. A good brain sheet is invaluable -- I still make one after 15 years! You'll get your rhythm down, will get the hang of what info you need for calling the doc, you'll learn how to talk to pts/families. There will be times that you won't know what to say...because sometimes there's really nothing you CAN say beyond "I'm so sorry for your loss." (I work in an ICU with largest pt populations trauma and strokes...so see quite a bit of deaths.)

Most of these things come with experience.