Nursing Practicum

Mahage, LPN · Apr 24, 2009

There are so many situations where the right thing to do is vague. Sometimes it depends on knowing your doc and you couldn't possibly know the doc well enough at this point to make some of the decisions like range of motion or whether or not to push liquids. As for the permits and forms, I think we all learn that one by experience, lucky you, you learned it while still a student, I learned it only while in orientation and I have heard of some who were off orientation and still hadn't been told or shown what to do regarding permits. You sound very invested in being a good nurse, you will do well but the learning curve is steep. Be brave and if you don't feel like you are getting the info you need ask someone else. You always have the charge nurse as a resource and if she isn't focused enough or willing to give you what you need, find a very experienced coworker to go to. Be willing to help them all you can and generally they will be willing to help you. There will be some jerks and you will learn them quickly.

You are going to be a great nurse.

Mahage

classicdame, MSN, EdD · Apr 24, 2009

Wow, sounds to me like you are doing a great job. All the right critical thinking. Paperwork is a nightmare to learn and is constantly changing so is an enormous challenge for anyone, including experienced nurses. As for the attitudes, the other nurse are reacting to stress. They will be relieved when you don't need to ask questions but in the meantime their attitude is creating barriers that slow down your orientation to the unit. Very self-defeating. I understand but still it is non-productive. The best I can tell you is develop a thick skin, continue to focus on the patient and allow time to cure some of these ills. Also, when you are precepting a new nurse in the future, remember how you felt "back when:. Good luck!

accessqueen · Apr 25, 2009

One of the best ways to learn things when you are new is to understand that wherever there is one thing that you missed, (i.e. pre op checklist), that's the time you go to someone and say "ok, now I know about pre-op checklists. What are the other areas that pt's go to that I need to know what papers to send or what actions to take? " Examples: what tests/procedures do patients need to be NPO for? hold certain meds for? get special preps for? need specific checklists? need specific IV access for?

Find out what are "typical" orders for the most common things you see in your area. (i.e. CPM settings). Obviously you don't want to go around making up your own orders for patients, but knowing what is typical and routine will help you recongize an unclear order when you see one, also will hep you recognize an erroneus order.

PT should have checked the patients orders so don't beat yourself up over that one. You'll have enough to beat yourself up over, don't take the blame for others.

There's no question, nursing is hard work, and unfortunately nursing school does not teach organizational skills real well (or at all). Besides learning specific nursing skills and care, go to the best nurses in your area and pick their brains about how they get organized, set their priorities, etc. They all have different tips that can help you.

THe biggest thing to remember is be PATIENT oriented, not TASK oriented. If you are patient oriented you will always have some sense of satisfaction because you can go home feeling like you helped someone. If you are task oriented you will always feel flustered because it will feel like you can never get caught up or accomplish everything you need to in a perfect manner.

llg, PhD, RN · Apr 25, 2009

I agree with the others. It sounds to me as if you are doing a fine job. "Not knowing everything" is normal. That's what your preceptorship was for -- to help you learn some of those things you had not known before.

It also sounds as if the staff you have been working with have been pretty reasonable. Sure, they get tired or irritated at times, but you can probably understand why -- and don't hold that against them too much. Their days are hard, too.

Just keep 'plugging away" and I think you will do just fine.

AMarie85 · Apr 29, 2009

Thank you so much for your advice.... I'm doing much better now.... I'll be graduating next friday and I'm really excited about that.... I am also assured that wherever I work I will get a good six to twelve weeks of training so it will be like starting from the beginning again which will help me alot.... I tend to learn by repeating things over and over....

My next concern..... Passing NCLEX