On Monday I will begin my final semester of nursing school. This semester I will be completing a preceptorship. I am EXTREMELY nervous about next week. I am hoping some of you can share your preceptorship experiences with me or at least give me some advice!
My first concern is that I asked to be put in a pediatric hospital (preferably a cardiac unit). Well, it turns out that only 6-7 students from my class got peds, and I got put in an adult cardiac ICU!!! First, I feel that this will ruin my chances of ever getting in peds. The two pediatric hospitals in my area hire students that either worked as techs for them and/or completed a pediatric preceptorship. I won't be getting to do either. I won't give up though, I'm still going to apply.
My second concern is the fact that I will be in an ICU!!! I honestly feel like I haven't learned much the past 3 1/2 years. When we had group clinical rotations, I never got to do much. I mostly got tech experience with baths and changing linens. I gave medications a few times and started an IV once (which I sucked at). I am TERRIFIED about being put in a critical care setting. This is all final, so I can't change it or ask to switch with another student. What can I expect from my preceptor? I am wondering if I will be with her the whole time or if she will expect me to do things on my own.
Well, I start tomorrow. I am so nervous and scared to the point of crying. I'm going to review as much as I can. I'm also going to watch a couple of videos on youtube. But even then, I am sure that after studying I won't remember 85% of what I studied, so what's the point? I can only hope my preceptor is nice and understanding. I'm going to let her know about my lack of experience. I am truly hoping that the first day I'll get to do more shadowing just so I can get more comfortable. But, who knows, she might expect me to care for a patient. And if that's the case, we'll that patient's life is going to be even more at risk!
You are not a new grad RN who just got hired onto the unit. This is a clinical - only you do not have classmates so you get a lot more attention. You will NOT be expected to know critical care and you will NOT be expected to go in and do things on your own. The purpose of this preceptorship is to get one-on-one learning with an experienced RN (and be experienced I mean experienced in the cardiac ICU setting and experienced precepting students). Go in there with an open mind, an eagerness to learn, and a lot of initiative and you will have a great experience. Unless you feel comfortable doing so, you will not be expected to go in and do things alone! It's a learning experience!
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
if you go looking for a "witch' of a preceptor, you're more likely to find one. if you go looking for the best, you're more likely to find it. stop listening to horror stories . . . even preceptors are human.
if you go in with a good attitude, ready to learn i'm sure you'll learn a lot. you might even discover that you love ccu. if your dream is to work peds, a little adult experience isn't going to hurt you at all. you still need to learn to be a nurse -- how to do assessments, how to give medications, put in an ng, an iv and a foley, how to talk to patients and doctors and families. there's a lot to learn.
once you've had your first day on the unit, you'll have a great idea what drugs, disease processes and procedures you'll need to look up. good luck! i hope you have a great experience.
It wasn't nearly as bad as I thought it was going to be. The first day my preceptor only had one patient who was getting better and was eventually transferred to the floor by the end of our shift. My preceptor's personality is the opposite of mine; I'm more introverted. So our relationship is somewhat awkward, but hopefully it will get better. The first day I felt like a total idiot, not knowing what to do, feeling so confused. She was patient with me. The second day my preceptor's schedule was changed to on-call, so I got put with a different nurse, who was really nice. But, both of are patients weren't very complex. The first one got transferred to the floor, he was stable when I was there. There were talks that the second patient was going to get transferred. I felt stupid the second day, but I feel like I did do more and I was a bit more comfortable. I guess I was excepting more critical patients in the ICU. The patients I took care of were just like patients in my other clinicals.
And every time I come across something new, I write it down and look it up when I get home. Now something I don't get is VENTILATORS. All the different types, the settings, ... I tried looking it up but get even more confused. So if anyone has any websites that are helpful, please let me know. Also I need help with IV pump machines, so I'll try to look that up on Youtube.
I might try to get in 2-3 shifts this week. I must say 12 hours is tough. I am exhausted by the time I get home. But this is good practice.
I also get so nervous when someone asks me something. One of the patient's family member asked me something, I knew the answer but I think I just ended up confusing the patient. When the nurse came and answered her, I was like: why didn't I say that?
Also one of the doctors asked me something, and I couldn't answer him because I completely FORGOT. Right when he left, I was like I know the answer, We did do that, why did my mind go blank the moment he asked... ugh...
And every time I come across something new, I write it down and look it up when I get home. Now something I don't get is VENTILATORS. All the different types, the settings, ... I tried looking it up but get even more confused. So if anyone has any websites that are helpful, please let me know. Also I need help with IV pump machines, so I'll try to look that up on Youtube.
You do not need to be an expert on the ventilators. If your hospitals are anything like ours, the respiratory therapists manage them. Nurses obviously need to have a general idea, but nothing like the RTs! :)
Part of my patient charting has a section where I have to include the numbers from the ventilator screen. I am still struggling with this. I tried doing a Youtube and Google search but I have ended up even more confused.
I would like to learn the basics... the different types and their differences: BiPAP, CPAP, AC... the settings Mean, Peak, FiO2, TV/STV....
If anyone has any documents, websites, videos, or books that would help me understand this, please share... or if you're willing to teach it to me... message me
I can't help with vents, but just wanted to say good luck with the rest of your precepting. I, too, didn't get the spot I wanted. I ended up having a fantastic experience and got a job on that same unit. I've floated to my hospital's CCU a couple of times--you are lucky! Enjoy it. :)
Since no one can help me with vents, maybe you guys can help me with IV pump machines. I'm definitely feeling more comfortable with using them except that I'm confused about secondary pumps. When do you use it and how do you know when to use a secondary IV? Also what does Keep Vein Open mean? And when do you do so?
Keep vein open is when an IV is running at 30 ml/hr. This is what I learned in school + my hospital. However, your hospital policy may be different on what rate KVO is so please check the policy. It can also vary if it is a central line or a PIV. It is, quite simply, to keep the vein open. Generally, the doctor should specify a rate (most ignore that policy and just order KVO).
At my hospital, we use a second IV when a patient has to have two IVs running at the same time that are not compatible. Otherwise, we always try to do piggyback or tandem. One IV can be hard enough to start and maintain :)
I did my preceptorship in ICU and I loved it. Be willing to do anything and everything and JUMP on an opportunity you can get to do things. Tell your preceptor that you want to do as much as you possibly can... Let them know you've never put in a cath and that if someone needs it, you want to do it. I believe you control how much you learn or do during your preceptorship... It's a great learning experience, if you're willing to help other nurses as well. I had my preceptor, but I also volunteered to do suctioning for one nurse, trach changes for another nurse... ANYTHING you have the chance to do, DO IT!
Keep vein open is when an IV is running at 30 ml/hr. This is what I learned in school + my hospital. However, your hospital policy may be different on what rate KVO is so please check the policy. It can also vary if it is a central line or a PIV. It is, quite simply, to keep the vein open. Generally, the doctor should specify a rate (most ignore that policy and just order KVO).
At my hospital, we use a second IV when a patient has to have two IVs running at the same time that are not compatible. Otherwise, we always try to do piggyback or tandem. One IV can be hard enough to start and maintain :)
KVO I think varies by city.. All the hospitals I did my clinicals at, KVO was 10 ml/hr
foreverLaur
1,319 Posts
You are not a new grad RN who just got hired onto the unit. This is a clinical - only you do not have classmates so you get a lot more attention. You will NOT be expected to know critical care and you will NOT be expected to go in and do things on your own. The purpose of this preceptorship is to get one-on-one learning with an experienced RN (and be experienced I mean experienced in the cardiac ICU setting and experienced precepting students). Go in there with an open mind, an eagerness to learn, and a lot of initiative and you will have a great experience. Unless you feel comfortable doing so, you will not be expected to go in and do things alone! It's a learning experience!