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.
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.
Ask an RT on the floor to explain the vent settings to you :)
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...
Don't be so hard on yourself! I froze up so many times when I should've offered patients an explanation, and my nurse had to jump in and answer. ALSO, something that made me feel really stupid, Dr came in and was putting in a subclavian PICC and asked me where we was placing it "below the clavicles" and I was like uhhh, even though I knew this. I felt so so SO stupid. It was just being put on the spot like that, with both the MD and the patients, I had a brain fart. It happens. My preceptor told me talking to the doctors and the families will become easier with time as you gain more confidence :)
Sunday was my last day. I can't believe it went by so fast. It was so funny to re-read my initial post. This was a great learning experience for me, but I felt that it needed to be longer. I feel like the last 2-3 days is when I really started to feel comfortable and more independent. I felt like I was just getting started. I wish it was longer because there is so much more that I need to learn. That last day we had a 3 patient assignment, and it was crazy! This clinical has motivated me to start studying for the NCLEX. I checked out a bunch of books from the library today. I also just started a patient care tech position.
I will tell you though that on my last day one of the fellows came into my patient's room and upon finding out that I'm a nursing student began quizzing me about my patient's pacemaker... I don't know much about them, it was my first time having a patient with one. All of my answers were wrong and I felt like an idiot. When he asked me what year I'm in, and I told him, he gave me a strange look. So this also has motivated me to start studying and learning as much as I can.
One last thing,
I am really interested in working in the ICU now that I have had this clinical. I asked my preceptor what she thinks of new grads starting out in the ICU, she told me if it's a thorough orientation program then she's for it. One of the other nurses though strongly suggested that I get at least 6 months - 1 year experience on a floor and then move into the ICU. This makes sense because I feel like there are a lot of skills that I need to learn and fine tune before I start working with the critically ill.... but now I'm not sure. I know there might be other posts about this same question, but I'm curious ... what do you all think?
Again thanks for all of the encouragement and support! I made it!
I am really interested in working in the ICU now that I have had this clinical. I asked my preceptor what she thinks of new grads starting out in the ICU, she told me if it's a thorough orientation program then she's for it. One of the other nurses though strongly suggested that I get at least 6 months - 1 year experience on a floor and then move into the ICU. This makes sense because I feel like there are a lot of skills that I need to learn and fine tune before I start working with the critically ill.... but now I'm not sure. I know there might be other posts about this same question, but I'm curious ... what do you all think?
Personally, I am a firm believer in trying to start out where your heart is. I think it is silly to waste a year in med/surg when that is not what you want to do. I fully intend to try to get a new grad ICU position when I graduate and a lot of hospitals in my area have new grad critical care nurse internships. IMHO, if critical care is where you want to be, you WILL be successful at it.
I accepted a position on a telemetry unit because I feel I need to have stronger cardiac skills before I go to the ICU, but if you are comfortable with your knowledge base, then go straight into ICU.
fsh1986
39 Posts
Ask an RT on the floor to explain the vent settings to you :)