AusSRN

You've answered my question to a T. Thank you very much for your time!

I think it's great that you are thinking about patient safety. Going home and questioning nurses practices isn't a bad thing. definitely take bad practices as a learning opportunity of how you don't want to practice. I don't think this is you being a know it all student, it is something that should be checked. How does this nurse know what dose the tablets are if she isn't checking packaging? For example I did a patients medications two days in a row and one of the medications was 100mg so I had to half a 200mg tablet. In my head I thought "**** I didn't half this yesterday", so I dug through the drawer of meds and found that there was 100mg tablets and 200mg tablets and realised that the day prior I had used the 100mg. It's a bit different, but still proves that need to check.

In this situation, I think the most important thing to establish is why? Why does this patient not want to be turned. Are they in pain? Coginitive deficit? Or do they simply just not want to. If possible education on the importance of regular repositioning and explain the risks of pressure areas to this patient. Can you suggest to them to get out of bed for atleast an hour a day? You cant force them, but you can understand and education and feel as if you've done your best, atleast. And lastly, document the patients refusal.

Hi allnurses community! Im a new grad and have always found I struggle with writing notes. Patients who have notable things happen during the day, I write as I go. But for the other patients where I write near to the end of the shift I struggle with. I find I over think it and my mind goes blank. I am just wondering if anyone has any structure to writing progress notes? As a student I remember being given a really good one that I can't remember the whole thing. It was something like CNS, elimination etc. I've heard of the "go from head to toe" but I'm not a fan.. Just something as a guide and to jolt the memory as I have so much running through my mind in one day. Much appreciated! :)

Hi! Sorry if this is under the wrong topic. I am a final year, last ever clinical placement, two weeks in the Emergency Department. Which I am loving so far! However, I would like to ask Emergency nurses (and others) opinion on this: Our facilitators have told us we are not to go into a resus. It doesn't matter if you are allocated there, you cannot be involved or even observe. I can understand that these can be chaotic, and sometimes confronting. But I don't feel at this level, about to be an RN that we need to be this sheltered or bubble wrapped. The rational is that it isn't a great learning environment for student; totally get that but it would be great to see if I can clinically think why something is happening. Another reason, which I also agree upon is that if that were you or your family member you wouldn't want an audience. What are your opinions, Students in resus or not? Thanks in advance. :)

Hi everyone, I am a final year nursing student, I have finished all the academic side of things and just have 5 weeks of clinical left. I am currently on a busy surgical ward in a hospital that was where I dreamed to be. On my last placement I felt as though I fit right in, I was contributing to the team and I felt so confident by the end of it. But now 5 weeks out from being a RN, I feel so completely incompetent and useless. I'm finding it hard to fit into the team, I feel like everything I touch turns to sh*t! And I'm constantly anxious that I'm in the way, wasting the busy nurses time and it's hindering my learning and also my confidence!! I suffer from from anxiety and I feel like my nerves are getting the better of me here. I am so exhausted from constant worry, and I'm already finding myself laying in bed worrying about the things I did that shift. I hate following and relying on another nurse, I love love love working in a team but I hate as a student that I can't go give those meds, go make those IVABS in my own time. There's always someone watching and waiting on me making me feel rushed and then I just fumble and it gets so awkward. Did anyone else feel like this toward the final I was really expecting to go in here confident, excited and ready to work as an RN. But I've lost all of that.

This is what I thought also, as I gave the heat pack and just as soon as I got back to the nurses station she buzzed again to notify of the bleed. I feel as though it just bought her attention to the bleed. But I was made to feel as though I contributed to it.

Thanks a lot for your advice. :) I am finding that I'm dwelling on it too much and need to move on. I may try journaling. I'm not on placement today so I can't even be reassured that this patient is fine. But thank you again for your response.

Hi everyone, I am a student RN, a final year on my final placement. I am on my 2nd day at a big teaching hospital and I felt confident all day. My buddy RN left 2 hours earlier than I was due to finish and therefore I assisted other nurses and answered buzzers to help out. A patient asked me if I could heat up a heat pack she had to help with pain she had in her knee post TKR + infection = VACC dressing. Without hesitation I pottered off and heating it slightly for her and said I wished her to feel better soon. Half an hour later I saw nurses rushing in an out of her room, then a clode blue.. It turned out that there was a bleed (for the 3rd time in 3 days) in the wound on her knee... this lead to hypotension and a code. I was approached by a senior nurse who informed me that it is hospital policy we do heat up heat packs for patients and because I had done this, this patient placing it near her wound caused vasodilation and the bleed. I was nearly in tears at the thought that my good intention caused her to code. I spoke to this patients nurse who explained she probably had already had another bleed but the heat caused it to bleed more, and quicker. Not only did it cause this outcome, there was the potential to cause a burn to the patient. This is so obvious to me now, but the only thing I considered was if she had a pain patch such as fentanyl as I am aware that heat to these can cause high dose of medication being administered? But I cannot shake the self blame or guilt. I know I will learn from this but I can't help but feel so defeated and incompetent... I don't know how I'm going to go back without being anxious about everything I do now. I've never been a cocky or arrogant student nurse but I do like to be independent as possible. Now I feel I will be fearful to do ANYTHING. Have you made a big error and how do you get over that guilt?