mstaylor

Thanks everyone! What I find very hard is whenever there is a new procedure such as hanging blood (which I have never done before), changing the settings on the PCA (new for me), Heparin IV(new to me) or any NEW procedure on the med-surg floor.....I am told I need to look up the policy and read it. I never know from day to day what type of patients I will be getting for that day. I have looked at the policy's and procedures and it is quite time consuming to read all of this info. And the list of these policy's is never ending. The moment I am finished getting report at 0700 to 0715, I have patients calling me for problems, IV machines not working, etc.....and I have not had a chance to review their chart or learn about this type of surgery or new procedures to deal with for that day. I have an 1 1/2 hours to get info on each patient, their med info, lab reports and assess and document on each patient. And during this time, I am called numerous times to answer my patients lights, toilet them, bathe them, clean up patients incontinent in their bed of urine or diarrhea, get their breakfast ready, do the I&Os, vitals, etc.. My orientation right now is 4 patients and no NAC. I am still with a preceptor, but she is not to help unless I really need her. All the other experienced nurses have NACs to help them. Every night after work, I read policies on my own time and take some home to read. I also constantly have a different preceptor. That is hard because each one tells me, "That is not how it is done here." So I am not sure who to believe and it is things not specific in the policy. Example: documentation on the assessment sheet. Like one nurse tells me I cannot chart those specific words and a different preceptor the next day will tell me I must word my assessment in this way. I feel like I am in Nursing Boot Camp. But, as negative as this all sounds, I still love being on the Med-surg floor. And everyone of my preceptors is so friendly and nice to me. They all make me feel very welcomed! I just wish the program on training was better and more consistent instead of making me feel like I am spinning out of control. I find that Admissions and discharges are very hard. The process is so complicated. Thanks for all of your support! I have another week left of training.

Thank you, thank you, thank you for giving me such inspiration! I had another really bad day today and my weekly evaluation by the supervisor. She said I am doing good but need to work on time management. And she told me again today I need to be taking care of 4 people next week and manage them well. I get so far behind because I am not sure about certain policies that take forever to read and not sure who I should contact for certain things. Anyway, I will hang in there!

I have another comment about my orientation. I feel so frustrated trying to get done with everything managing 3 patients. I had 2 heavy load patients plus one demanding young adult patient. It took everything I had to get done with everything before the end of the shift. 15 minutes before giving report to the next shift, all 3 of my patients needed time consuming needs, plus I had to finish my I & Os and end of shift notes. So of course, just one patient nearly took 15 minutes and I have the nurse on the next shift standing there waiting for report looking at me as though I am incompetent. I asked my preceptor how she handles this type of situation. But got no response! Yes, I was assertive when I asked. By the end of my orientation I am supposed to be able to finish my shift managing 4 to 5 patients. I don't feel like I am getting good instruction to help me reach this goal.

it happened again to me today. i had a 10ml syringe of pepsid to give over 2 minutes (5ml per minute). i went into the room to give it iv push, but my preceptor said, "oh no, just put it in the infusion pump!" i don't understand why. also, i have been reading up on different iv meds so i know the common ones as to how much time it needs to be iv pushed. most are anywhere from 1 minute to 5 minutes. of course i am trying to be a good nurse to time my iv pushes (a couple of preceptors let me iv push instead of putting it in the infusion pump). these preceptors said to me to just push it in quicker, there is no time to wait the full 1 or 2 minutes cause you need to get to the next patient. yes, i feel like i am going crazy in my head with all this. now i am looking at the clock half way through the day to see how much time i have left to go home.

Thanks for sharing your story Nrs Angie. I also have those similar stories happening right now with the way I have been doing certain nursing procedures for the last 10 years as an experienced nurse and what I learned in school compared to how the nurses want me to do things in the hospital. I am glad for the nurses to show me their way, but at the same time it is quite frustrating as I am learning my new job.

i am feeling quite overwhelmed with orientation. i am a rn with 10 yrs of experience in ltc, with no hospital experience. in a 5 day period, i have been orientated by 3 different nurses, all of which have their own way of doing things. so each time i get trained by another nurse, it slows me down because now i have to switch gears in my brain to figure out and learn their way for the day. every time i get a new nurse to train me, i have to start all over to show them that i know how to do a head to toe assessment. i have 3 patients now and have so much to learn. many times during the day i have to call and wait for my preceptor to show me how to do a procedure, or have her watch me (she is busy with her other 2 patients). and plus, i have other nurses that call me for their patients to watch new procedures or do it for them because i have to get a lot of skills checked off by the end of my orientation next week. what bothers me is that at the end of the day (with everything done), i am told i need to work on time management. yet some of my time loss is anywhere from 1 to 2 hours during the day waiting for my preceptor or pulled to do procedures on other nurse's patients. it is noticed by my preceptor i am slow to think about what i am doing, but that is due to my lack of no experience in this setting. every thing i am doing is new to me from doing labs, setting up ivs, pulling meds out of the pyxsis, etc.......... is this normal to happen during orientation? what is it like at other hospitals?

yes, thank you daytonite.....i came up with those same answers when i did the math in my head prior to giving the meds. but my preceptors told me different answers such as for the 1st question, 75ml/hr or 150ml/hr. i am glad i am not thinking crazy. i am having a hard enough time learning how to work on the med surg floor.

I have been an RN for 10 years with almost no experience in using Infusion Pumps for the last 10 years. I have just started my orientation on the med-surg floor. Everything I am learning is new to me. I am quite overwhelmed but I am excited and eager to learn this speciality of medical-surgical nursing.

Thank you UKstudent, that is what I came up with when I did the math. For the first question of 10ml in one minute...different nurses told me to set the rate at 75ml/hr or 100ml per hour or 150ml per hour. It was my first two days on the floor and already quite overwhelmed, I thought I was going crazy when they told me these off the wall rates. Again, thank you!

I'm new in the med-surg unit. The nurses asked me to set up the IV pump to infuse prefilled syringes. I am confused as to what to set the rates at. Each nurse tells me something different. (yes, I know I can IV push the first two questions) I do the math, but I do not come up with what they want me to set the rate at. 1) Prefilled syringe 10 ml to infuse over one minute. (I can't remember the med on this one) What is the rate set at? 2) Pepsid 20mg in prefilled syringe of 10 ml, infuse over 2 minutes. Rate? 3) Prefilled syringe 30 ml, infuse over 30 minutes. Rate? Thanks for your help