newstudentn09

I appreciate the responses guys. TCV...I'm supposed to be as independant as possible so I am doing the head to toe, vitals, meds, orders, ADL's, I & O's, and of course charting that and other misc charting, such as education etc. One of my preceptors gave me some great time management ideas....we do bedside rounding so things like checking fluids and pain meds I try to check on during that point. I basically try to do report, look at labs, get meds, do vitals, head to toe, give meds and then chart. I think part of the problem is how long it takes for me to do my assessments and my charting. Thanks for your imput! Janfrn-thanks for that info...I remember that being briefly mentioned in school and will look into it more. Thanks for the advice because I did not remember that. I was told that I'm good with the patients, have a great attitude and it's obvious that I'm trying and have made improvements...I guess I just wish that while I may not be exactly where they want me to be, I will get there and because I care about my patients and my job and am actively trying to improve, that I'm a keeper. I will do my best and give it my all and hope it works out. Thanks again, I'm very appreciative of your response!

Hello all! Hoping for some advice!! I am in my 6-7 week of orientation as a new grad on a busy neuro unit in a big hospital in CA. I've had a few different preceptors, one had concerns about me getting the whole picture, another told me I was doing fine and another apparently has concerns about me getting the big picture. I've had a meeting with my manager and they need to see improvement by the end of the week, or, I'm assuming, I'll lose my job. I'm not quite sure where I'm going wrong, what to do about it or how to improve. I havn't made any major errors, no med errors or had any major mishaps. There are times when I am late getting my vitals and assessments done/charted and I stay pretty busy. The RN's on my floor take 3-4 patients and I am taking 3. These meeting with my manager make me nervous so I'm not sure what to say when she asks me what I need to improve. She also asked me a question about a patient's condition and I didn't give the right answer, I didn't think of it but as soon as she told me the answer I knew I knew that, it made sense to me. I really think I would be good at this type of nursing, I just think I am a little slower than most. I'm terrified of losing my job. I think what bothers me the most though is that my preceptors haven't really told me what I'm not getting, only one told me that they had concerns. Instead they tell me I'm doing fine, that I need to be more organized and have better time management but that comes with time. I was also told that I try to do too many things at once, that I need to stay focused on one thing and finish before I start something else. I understand this, that's how errors are made. But at the same time, you have to be able to multi-task in nursing and sometimes you may be in the middle of one thing but have to stop because something more important comes up. My plan tomorrow is to tell my preceptor that what I need is for them to allow me to tell them what I'm doing and in what order and why and then go over with them "the big picture" so they can give me feedback on what's right, what isn't and why. The other thing that bothers me is when I'm asked what I think I need that would be helpful and I tell them that being quized on my patients or having my preceptor watch what I do to tell me ways I can better organize my time and tasks I'm told that I'm no longer in school and shouldn't need to be told. There are some seeminly great people on the unit and I like it, I don't dread going to work. I just don't know what to do. Would love some advice! How far behind am I for being this far along in orientation?

I just accepted an RN job on a neuro floor where I currently work, although not in patient care. I had been applying since mid April and after roughly applying for 70 jobs I got my first interview. I was incredibly nervous for the interview and while I don't believe that I answered the questions as good as I could have if I hadn't been as nervous, I was offered the postion. To say I was surprised is an understatement. The hospital I work for is a teaching hospital and is stroke certified. I'm very excited but terrified at the same time. From what I was told, the patient ratio is 1:4/1:5 and the orientation time is 6-8 weeks. I've heard very good things about this unit and have been told that the preceptors love to teach and their turnover is low. I never had neuro experience in clinicals so don't know what to expect. The patient population as well as the specifics of the unit were went over in the interview but due to my nerves, I don't remember all of it. From what I do remember, the patient population consists mainly of stroke patients, spinal surgery, seizure monitoring and head trauma/injuries that are not critical enough for the medical ICU. I think I'll be able to learn a lot on this unit and like that I will also get cardiac experience as many of the patients are telemetry. I'm curious though as to what are the most common skills used for this type of unit? For those of you familiar with this setting, does 6-8 weeks of orientation seem appropriate for a grad nurse? They do have a new grad orientation I will complete but I'm not sure what all that involves. Any tips, advice or other words is very appreciated! And good luck to all those new grads!

Thanks for the replys girls! I will try your suggestions!

I just accepted an RN job on a neuro floor where I currently work, although not in patient care. I had been applying since mid April and after roughly applying for 70 jobs I got my first interview. I was incredibly nervous for the interview and while I don't believe that I answered the questions as good as I could have if I hadn't been as nervous, I was offered the postion. To say I was surprised is an understatement. The hospital I work for is a teaching hospital and is stroke certified. I'm very excited but terrified at the same time. From what I was told, the patient ratio is 1:4/1:5 and the orientation time is 6-8 weeks. I've heard very good things about this unit and have been told that the preceptors love to teach and their turnover is low. I never had neuro experience in clinicals so don't know what to expect. The patient population as well as the specifics of the unit were went over in the interview but due to my nerves, I don't remember all of it. From what I do remember, the patient population consists mainly of stroke patients, spinal surgery, seizure monitoring and head trauma/injuries that are not critical enough for the medical ICU. I think I'll be able to learn a lot on this unit and like that I will also get cardiac experience as many of the patients are telemetry. I'm curious though as to what are the most common skills used for this type of unit? For those of you familiar with this setting, does 6-8 weeks of orientation seem appropriate for a grad nurse? They do have a new grad orientation I will complete but I'm not sure what all that involves. Any tips, advice or other words is very appreciated! And good luck to all those new grads!

When I first started applying I only applied for new grad jobs but wasn't getting anywhere and started applying for just about everything. I just got hired for a position that had a requirement of 1yr neuroscience or critical care experience so sometimes you never know. During the interview the nurse manager told me that she loves new grads. Never hurts to try! Wish you luck!!

Hello everyone! I have to do a presentation on, "Refusing assignments when care would be unsafe-does the RN have the right to refuse patient assignments if staffing is poor or if the RN is unprepared? Does facility have the right to force the RN into mandatory overtime?" I'm supposed to describe the issue, give my opinion and then suggest some resolutions to solve the problem. My plan was to look at any state laws on the subject and if there wern't any, look at the policies of the local hospitals. I also wanted to include the positions of different associations such as the ANA. I'm finding info on the mandatory OT but can't find info on RN's refusing assignments from anywhere, including the ANA's postion on the subject. I'm also going to look at the nurse practice act and the position of Magnet. Does anyone know where I could find good info on RN's refusing assignments? I don't know why I'm having such a hard time, I would think that organizations such as the ANA would definatley have a position on the subject. I live in WA state and was going to look into local hospital union agreements also to see if that could provide me some info. Any help anyone could give me would be greatly appreciated! Thank you!

Hello! I just started nursing school and have been reading this board for the last month or so. I havn't seen this asked before but I havnt went through all of the messages so forgive me if this has been posted. I need to purchase a drug book, med dictionary, nursing care plan book and lab diagnostic tests book and have been told it's our choice, our instructors can not recommend one over another. What's the best or do they really all stack up the same? Also, like some of you, I am using the 7th edition of nursing fundamentals by Potter and Perry. At work I have internet access and wanted to utilize the book's website if helpful. I went to the website listed and registered but it only lists the 6th edition and comes up with nothing when I enter the 7th edition. On the back of the book it says the site has video clips and other resources I'd like to use but can't seem to find on the website. Can anyone help? I plan on utilizing the cd that came with the book also but can't use the cd at work, only the internet. Thanks in advance for your help!