CS1234

Im interested in this topic also. Im finding out that many nurses at my institution "take off" orders for different reasons. They are - "I saw the neworder", "I saw and initiated the order if appropriate", "the order iscompleted", and "I have professionally evaluated this order". My institution also has electronic medical records (EMR), no paper charting unless we are on contingency. So, because of this, my institution is trying to define "taking off orders". Regardless, thank you for the continued discussion. If you have your hospital's policy, I'd greatly appreciate seeing it to develop one for my institution. Thanks all!

I will admit, I do have "12 hour brain" especially after three straight twelves. BUT I do love seeing positive outcomes in my patients when I am with them for 12 hour periods.

.... you read that correctly. i recently transferred to the icus after three years med-surgical experience. i have been on orientation for approximately a month now and the precptor i have is absolutely experienced in icu nursing after spending 20+ years in a trauma i level hopsital. while the hopsital in which i work is definately not that acute, we still have critically ill patients. this weekend i worked three twelves with the same patients all three days. these patients were assigned by my preceptor (who also doubled as the charge nurse all weekend long). these two patients were what we call "pcu status" patients, meaning, they should be in pcu, but pcu is full. so, these two patients are in the icu. pretty much glorified medical surgical patients with nothing acute...no ventilators, no titration of drips, no arterial lines, swans, no "get-the-crash-cart-ready" etc. these cases were nothing that i have not received in medical surgical nursing. my preceptor, checked e-mail, texted, and worked on her novel all weekend long. she checks in with me occasionally and asks if everything is "okay", which is nice of her.... i have asked her for higher acuity patients in the past, and expressed that i am afraid to come off of orientation not having but one vent patient etc. instead i get pcu status patients. and when i ask "what happens if i am not ready at the end of orinetation to come off" she replies, "you'll just be on it longer". not acceptable! i hope she is joking, but i overhear her making jokes to her coworkers "im not doing anything, [this writer] is here, she's doing the work". she obviously feels that i am more then capable to handle these pcu patients or else she wouldnt leave me alone with them for hours upon hours while she is in another area of the unit working on her novel. she even told me on saturday that she was going to sit by c (our team mate) because her patient was looking pretty critical and she thought c would need some help. she stranded me on my orientation and went to assist with the critical patient that i should have!!!!!!! arg! i feel as though i am given the easiest assignment on the floor so that she doesnt have to do work/teach me. and thats not fair to me. i have a lot to learn about icu nursing. so here are my questions... i have already adressed with her that i want the hardest patient and the first admission every day and i continue to get non-acute, non vented, non titrating drip etc patients. should i reiterate that before i go to our nurse manager? should i request a new preceptor? what is interesting is that on the med-surg floor that i came from, i was a preceptor. and i would never give my orientee an easy patient to get out of having to do work. but do i want to make a cannon-ball splash in my new department by demanding a good preceptorship? do i allow my orientation experience to suffer and keep quiet?