nwrn2010

Take it as soon as you can! We had an awesome review course by F&S. My best friend in nursing and I stayed at a hotel in the city our test was and we had a pool. We enjoyed the sun the day before our exam when we got to the hotel and that night we ate at a restaurant by the river and went shopping :). DO NOT STUDY the night before. I promise it will only make you more nervous and increase anxiety. Relax the night before with lavender candles and bubble bath from b&bw. It is hard to explain but the questions they ask is really nothing you can study the night before. It tests your knowledge you have gained throughout the program, cramming will not help. I passed the first time with minimal number of questions, so did my friend! There is also a trick you can do after you take it to find out if you passed without having to wait the full 2 days! :) GOOD LUCK! :)

I am a new nurse also and I might can help you with some of your concerns. If an IV has infiltrated...it is pretty noticeable. Usually, a bubble forms and if not, when you feel the area where the catheter should be, it feels "squishy". That needs to be taken out immediately and apply cool compresses (check with your hosp policies if you have to have a doctor order for these). Another way you can verify if the IV site is still working is to take the tubing out of the IVAC and unclamp the tubing halfway or so and if the fluid drips freely, it is fine. It needs to be restarted if the fluid does not drip. Of course, you can pull back on the catheter to ensure it isn't kinked before removing it. If the site is red and tender, it is probably phlebitis and warm compresses should be applied after removal of the IV. About the Phenergan/Dilaudid med administration: I have had other nurses tell me that the effects of Phenergan will potentiate the pain meds. In other words, they play off of each other causing a more sedative effect. Correct me if this is wrong fellow nurses! In fact, I have had pts request them both at the same time, and if it wasn't time for the phenergan (usually scheduled q6) they didn't want the morphine/dilaudid. These patients are usually current/retired medical professionals and usually nurses. :uhoh21:

I am also a new graduate and I learned a lot from this post. Being new and terrified to make a mistake, I check the order at least 12 times before I administer anything. I never want to become too comfortable giving meds because it's the fear of making a mistake that causes you to exercise extreme caution. I was pulling meds out of our omnicell yesterday and I always look at the med before i shut the drawer to make sure it is what I am supposed to be administering. It told me bin x was aricept and I pulled diltiazem out of that same bin. I called the pharmacy and we got it straight but even with a computerized system, meds get misplaced!! ALWAYS CHECK THE MEDS!! Another incident with the omnicell and this happened to another nurse: a vial of Lasix was mixed in with the vials of heparin! Both have orange caps!!! It is so important to read labels and make sure it is correct. This nurse caught the error as soon as she picked it up but it is still scary. I know we get in a rush on the floor but we should always take time to do the 5 rights!

Thanks for posting this!! It made me feel SO MUCH better! I know my patients are thinking, "what the heck is she doing?" I check, then double check, then check, check, check, and before handing them the cup check again. Haha! Of course, it gets better throughout the shift but it still takes me forever! I am just scared to death to make a mistake. In fact, because of my checking and reading everything on the eMAR I discovered a small, yet still an error. One of my patients last week had Nystatin ordered and I have previously administered it to another patient where the order read "swish and swallow". However, this patients order stated to "swish for 3 min and spit". I was pouring it into the cup when the patient stated, "do I have to take this? It makes me nauseated." I gave her the ordered instructions and she told me she had been told to swallow it. Definitely not a life-threatening error, but still an error.

It is unrealistic to check every med by the physician orders. I will verify the order if I am the first one to give it or it's a questionable order. The first nurse signs off these orders, the pharmacy checks it again, and then it is checked during the 24 hour chart check. Even though it is possible to miss things and mistakes are made but I could not imagine checking every order.

Zofran is definitely compatible with LR. However, I recently gave zofran IVP with LR being the primary IVF and ampicillin had finished infusing as IVPB and found that it's not compatible with ampicillin. Precipitate formed so I clamped the line, no harm done but still scary! Will never do that again! Now I find it good practice to flush the line before and after IVPs!!! :) For the post about it being incompatible with LR, perhaps there was something else hanging that made it incompatible?

It is great to help out with the basic needs of the pts especially when you do not have anything else going on. However, when I became a senior nursing student, our instructor had to make it clear that we were not there to do the aids job for our patients. We would walk on the floor and they would immediately ask what pts we had because they thought we would be taking over for them. Don't get me wrong, if my pt needed something I did it. It is important to make it clear that you are there not really "shadowing" the nurse, you are the nurse! Tell her what you will be doing under the supervision of your instructor. To get the most out of your clinical rotation, try to make yourself as comfortable as possible and tell yourself that you are the nurse! :)

Well, I am a female and clicked on this thread! Haha! Am I allowed in here??? We actually do not have any male nurses on my floor but there are several male PT, RT, etc...and they flirt but I would not even call it "flirting". We all have fun and need a laugh every once in a while (as you all know!). What about the female patients?? That's my concern, these dirty ole men! lol Not to mention, their wife, girlfriend, fling, etc is right there in the room! Can be embarrassing and uncomfortable, right??

All of these posts have some really good advice for getting the most out of your clinicals. I can also remember when I thought some of my nurses in clinical sat behind the desk more than she was giving patient care. Pretty easy for me to say when I only had at the most 3 patients. You too will quickly learn when you have 6-7 patients, grouping pt care together and delegating are so important because our jobs as nurses (other than overall care and management of the pt) is to assess the labs, xrays/tests, signing off orders, and notify the doctor of any changes. Not to mention constant admissions/discharges. I love doing patient care but most of the basic care is usually delegated because more than likely, another pt is requiring attention. While you are in clinical, my advice would be to get into everything you can! Discover equipment, touch the different tubings and familiarize yourself to the hospital's way of running things. Always volunteer and make yourself available! I would always get to do more cool stuff because I would be in the hallway or at the nurses station when I felt like something was going on (which is pretty much all of the time). Don't spend your time in the "conference room", get in the action! I understand that you feel like you are "in the way" but take responsibility for your own learning experiences and create opportunities for yourself. I promise, you will benefit in your first job the more you experience in clinical! :) Best of luck to you! And remember, these nurses where once students too! Of course, if you feel like you are not learning enough, get your instructor involved! They can pull out equipment and explain procedures! Also, let the instructor know what you would like to do (IVs, foleys, trach care, central line dressings, dressing changes, NG tubes, etc) because it is much different with "real" pts than it is with those dummies! :) Hope this helps! And the most important thing about clinicals, HAVE FUN!

Thank you for your input! I am actually already starting to learn that I have to let some of the less important things go...at least until the important things get done! I became so anxious when my meds were late and now I have become a little better about grouping things together without decreasing the quality of care to the patients. The pts will get their meds eventually, I am only one person! I worked today and I didn't leave until 8:45 because I was behind on charting. But guess what? Other nurses (with 10+ years of experience) were right there doing the same thing! Some days are just busy! Coming from a student nurse (with 3 pts at the most) to working on this floor with 6 pts, I have already improved on time management and prioritization. You can't just learn these techniques, they come with experience. However, I have an awesome group of nurses who are always there and help when I am drowning. I even call on them for questions that might even sound crazy to them but they never make me feel crazy for asking. I would much rather ask and be sure, then to do something and be wrong. I know that this experience will prepare me for any other area of nursing I decide to go into. I just don't think I could be in a non-hospital setting and gain such a broad knowledge base. It comforts me to know that I am not alone when I feel like I am going to lose it! Haha :) Oh, and another point I have already learned: go with your "gut" instinct! If you feel like there's something going on with the pt, speak up and get an order! You are probably right!

Thanks for your input! I apologize, I had a preceptor but I am going on a month working "independently". Most of the nurses are very helpful while others aren't but that's everywhere! Thanks for making me feel "normal"!

I am currently working at a local hospital on a med-surg telemetry floor. I have started working without a preceptor for going on about a month and I am having trouble adjusting. I find it hard to sleep the day/night before my shift as if anxious about what tomorrow will bring. I also worry about making mistakes and causing patient harm! I am very careful but it gets hectic on the floor and I come home and worry if I hung the right fluid or gave the right dose of the meds. Is this something you are going through as well or am I alone? Should I reconsider being a nurse? How long will this last? Help!!

I am a newly graduated RN that has been working at a small local hospital for about a month without a preceptor. I did not have a clue that nursing would be this draining (emotionally and physically) but I love it with all of my heart. However, I am having trouble sleeping the night/day before my shift begins. I find myself getting anxious about what tomorrow will bring and nervous about making mistakes. Is this something that every nurse goes through? How did you cope? Please help!