sasrn0988

I worked PCU/step-down for about a year before I transferred to ICU. The patients I saw were more med surg/trauma since that was the unit that I primarily worked on. I would see trauma patients (we are a level 2 trauma center) and I would see patients who were BiPAP/CPAP dependent (who needed to be intubated if they couldn't handle non-invasive) and I would always see afib patients, sepsis, alcohol withdrawal, CHF etc. There were specific gtts we could do on PCU before they got upgraded to ICU. Overall, it was a good experience as a new grad, but it definitely varies between hospitals!

I took the CCRN after studying for about 7 months, I worked PCU before I took the test but I only had about 1 month of ICU on my own. I would say the Pass CCRN and the AACN 180 question book were what really helped me pass!

I recently had an African American patient call her 1:1 CNA a slave and told her to go back to Africa...she could answer all of her orientation questions correctly, too. She also took one look at me at continually called me a liar and said she didn't trust me until her daughter told her otherwise.

I am almost finished with a 12 week PCU residency. I am a new grad and I'm not going to lie, I'm kind of nervous of being on my own soon! I am most worried about time management/falling behind since it is an extremely busy floor with lots of admits and transfers at night. The majority of my co workers seem very supportive of new people, which is great. Anyone have any tips on how they survived the first few months on their own?

Thanks for the responses! I will be trying to incorporate some of this info along with what my preceptor's have said into my future notes.

Thanks for the replies! She was my preceptor for the night, but said that she wanted to show me how to do everything I listed above as well as which MDs to call, but said there wasn't enough time since she had to "help me a lot". She just barely showed me how to do everything that was new so I got behind on charting and had to clock out late. At least I know what to do for next time.

Last night was my first night shift, I have been orientating on days for about 5 weeks so far. On day shift I had started to figure out how to plan my day and what needed to be done. My preceptor told me I was doing a good job and it was going well. Last night, about half way through the shift I kind of lost it and the nurse I was working with told me it was a "disaster". There were about 3-4 additional things I had to factor in on night shift (am labs, totaling I&O, 24 h chart check, reviewing new MARs) and I didn't allot enough time, so I was late on charting. I told the nurse I was working with that the flow of nights was different for me (it was my very first!) and she kept telling me that night shift and day shift are almost exactly the same. I guess I feel kind of frustrated and a bit discouraged. I just wanted to vent I guess!

I just started about a month and half ago and I have these exact same feelings. I just had my first night shift last night, which didn't go so well, but I understand where you are coming from! I really can't wait for the 1 year mark :)

I definitely like the way you said you should be able to see exactly what went on during the shift. That's something that I will be keeping in mind during my next shift. I do fine when charting the shift assessment and reassessment on the flowsheet, it's just the notes that I struggle with. For instance, this is how I would start one of my notes, but some nurses have told me this is too vague. 0730-assumed care at the bedside from noc rn 0815-assessment complete, no cp, sob, denies pain. vss, will continue to monitor anyways, that is just an example of what we are expected to do. One nurse said if my notes are too vague then it looks like I haven't done anything for the patient even though it is charted elsewhere on the assessment flowsheet. I just want to understand/gather more info on what others write in their notes and if anyone writes out extensive notes about the entire day, including routine activities, like some nurses I have worked with.

I'm a new grad currently in the middle of orientation at a hospital that is still using paper charting, at least for a while. I was wondering (for those of you who currently use it or have used paper charting) what you put in the nursing notes/nursing narrative. My preceptors have said I need to work on this as my notes are too vague. Sometimes I feel like I am double charting things that are located in another part of the paper chart. If anyone has any suggestions as to what is most important to put in the nursing narrative please share.