Michelle123

Just curious, you are talking about continuous aren't you? Doesn't that cause issue with requiring the woman to lay in bed throught her labour? Or do you have portable monitors? Do you get many women that refuse? Or place their own restrictions? Say Doppler once an hour or something?

I'm concerned with the 'us and them' mentality between the wards and emergency at my hospital. I'm just wondering if it's just me or does it happen in other areas? It feels like I am always inconvienincing them when I take a pt up. We get icy reception and the poor pt often feels like they shouldn't be there. I feel really embarrassed to be there. Don't they realise we are all there for the same reason, and we are all busy. We should be supporting each other. Or is it just me?

Yeah seeing docs do IV's and stuff on TV. Doesn't happen in real life. The only time I see a doc routinely do IV's or bloods is in emergency. Actually the only time I see a doc routinely do anything practical with their patient (aside from assessment and writing drug orders) is in emergency. But in the shows, the nurses are nowhere to be seen or at the very least in the background. Funny the reversal isn't it.

I must admit I'm pretty ok with most things now. I still get watery eyes from being up close to the really bad BM smell, and sometimes vomiting will do the same, but the one thing that really bothers me are babies/toddles crying, like really crying, when they are scared, and upset, and don't know whats going on. It breaks my heart. I just want to scoop them up and snuggle them. But of course that woudn't really help and I think they wouldn't feel the same way I do about it :) Some weird scary nurse that you have never seen grabs you for a cuddle! But I've only had to do suctioning a few times. Plus I love anything wound like. Anything that needs to be lanced and I'm in there. Anything with a discharge, you can't keep me away from. This is why my hubby wont let me talk about my day at the dinner table!

Hi everyone, I have just started a 2nd yr Emergency nursing program. I am in my 6th week of it. I rotate between a few different hospitals the main one being a major trauma centre, which I get to spend the most amount of time. The hospital I am at currently is the same hospital I did my new grad year which is fortunate. I feel that I have been eased into this transition, but it is still a little overwhelming. I also am in the process of learning how to take bloods and cannulate, but I need to be supervised at least a few times, and I'm not all that confident about it. The program co-ordinator has been understanding and has assured us that we don't need to worry about it yet, but I do feel a bit stupid not being able to do it yet. I'm just focusing on my assessment skills atm, and thinking through the pathophysiology and what could be going on. I'm learning a lot and also feel that the docs treat me differently then they do on the wards. Different in a good way. But maybe that is because we spend more time together in emergency. Anyway, Just thought I'd introduce myself as a newbie here and let you know I'll be here asking questions all the time. Any tips? Michelle

Over here they ONLY employ midwives in L&D. So this is the only way for me to get experience. So back to the original question, any tips?

Nope.

No, here you can't get experience unless you are a student or registered midwife. The whole point of the program is not only for you to complete the post grad diploma, but you are employed as a student mw throughout the program. I guess we do things differently here in aus.

Some of the HTN that I come accross is because due to the length of time the person has been in ED, or due to their injury (I'm on a surgical ward), the person either hasn't had their regular antihypertensive meds, or their regular med weren't all charted, such as a GTN patch or whatever.... But that isn't usually the case with medical patients I've come accross.

I'm currently rotating on a busy surgical ward.. We have ortho, general surgery and a few urology as well as general medical patients (the overflow from the medical ward). Most days we are above capacity -44pts. The ratios are 5 patients to one nurse, but it is in groups of 10. So in my team there are two nurses for 10 patients. I am responsible for knowing what is going on with all 10 patients and for their care when my team mate is unavailabe. I'm still very overwhelmed. Most if not all of my patients need full assists with mobilising, showering and or bed sponge. This last two weeks, two of my patients required a sling lifter to get them out of bed. It takes me so long to get everyone up and showered and ready for the day it is almost lunch time. Then I need to make sure the fbc are up to date, care plans are done, mid morning obs, lunch time meds, prn pain medications (that have to be signed out by 2 nurses) hand over needs to be done by 1300hrs for the afternoon staff, discharges, post op patients with 1/2 hrly obs. Then patients want to talk to me about stuff, which is important, but I just don't have time. I feel that I am lucky to achieve the bare minimum by the end of my shift. I don't feel satisfied at all. I'm not providing the nursing care that I want to give. I just don't know if I should just wait it out? Or if there is something else I could be doing? I've been working for 6 months now, but only two months on this surgical unit. Should I be doing better by now?

Hi, I am currently a new grad RN and have just applied for the post grad diploma student midwife position. They will probably have interviews the end of this month beginning of september. Do you have any advice for the interview (if I get one?) also, as this is any area I would really like to get into, I will apply again next year if I don't get a position this time. Would love some advice for the aspiring midwife?

I am a new grad who has just spent the last 20 weeks rotating in a medical ward where we have a portion of palliative care patients. We have had patients die before. But there was this one patient who I had been nursing for a while, she was in hospital for a long time and we had all grown fond of her. She had ca of the pancreas. She had a surgical consult and was told there was nothing that could be done, after that she just sort of gave up and wouldn't take calls or anything. Anyway she died the other day, I was working the evening that she began to deteriorate, and then then morning that she died. we knew it was coming. I had been sad before when patients died, but not like this. I know that this is something that is going to happen throughout my career, how do you more experienced nurses cope with it?

The main thing that changed for me, was when I sat back and watched the other nurses. I listened to them in handover, and on the floor and I heard things like, "Oh I forgot to do that" or "I can't read my writing it is something about this" in handover. As I saw the other much more experienced nurses fumble through a handover, lose their handover sheet, forget to do something, or whatever I realised that it wasn't just me, and it wasn't just because I was a new grad. It's just that we as NG's are so focused on what we are doing, that we feel that everything we are doing is being watched. The biggest thing I have decided to do is go easy on myself. I'm strill trying just as hard, but I don't apologise for it anymore. I thank people for their help. You will see other nurses help each other, they do on my ward. One thing I don't rush is meds. Can you take your med book with you as you go? Particularly if you are giving out antihypertensives or whatever. You will get better, it just takes time. You will have bad days, but they will reduce in number. You will probably always have those days, even nurses that have been there for years do. Take care of yourself, and be gentle on yourself.

Thanks for all the replies to my other thread. I feel like I keep asking the same questions over and over again.... How long does it take till you can do things quickly? It took me almost an hour the other night to mix up three (different) IVAB's, get them checked and hang them (including flushes for those not on IV fluids) for three different patients, they were all due at 1800hrs. Doing the meds/obs round takes me forever, I get caught up with talking to patients about things, they ask questions and stuff... I'm thinking as I write this that I have a problem with distraction...once a patient asks for something then I'm doing that instead. When I was on clincials, I had plenty of time to spend with patients, and didn't understand why the RN's had a problem with the limited time they got to spend with patients. And now I realise. I'm having difficulty saying to patients, I can't do that yet (box of tissues, ice, fluff pillow) but once I have finished what I am doing now (obs, med round etc) I will be able to. I need to make my own brain sheet, to keep track of things. Is it just me? Am I the only one who has to learn to ask patients to wait for the non essential stuff while I finish my assessments? Anyway I guess I just need to work through a few things. I've got 3 arvo's and 3 mornings.

This is the first thing I do when I come on shift after report. I do a full set of obs and an assessment. I also look through the chart for when meds are due and to see where they are up to with their care plan. To me, it is an essential part of the nursing process.

I have just started on a medical ward. I had a week of supernumerary and then I started on my own. As you can imagine being a brand new nurse, I am overwhelmed to say the least. I'm frustrated that I am not able to spend the time with my patients that I want to (and was able to during my placements) but I am positive that once I work out my time management and become more efficient I will be able to do that. I'm curious about the different ward routines that you have? We have 7-1530 mornings, 13/1330-2130/2200 afternoon shift and 2100-0730 nocte shift. Generally the morning shift has 4-5 patients, and the afternoon has 6 patients per nurse. I've done mostly afternoons, so trying to get my head around getting everything done.... I was thinking that if you share your routines I might be able to pick up some hints or tips. I absolutely love this job, I've only been an RN for 2 weeks, and still feel like I'm in over my head, but I know in my heart that this is the job I was meant to do.

Last night was my first shift with my own patient load. In our new grad program we spend our first week doing the corporate, OHS, manual handling etc orientation, we then spend a day on ward orientation, then we have 5 days as a supernumery, buddied up with a preceptor with increasing responsibility. Anyway last night was my first shift without that, and it did not go well to say the least. And it's not like I sat around talking, I didn't get a chance to sit down at all. I felt like I was always rushing around trying to get stuff done, but I was always behind. Other RN's were asking me have I done this or that (trying to help me) and I was always saying no not yet, then they would remind me that I needed to get it done. (which I was aware of believe me) I'm strugging to keep up. I feel like I don't get time to actually talk to my patients. It's so frustrating and it's really getting me down. The other new grads seem to be coping, why is it just me? I felt like crying last night, it was horrible.

Hi, I'm not sure if there are differences between countries, which I am sure there would be, but I am interested in how you prepare for verbal handover (I think it is referred to as report in the US?) and the documentation/charting. Do you have a set formula that you use?

This is something that I am interested in, I won't be doing perm noc's but a rotating roster that includes them. My son will be almost 18 months. We co-sleep and he is still breastfeeding. So far days have been managable, I express once on a shift, which is more for my benefit as he doesn't have milk when I am not with him, but he still feeds multiple times through the night so not sure how he will cope with that. I may have to take two breaks to express.... I'm not sure how he will sleep with DH and not me. When I am on arvo, he will go to sleep with DH once he is sure I am not there, but he knows that when he wakes up I am usually there. To be honest, I think it will just take some adjustment. You will need to be flexible and able to think outside the box, as your family may need something a little different. Maybe, you could have someone come and stay with you during the day, do you have two levels? Maybe they could have your toddler downstairs, and you could have upstairs, that way you could also have some snuggle time with your baby? How much time will you be taking off when your new babe is born? I would also suggest sitting down with your toddler and just explaining to him that there will be some changes coming up, and reassure him. If all of a sudden his routine changes and he wasn't prepared for it, it could be distressing for him. It may still be a little distressing. Also, bear in mind when you tell him about your pregnancy, you don't want him to think that this change in his routine is to do with the baby. I'm sure if you are flexible, well supported and take into account your family when working out the routine it will be doable. Just think, if you do your nocs in a block you will have more time at home. What the PP said about taking a nap coming onto your day off and going to bed with family sounds good, even if it is a little later. Invest in a good big bed! Don't forget to make time for yourself and your dh as well as your kiddies.

Hi everyone, I will be starting my new grad rotation in med/surg in Feb. It's like 7 weeks away! Anyway, does anyone have any advice or tips on things that I can do to prepare myself? Not that nursing school wasn't adequate preparation () but I just want to make sure that I get the best out of my orientation and graduate program.

I know that there have been a lot of us (particularly students) who have been helped by Daytonite, she has provided so much indepth information, links for further information and advice on how to improve and integrate our clinical knowledge with our practice. So I just wanted to start a thread to say thankyou. For the assistance you have given me, the support and encouragement throughout my degree. You are someone who I look up to, and one day I would like to have as much knowledge and experience that you do. So, anyone else want to chime in too? Feel free! :redpinkhe

Thanks so much for that. I just wasn't feeling it with regards to flow organisation... Not sure if you've ever been there :)

Hi, As my final assignment, I am putting together a case study - this one is in relation to cataract surgery, which discusses presenting S&S, health history, co morbidities and how they impact on the surgery, pathophysiology and assessments, and a nursing care plan etc. I have all of the info, and it is pretty much complete, but I'm struggling with a logical flow. I just feel that I am jumping all over the place and repeating myself. Does anyone have any links to case study templates??

The bleeding could have been from something other than the CPR. It is a very unique experience, the feeling of ribs breaking under your hands as you perform CPR.... But it could have been a number of things. I assume that it wasn't a good outcome? Were you able to debrief about it?

It must be really difficult. You are halfway there (to the 1 yr mark). Can you hang in there and try and get as much accomplished as possible while you are there? I'm not all that familier with some of the protocols in your area, are you able to initiate a few programs or whatever while you are where you are? Maybe you could build up a portfolio to use for getting the job that you want?