TeeDotNurse

Hey thanks for the reply, I did read the entire preceptor handbook from the school, which she just gave to me yesterday, but some of the documents that she should have supplied me she has yet to so I will ask her for those next day. I went to her same school and also was a graduate tutor at the school so I know what they are expected to know by the time they are consolidating. She should know normal blood sugar ranges and basic medications etc at the very least. However, I did not consider different learning styles or ask her about this. I sort of am just following what my preceptor did with me when I consolidated but its true that while this method was effective for me it may not be for everyone. I will discuss this with her next day and see what has been effective for her in her previous placements. I do realize that perhaps she is anxious and that is a barrier to learning but when I take the time to go over something in great detail (read the entire hypoglycemia protocol directive and policy, discussed and looked up the different insulins and oral antihyperglycemic meds and reviewed normal ranges of blood sugars) and then the exact same situation arrises the next day with the same pt and same time of day it is frustrating when she doesnt recall what we discussed and what we did about the situation (a diabetic pt with sudden drop in cbg). Anyway, thanks for the feedback! I will try to ease up on her and see if that works and discuss her learning style and see if that helps any. My co-workers are telling me I should tell her school that she is not ready but I can tell she is trying so I really dont want to have to do that!

Hey all, I am preceptoring a consolidation student this semester for the first time and was looking for some tips or even just anecdotes of others' past experience. What worked, what didnt, how much to expect how quickly? My student just finished her 2nd week and does not seem very strong academically but has a good professional attitude and is good with patient care- she worked as a PSW (I think similar to what you call CNA's or techs? They do bed baths feeding transfering etc) during school so she has that advantage as our unit the nurses do total care. It is a very busy acute medicine floor with telemety and we get a lot of heavy, confused, total care patients as well as psychiatric comorbidities. Which means I barely have time to get my work done let alone stop and explain everything because she still doesnt know it. Everyday I ask her to go home and read and review certain things but progress is slow-going. I wish I had more time to be patient with her while she problem solves for herself and looks things up but since she started I have been leaving late and missing breaks while she goes just to catch up! Any similar experiences? How did you handle it?? Thanks!!!

First of all, I think its awesome that the OP is self-reflecting on this as there is no one correct solution but only possible strategies to be applied and reviewed in the future when similar situations arrise, as they inevitably do! I can definitely see both sides of the argument for giving him the coffee to prevent conflict and de-escalate as well as the obligation to follow MD's orders. For me what I often do when patients are pleading for things that are contra-indicated to their treatment plan is I say something to the effect of i'm very sorry I can see/understand that this is difficult/ uncomfortable/ frustrating etc/ for you but LEGALLY by law I cannot give you coffee/ water/ food items etc and I could be sued if I do because the doctor has ordered this because (insert pt education of risks) and by law I have to follow the doctors orders. However you are an adult and can make your own decisions about what treatments you wish to accept and follow so I cant force you/prevent you from doing/having xyz and you are welcome to discuss this with the doctor I can call him/her for you if you like and in the meantime I cant stop you from getting it/doing it yourself, I just cant be the one to give it to you i'm very sorry. This of course would be abbreviated for the agitated patient but usually once I throw around the legal terms they get it and attempt another strategy i.e asking family or negotiating. While I do have an obligation to follow doctors orders I am not here to force any treatment on an a+o and competent person. I would also use my judgment in the moment and weigh the risk vs benefit. For fluid restriction usually 1 extra cup of water is not life or death and sometimes sneaking an extra cup of water can make the difference between a calm pt and a code white (more often in confused pt's who dont understand why they cant have it though) In this case he ultimately prob just wanted his booze!

Oh what a relief, thank you for the replies! I am a new nurse only about 6 weeks in so this was my first time with vre. The charge nurse said I didnt need to disclose it but I wasnt sure if she just didnt want to do paperwork lol. So glad to have you more experienced nurses :)

I should add that was 2 years ago so I guess it could change now? But hopefully not. Its a good skill to have. For community/home nursing also

Us as well! We didnt get past first semester without this. We use manual for all our isolation pt's as well as if we cant get the reading with the automatic- usualy if it is too low. But for an abnormal reading I just wait a few mins, recheck on same arm, then on other arm.

THIS was my first thought, too!

Hi all Lastnight on the overnight shift I had a very confused pt on contact precautions for vre. At one point last night he somehow managed to get his lapbelt off and get out of his wheelchair. He is very unsteady on his feet and has had several falls including a recent head lac. So with that in mind I ran to catch him without wearing a gown or gloves. I washed my hands and arms verywell but I am still worried. I realize this will likely not pose any threat to me since I have a healthy immune system but my questions is was the handwashing likely sufficient and if not how long am I at risk for infecting other patients?? Any info provided is appreciated I had a terrible time on google lol

Not getting into the experience issue for being an NP but sometimes you have to work around what employers want or else risk wasting your tuition money when you cant get a job. If it were me, and employers were looking for full time employees, I would take time off school and work full time then request leave to work pt and complete school. Schools will always be there to take your money. The other consideration you should investigate is the employability of NP's who have graduated without RN experience. As you mentioned its a common education path in your area but personally I would want to know how the job market has been for them. Good luck to you!

This. This worked for me in the past also. I always try to work out problems I may have with someone directly first before going above their head. Especially if it isn't someone you need to work closely with long term. Wouldnt be worth it to me, personally, to go to management about this. Also it's good practice with being assertive and problem-solving. :) all the best to the OP with her new position!

Hey any info available from last year's survey for Canada?

Update: I got the job!!

How did that work for you? Did you get hired? If thats the route you want to take then a better way to phrase it is to say what things you have to work hard on and what things come more easily. At least imho. Saying you dont have any sounds like you are either not self aware or stuck up. As i said above I told them my weakness is impatience and gave examples of steps im taking to work on it. I got the job

I was asked what my strengths are and what I need to work on. I answered that my strengths are time management, organization and communication. I said I need to work on patience because I can be impatient but that I know this about myself and remind myself that not everyone moves at my speed and that's OK. I said that my experience being a peer tutor and working with children has helped me to learn patience. They seemed satisfied with that answer and have since contacted my references so im hopeful! I would just say something that is honest and you really are working/ want to work on. But nothing dangerous to patients!! Like inattention to detail lol.

Thanks for the feedback, thats an excellent suggestion. I am actually working at my school now as a graduate tutor so I will definitely pass it on to them. I have no idea if it is just my school or if it is not in the curriculum in my area but I will look into it. In the meantime, I have asked a friend who is a lab tech to borrow her EKG text books so I can be prepared in the future. I am disappointed and wish that my school had prepared me better for this because I was totally caught off guard and this was really my dream position, but all I can do is learn from it for the future!