SilverSister

Hi guys :) Well I completed my first week on day shift ... WAY different from night shift and harder. Harder as in, doing the discharges, putting in orders, going to different screens to FIND the orders, etc. And I'm going to be on yet another week of orientation, in the day shift. I'm pretty glad of it. Still haven't told anyone except my best friend and of course, you guys, but my attitude has improved and so have I. All three days I've asked my new preceptor for her evaluation, and she's had very little to say. I'm doing a good job. Time management is my best thing ... always has been. Interruptions (that stupid zip-it that's always ringing) still throw me off and I don't even want to know what my blood pressure is these days. I took a benedryl the first two days of day shift, thinking it would help my calmness, but really didn't see any results, and forgot to take it the third day so that solution is out. Kind of crazy anyway. But I'm doing better! I actually got .... (gasp) .... compliments! I purchased two pens that have different colors available, and instead of a clip pad I'm carrying around a notebook, so that I can keep organized. Much better. When I get more experience perhaps I won't need it. I have also been working on my "Buddha face," and what comes out of my mouth. It needs to be positive. And I finally managed to start an IV yesterday on a cancer patient! Dear heaven. I was too busy to turn a cartwheel down the hallway but thinking of it today I feel pretty good. Day shift? The days whiz by. No pesky down time that drags, like in night shift. I like that. If I can just learn the different screens and how to put in orders and find the new orders, I might make it. I need another week. So I'll be working Monday, Wednesday and Thursday, day shift this week. Probably going back to night shift after that but I sure wouldn't cry to be put on day shift. Nicer crew with which to work. I'm so happy to have found this board and to read everything that you guys had to say, and really grateful to you all. Thank you all so much!!!

Arkansas, that is GOOD advice. I wrote some of it down. :) ty :)

That's a really good idea about color coding - a friend of mine had a pen that she used in nursing school, that could change colors with just a flick (instead of having to change pens) and I think I'm going to invest in a few of those.

No we never use the same lines for different meds. We can use the same line for the same med, for three days, and put a sticker on the line to make sure that the line is not out of date.

Wow. Now that was helpful. I keep tweaking that report sheet of mine so that it is more helpful, but at this point every patient gets one entire sheet, with 1/2 the sheet devoted to writing down the meds/tasks, their route, and any other little note I need there (take BP, etc). Since we already have a report sheet that gets passed from one nurse to another until the patient is discharged (I shred my own at end of shift) I don't have a place for systems (already on the primary report sheet, which I am not supposed to write on - it only has the stuff on it that was given by the ER or whoever, when the patient arrived) but could make a space at the end of the sheet for the critical system effected in that patient. I went through some of those "brain sheets" and my sheet is similar. I'm not sure how to PM on this site will have to look that up. Thanks! :)

Hi Iowa, Congrats on a second career at 51! Was it as odd for you to be back in college again after so many years? Was for me. Chalk boards and pencils have DISAPPEARED! Lectures are all from the power points that come with the books! My learning curve had to be fast and furious when I went back. Indeed that is the way it went down, with the vanc error. In fact I didn't make it as terrible as it actually was. That young nurse is a horror. Not the first time she has said something to someone that was "mouth-hanging-open" awful to someone ... this time it was me. The Nurse Manager now knows about it (because MY error with the vanc was reported to her - thus my extra week in orientation - and she talked to me about it and I mentioned the way it went down) so I think that's all I need to say about the matter - it will be resolved by those whose job it is to take care of such things. I can't just walk away ... this is now my livelihood and I have loans to pay back. Part of the weirdness of it, though, was the fact that I AM 50, and she's in her mid twenties. The arrogance sometimes just astonishes me. On the flip side though I'd love to grab some of that "No problem I can do this" attitude that is coming so easily to my younger classmates. An attitude adjustment is in order. And a few extra layers of skin. LOL.

Hello, I am a new nurse. Just passed the NCLEX July 16 after graduating in May and acquiring a job which started June 8. I graduated top of my class. Not because I am all that smart but because I work very very hard. It's not helping me in the new job ... a busy 38-bed oncology med-surge unit at a local hospital. I had to get an actual nursing job to discover how imbecilic I can really be. My hope had been that if I just tried really really hard and worked really really hard, I'd do well. Not happening. I'm a nervous wreck. About 100 times every day I wonder if I should see a doctor, myself, and get a prescription for a beta blocker, because when I lay down at night I go over everything that happened during the shift, and my heart feels as if it will beat out of my chest and fly around the room. I'm 50 years old and should be way too mature to be having these emotional ... reactions. Here is a list of my so-far mess ups (after only 7 weeks!!!) 1) I hung meropenem and there was still about 50 mLs of vanc left to infuse. What was I thinking? I don't know. Nothing. It was time to hang the meropenem and the pump had stopped on everything else so I just hung it. For this the charge nurse stomped down the hall, hauled me into the patient's room, and dressed me down in front of the patient. I was surprised the patient even let me into her room after that. I can only say that the patient actually liked me, after complaining bitterly of day shift's neglect. I checked on her often ... I have people skills. Too bad I didn't THINK and check the vanc before I hung the meropenem. Stupid. 2) (and very serious) I was late administering Reg Insulin. Really late. As in, about 2 hours late. I gave the Lantus but not the Reg insulin, and discovered it in a run-through of the MAR 2 hours later. Had to call the doctor and then WAIT on his call back, after checking the insulin level (which had risen), and reporting to him the value. Then I could administer the late dose. 3) Didn't know how to interpret under the "orders" tab and so didn't put telemetry on a patient who had come in for DKA. On shift change the nurse I was reporting off to asked me about it and I was like ... "duh ... what?" and had to put on the telemetry before going home. This is not to mention that I am slow at EVERYTHING. And it makes it even slower because I can never find my preceptor to ask things. Protonix? It comes in a powder. Great. I didn't know what to reconstitute with and couldn't find it on the little vial. Had to find someone to show me how to do it. So another nurse notices how long it took me to administer this because it takes long to find someone, gather the necessary materials from the overwhelming supplies room (where nothing seems to be in logical order) and administer, and tells me she's glad she's not my patient. Not to mention it was only LUCK that I looked it up in the computer and discovered it needed to be administered over 2-5 minutes, or I would have pushed it at lightening speed and maybe done some damage. I swear, too, that if I had a nickel for every time someone has said to me or asked me "didn't I tell you this before?" or "your license is at stake!" or "you must go faster!" etc., I wouldn't owe anything for my school loan. It'd be paid. My list of fantasy comebacks is growing ... The other night I tried to administer a PRN percocet (PO) to a patient, and the minute the pill touched the back of this poor lady's throat, she spit it out and began to cough. Hard. Then gasp. Drool coming from her mouth. I had no idea what to do besides raising the bed and patting her back ... and I called for help. Immediately 4 nurses and 2 young doctors in the room. And we all stood there and watched her get over it gradually. I was told I over reacted and that my problem (among many) was that I was always looking for zebras and there are only horses. I need to get out of the HURST mindset where every symptom is one where the patient is potentially dying (and if I don't recognize it I am a scary nurse ... which of course I already AM a scarey nurse) and recognize the horses, so to speak. I made up a new sheet for myself - since the hand-off sheet is confusing to me and doesn't help with med administration. It DOES help me, but I've been told numerous times that it's no good ... I shouldn't be using all that paper I should just be writing down times of administration, not meds, or should be remembering things, or writing down the first letter of every med, and then not taking the WOW into the pixus room. And I definitely shouldn't be standing there with my sheet asking the handoff nurse questions and writing down her answers to fill in my sheet ... it's insulting to the handoff nurse. And I should not trust anything the handoff nurse says ... I should check the WOW myself, because she could be mistaken and my license is at stake. So what good is a handoff? Apparently just to report what the patient did on the last shift. Everything else should be gotten from the machine. Only there is little time to gather the information from the machine. It does no good to come in early because they don't make patient assignments until 5 minutes before shift change. I could REALLY use them doing it before that, and would get my "stuff" together off the time clock, so that I'd have more of an idea of what was going on, before shift change. 15 minutes after report people are asking me if I've made rounds on my patients (I'm supposed to have done a head to toe on 6 patients in that time period, like everyone else does). Anyway ... I'm not doing well. I'm seriously not doing well. They've put me on an extra week of orientation. I feel like I could use another 4 weeks of it. They said they're taking it week by week and tried to be very reassuring that so many new nurses have been through this. And I've been switched to day shift for a week, so that I can precept with this other gal, who the Nurse Manager says is more like me and "quiet" ... which, I'm not all that quiet, but seem so when I go to work. Sitting there in the Nurse Manager's office, I was trying to be very calm and professional, but was preoccupied by my uncontrollable mouth, which wanted to quiver. Geez. I wasn't about to cry but my mouth disagreed. I have not told anyone except my best friend about this. Too humiliating. Will I be a bad nurse? Is this a bad omen? Am I only fit to sit by someone's side and pat their hand? Heck it's my only skill. Oh except for charting. Apparently I'm a rock star when it comes to charting, and apparently this is an unusual skill for a new nurse. Not exactly going to help anyone get better though, being good at charting, which carries no stress because no one ever got hurt or sick from a nurse forgetting to chart gastrointestinal sounds, have they? I am frightened.