Red398

Well, at least were in this together like previous posters have said, it just takes time.

I'm a new nurse, also, on a tele unit. We have pre-made SBAR sheets we use in report, but the main things I make sure to know: Name, age, when/why they were admitted, allergies, diet, which MD is on them, any planned procedures, IV size/placement and fluids going (we have a lot of patients on heparin), any other lines to them, do they get accuchecks/insulin, their rhythm on the tele monitor, and as for history, I usually only ask for pertinent info according to system. Ex. Pt admitted with chest pain (very common) so I want to know their history involving that. Do they have a history of MI, previous stent placement, HTN, etc. I find simply asking the patient if your unsure is the best route to go. And most patients are very happy to talk about the reason why they're in the hospital (sometimes too much ) Multi tasking is your friend. Talk and assess at the same time. You'll learn your own routine!

Thank you all for your comments. I do look back from just a couple of months ago and realize how much I've learned. I think my nerves just get the best of me sometimes. But again, thank you all!

Hey Allnurses, I'm sure this topic has been posted on before, but I could use some encouragement right now. If you've read my previous post, you know I'm a new grad RN. I got my first job on a cardiac step down unit. And I have to say, it's definitely not what I expected. I'm not in orientation any longer, so I'm on my own. The problem is: I always feel like an idiot. I know I'm not an idiot, but I can't help but feel that way. It's not that I don't know information about, say a med or a disease process, it's applying it that's the problem. If I'm confused about something I'll ask a coworker, who are all great, but as soon as I get an answer I'm like "Duh, I knew that!" Or say I'll give a potassium pill, which is very common, I know I'm supposed to check the potassium level first, but sometimes I don't remember until afterward. I suppose I'm just having a problem putting all the pieces together. I feel so rushed sometimes its hard to think. Fortunately, due to previous experience as an LPN and a great preceptor, I've been able to keep my head above water. All I'd like to know is, please tell me this goes away and one day I'll be competent

I cut off at 75 and I bet at least 35-40 of mine were sata. I didn't think they were very difficult. Although, I took a lot of sata practice questions prior, so I guess I had just gotten used to seeing them.

Ouch. You sound a bit defensive. Actually, I am "squeeky clean." Like previously stated, marijuana is illegal on a federal level, and illegal in my state. I willingly chose not to partake, so I could obtain a license and job as an RN. Not that I'd be interested anyway, regardless of occupation.

Thank you for replying. That sounds like an excellent idea!

Night person here like the 2 previous posters, set multiple alarms. I had to get up at 4:30 to get to clinical on time. For me, nothing made it easier. I just had to suck it up and get up anyway, no matter how little sleep I had. My routine was simple, as I made sure to wash and blow dry my hair the night before, so all I had to do was throw it up, put on my uniform, brush my teeth and go. It was a miserable time.

As the title states, I took my NCLEX last Monday and just found out I passed :) If you've read my previous post, I'm getting ready to start a job on a step down unit. And I'm extremely scared I am an LPN and do have LTC experience, but I know I'm now in a different role, and a new grad once again. I'm a bit concerned for a couple of reasons: The nurse patient ratio on this floor can be 1:5, which after doing my research on here, seems to be a high ratio for a step down unit. My manager said they try to keep it at 1:4 if possible, especially if the patients are on cardiac drips. Fortunately, this floor does not titrate. If they have to be titrated, they have to go back to the ICU. Also, the training is only 9 weeks. I was told if I need more time I could have it, but we all know how that goes. So yes, I'm terrified! I suppose I just need a bit of encouragement that I can survive the dreaded first year. My LPN experience will hopefully ease the transition, as I have basic skills (caths, dressings, tube feedings etc.) down pretty well, and I have learned time management due to my 20+ patients, but my patients at the LTC were stable. Any advice on transitioning to acute care would be very helpful. Thanks!

I'm a bit concerned over this "synthetic urine." If I understand correctly, you're using fake urine to essentially lie on your drug test. How unethical.

I, personally, prefer an actual text book. Don't get me wrong, I'm obsessed with my kindle, but reading for fun only

In the LTC facility I worked at, each patient had their own vial and/or pen. I've noticed hospitals I've done my clinicals at share one vial in the med room, as stated.

I took the exit hesi about a month before I graduated. It was extremely hard, imo. I did well, a 1100. But I was extremely shocked. I felt like I was making educated guesses on most of the questions. I studied with the hesi nclex book, for about a month beforehand. But I still felt like it was almost impossible to study for. However, you have posted some great tips!!!!

Oh no, this is exactly the answer I was looking for, as with previous posters as well. Thank you for taking the time to share your knowledge with me! SALI will help me remember :)

It's a shame to see a nurse who is so concerned about upsetting her boss she's willing to put her health in jeopardy. As others posted, please go see your employee health nurse!

Thank you everyone for replying. I have a better picture of what's going on now, concerning EKGs and lead placement. I know my experiences and interpretations, treatments etc. will come with time and experience on the floor, I just wanted a little extra boost before I started work. Thank you all again!

Thank you, Ali! Yes, that does help. I actually used to play baseball too so I understand your analogy :)

Thank you, Scrubs!!! Your picture and explanation are very helpful! I well definitely bookmark this page to refer back to.

We also did a code simulation, which was harder than I thought! But fortunately we didn't get a grade for it. More for the experience, I suppose.

Exactly, that's how my school was as well. We just learned the basics about reading the strips and treatments for some dysrhythmias. I've discovered the art of self teaching

Yes, that definitely makes more sense then what I was originally thinking. As I said, I think I was making it harder than it should be. I will be required to become ACLS certified so hopefully that will help. Thank you!!

Oh, well, I guess I expected it to be a more complicated answer then that! Thank you :)

Hello everyone! First topic here :) as said in the title, I have an EKG question. I am getting ready to take boards soon and I have accepted a job on a step down unit in a hospital, so I'm trying to refresh myself on cardiac. I am an LPN but I don't have any experience with EKG's, other than how to apply the leads. And of course, we had a quick lecture on how to read EKG's in RN school but I'm still a bit confused. Please correct me if I'm wrong, but from my own research, an MI has to be in certain leads before it can be diagnosed? I understand the basics of a STEMI and NSTEMI but I'm confused about the actual leads part. How can an MI be seen only in certain leads? I may be way off here but if someone could clarify or lead me to a good resource, I would appreciate it. Thank you!!!

I got the same vibe from you. Several of your previous posts present that type of attitude. Such as, "Or when I assess the patient and find a S3 gallop and tell my nurse and she just looks at me like I'm insane and does nothing about it, even though it's never been charted on. Like I understand you have a job to do, but if I tell you I found something abnormal or ask a simple question, it should be recognized at least." and "So, for me to share with the nurse that I auscultated an S3, should have grabbed her attention to listen to the patient again so that appropriate interventions could have been in place" You are a student. I'm all for learning, but your assessments of patients are not the whole picture. The nurses have more knowledge and experience, and you're acting like your assessments should be gold to them, when it's really their judgement call.

I just recently graduated RN school, but I have worked as an LPN in a LTC facility for several years, so I do have some experience. Your attitude is a bit off-putting. This is one of the reasons, in RN school, I did not enjoy clinicals. Don't get me wrong, I enjoyed utilizing skills and doing assessments, but I did not want to be the student always in the way. Luckily, our clinical instructor stayed on the floor with us, so we had someone to answer our questions. As a student, you really only get a glimpse at what nurses do everyday. Clinicals are nothing like the job (IMHO), and you sound like you expected to be catered to. Nurses are extremely busy, and if they don't have time to answer your question, then ask someone else or look it up. In my experience, even the doctors that made rounds on the units had more time to explain things to us, or even a classmate may know the answer. All the previous posters have made excellent points as well.