really scared of my pt tomorrow

[picurn10]

I went in this afternoon to prep/read the chart for my pt assignment for tomorrow and I'm just scared of all that's going on with the pt. She's got COPD, DM, recovering from a perforated bowel, she's on 02, got a foley, central line, peg tube, colostomy, has thrombocytopenia, and just this am was having runs of v-tach Not only that she's covered in wounds. Wounds from surgeries months ago that haven't healed, pressure ulers, and just all kinds of different things going on. Plus shes on 18 different meds and has about 5 different drug allergies. I feel like I don't want to so much as blow on her.... Nothing like easing my way into med surg clinicals

[VenaKavaRN]

Look at the bright side - you're going to learn a hell of a lot

[NurseyBaby'05, BSN, RN]

You'll be fine. Prioritize her complications/comorbidities and it will make things easier. Find out what her primary diagnosis is this admission and go from there.

-Find out if the v-tach is new and what her actual heart rate is and her baseline.

-Look-up her most recent labs as soon as you get to the floor. Keep your eye out for when that days labs come-up and watch for her CBC like a hawk.

-Is the perforated bowel fairly recent? I would keep an eye on that b/c with the combo of it and low platelets her risk for GI bleed is significantly increased.

Don't be intimidated by all of her tubes and lines. Most of them wind-up making your job a lot easier.

[chuckz, BSN, RN]

You know what's funny? Sometimes you will see the rundown on a patient, think they must look like living death, walk into their room and see them up and about...ambulating themselves.

Everybody is different and everybody has a different baseline. Just take it one step at a time, you will be fine.

[inland18mempire]

Worse case scenario is that you kill her by accident. it happens. Just kidding! You're scared now, but when you're a nurse you'll look back at this and wonder why you were so scared. You'll be a pro in no time!

[marie-francoise]

I'm surprised schools still do the "learn your patient the night before your clinical" method. We get the info on our patients at the beginning of the clinical, not the night before - when students should be, um, going to bed early (one would think). I wonder how many schools still do this previous-night method?

[RNisme]

Many times we get our pt information when we arrive at clinicals, and get report along with the staff nurse.

The explanation we rec'd was due to relatively short hospital stays - getting your patient assignment early would most likely result in that patient being discharged before you even get there.

The only time I was lucky enough to get pt information early was in my psych rotation.

[Starfish1]

Who assigns your clinical patient? if it is your teacher I would take it as though she things you are ready to handle something like this. I think it would be a fantastic learning experience for you- just take it one step at a time and use this as a great learning experience!

[SuesquatchRN, BSN, RN]

Y'know what, april&em? She is a very typical patient. She's a diabetic who smoked, hence the COPD. That's all. The rest of her problems - heart, wounds, etc - are because of the diabetes. At least that simplifies what's wrong with her.

Don't be scared. She's very, very much the type of patient you'll be getting in a straight med/surg unit.

[AZMOMO2]

We still do the night before pick a pt. The floor nursing give us a list of those that are not being discharged etc... of course this is so that we can write up the careplan, learn the meds, indications-contraindications, nursing implications for each med they are taking as we were advised to be prepared to be drilled over all the informations as we are working with them and passing meds. "Oh joy can't wait" she says sarcastically

[NurseKatie08, MSN]

I'm surprised schools still do the "learn your patient the night before your clinical" method. We get the info on our patients at the beginning of the clinical, not the night before - when students should be, um, going to bed early (one would think). I wonder how many schools still do this previous-night method?

My school did the night before method, but only for Fundamentals & Med Surg (and I do recall a lot of my Med Surg patients changing when I got there in the morning.) From there on out, we got our patients just as the staff nurses did, in report that morning.

[ChristineN, BSN, RN]

Take a deep breathe. You'll be fine. Just remember to stay calm, take it one step at a time, and don't be afraid to ask your instructor a question if you aren't sure what to do. :)