Recently off preceptorship, tips appreciated!

[sea_otter123]

Hi all!

I'm a new grad that recently finished preceptorship at a really busy T2 emergency room. I'm both very excited and anxious about practicing on my own, and would like to hear any tidbits of knowledge from everyone else. I spent a month of preceptorship in the emergency room in nursing school, and another two in the place that I am currently hired at.

I do understand that there are other threads similar to this, and I have read them. I want to add more into it, though, and I would especially love any advice on prioritizing patients. The facility I work at has a 1:4 ratio, and I could care for up to three ICU-level patients at any given same time, hence my anxiety specifically with prioritization.

[amyjm333, RN]

I have a few simple tips that I feel might help ?

1. One of the most important things to know as a new grad is that the large majority of your patients are NOT going to be there for what we as health professionals consider truly emergent situations. Always keep that in the back of your mind.

2. Prioritize and reprioritize often. Treat the patients with life threatening conditions first and the rest can wait.

3. Pain in and of itself is not lethal.

4. Although you may be 4:1 in your department, your charge and team members will likely not place more than one 1:1 nursing (“ICU patient”) with you at a time.

5. Emergency nursing is a team sport! Ask for help when you need it and offer to help when you have time!

[speedynurse, ADN, BSN, RN, EMT-P]

On 2/16/2020 at 4:11 AM, sea_otter123 said:

Hi all!

I'm a new grad that recently finished preceptorship at a really busy T2 emergency room. I'm both very excited and anxious about practicing on my own, and would like to hear any tidbits of knowledge from everyone else. I spent a month of preceptorship in the emergency room in nursing school, and another two in the place that I am currently hired at.

I do understand that there are other threads similar to this, and I have read them. I want to add more into it, though, and I would especially love any advice on prioritizing patients. The facility I work at has a 1:4 ratio, and I could care for up to three ICU-level patients at any given same time, hence my anxiety specifically with prioritization.

One other thing......advocate for yourself and your patients. A 3:1 ICU ratio really is not safe for a new grad, especially if they are true, critical ICU patients. A 4:1 ratio is very doable until multiple critical patients start being sent to your block - and that’s when you ask for help. Figure out how to prioritize acuity - the level 1s and 2s always need you (because they are generally too sick to speak for themselves) before a level 4 who is saying they aren’t getting care fast enough.

[DannyBoy8, RN]

Take breaks when you can get 'em. You know now having gone through orientation, it's an unpredictable but exciting place to be a nurse. But it's also filled with hungry and dehydrated nurses. I don't think I voided for 3 straight shifts once, LOL.