Published Jul 5, 2010
sweetER
96 Posts
Hi! I am a BSN student who will graduate in December, and I just accepted a job offer working as a tech on a surgical floor at a hospital I'd love to work at as an RN after graduation. I'll be working nights, and the nurse manager said I'd generally have 14-21 patients. I've never teched before, so I would appreciate any and all advice on how to manage my time and in general be the best tech I can be so I will impress them enough for them to want me as an RN. :) Thanks so much!
MJB2010
1,025 Posts
As a tech, I usually get assigned to an RN each shift (not sure if all hospitals do it this way) and all the RNS have different preferences.You are there to help, so if you see anything that looks odd to you, tell them. Like urine an odd color or cloudy, saturated dressing etc etc. As a newbie, things to watch for - make sure you are familiar with hip precautions etc or if patient has any movement restrictions. Make sure you know your patients dietary or fluid restrictions. Patients often ask for stuff they are not allowed to have on my floor, cuz eventually someone won't check and they will get it. I think the most important thing is patient care & comfort. Always get them fresh water, reposition them if needed, ask them if they need anything before you leave the room. Try to take care of everything while in the room. This really cuts down on call lights. I think a lot of people get hung up on the "to do " list and neglect the basic care & comfort & that is what makes all the difference! If you patient gets up or goes somewhere, straighten out the bed wrinkles, change any sheets that need it. I also check in on my patients often. It is also nice to ask your patients roomates if they need anything while you are at it (if you are going to get a pitcher of water, might as well grab two and save someone the call light) Just make sure the roomie is not on any dietary or fluid restrictions. Some staff will try to take advantage of you, so know what you are supposed to do and know your limits. Stand up for yourself politely if you need to. (like when I am in the middle of cleaning a C diff mess, please dont overhead page me 3 times to get you glass of gingerale. One nurse I work with constantly does this, patient care comes before staff beck & call)
If the patients like you, you are good to go. Some of them write lovely letters that end up in your personel file that can help you later. :)
stephenfnielsen
186 Posts
They will teach you what you need to know to do your job well... do that.
The difference between a good tech and a great tech in my opinion is communication and presentation. With that many patients you will probably have more work to do than can possibly be done. The nurses on the floor know this, present yourself as a hard working, cheerful person, and when you can't get to something that needs to be done, communicate it... don't just disappear. Always be positive, but try not to cross that line of being fake.
Calixan
140 Posts
Wow, with 14-21 patients, I am thinking they will have you do CNA work rather than Tech work. That is how my hospital is too. I am a Nurse Extern right now which is pretty much the same as a Tech, but the only time you really get to do Nursing stuff is when you're in the ER and starting IV's, foleys etc, but on the floor, probably just vital signs, accuchecks, etc. Still good experience though if yuo have never done patient care before. Good Luck!
locolorenzo22, BSN, RN
2,396 Posts
sorry for the length.
I worked as CNA throughout nursing school for 2 years. One of the MAJOR reasons that I got my RN job on the same floor was because of my work ethic and my skills as a CNA. I'm not gonna lie. with 14-21 patients, you may find yourself behind many nights until you get a system down. Don't let them throw you under the bus, let your orientation go slowly, and don't take a full group until you're ready. That's a lot of people.
Not sure of your hours, but I worked 5p-5am and this is how I worked. I would get on the floor at about 1640, pull up a list of the patients already on the floor(ask someone how to get this, as it will help you organize), look at a staffing sheet, see how many admits were still to come, which patients were to go home, and which ones were probably mine based on my room assignment. I could have 1-2 RNs for all my patients, or all 5 could each have a few. I always wrote down which RN had what patient, helped me know who to go to.
I got a manual bp wheeled cart(as any abnormal VS on a dynamap will require a manual one anyways-might as well save the extra trip), thermometer, pulse ox handheld, glucometer, all before report(kept it near me like gold). We did walking rounds, which based on the day could be long or short. depending on the number of incontinent patients, I would often just ask the offgoing CNA to help me check/change those patients as we did report. (that way I was good for about 2 hours).
To start off, I would make sure that I started at the beginning of my assignment and did their VS, required tasks, making sure that they had anything they needed, and informing the RN right away of any abnormal VS(temp above 98.6, pulse less than 60 or above 100, bps of SBP150.) NOT when I was done with vitals. It was a lot of walking, but the RNs appreciated that I could tell them right away.
As I got vitals, I answered my call bells, and helped the other CNA if they asked and I could. charted VS right after I was done.
I worked on a orthopedic unit. at 1945, I started getting glucoscans, and also puttting patients on their CPM machines(we did 2 hours from 8-10pm). I'd take them to the bathroom, and while they were there, I might have gone next door taken them, come out and gotten the 1st one back to bed. Once everyone had their CPMs on, I would look at my sheet and figure out who needed a bath on the night shfit.(usually any total care patient was done at night.) While the other patients were moving on the cpms, I would give 1-2 baths. By 2115, I started getting vitals again on anyone who wasn't a CPM patient. then I would go through, take off the CPMs, and get vitals on each patient as I took them off. (tip- learn how to take a good radial pulse...count for 15 seconds and multiply by 4. saves a lot of time. Also, if you are trying to distract someone, and tell them to squeeze your hand, cross your middle finger over your pointer finger. they can't hurt you that way.)
After getting done, and having everyone in bed, I would chart the next set of vitals. I would take a break, answer call bells until the morning rounds, and get vitals/empty foleys, etc. in the am about 2-3 am. my shift ended at 5am.
Take out your garabages during your middle rounds. keep your rooms picked up. number 1 pet peeve is a dirty room with a lot of linen around.
I really hope your expierence is a good one. I learned a lot as a tech that I use everyday as a RN. I still answer call bells, I still take patients to the bathroom, I still give baths if the CNAs are swamped. I shave all my male patients if I need to.
the number one rule of a good CNA: patient care comes first.
Don't lie to the nurses, if you forgot something, admit it. If you have concerns, bring them to the nurse. and don't ever think that "all the nurses do is hide on the computer, and sit most of the shift." we have a lot of charting, checking, assessing, and records to look though. sometimes we have to figure out when to do what, and when to give certain meds. sometimes we're concerned and we're trying to find out best course of action.
Good luck. and EAT before your shift so you can make it through!
That is a LOT of patients. I have 7 tops.
Lovelee82
85 Posts
I agree with everyone elses posts. I work days and I sometimes work with 1 or 2 nurses the other days Im running around the whole unit. My best advice is to plan your shift. Sit in on the charge nurse report if you can ( if you are working the entire floor) this way I can plan out my duties like vitals and fingersticks. Then I check with each nurse after they have seen their patients and plan any other procedures like blood draws, IVs, foleys etc. My nurses are great and give me a heads up on difficult patients ( or veins) and not be afraid to tell them what you can and can not do. I like to watch first, then try myself with nurses supervision until I feel comfortable doing it alone. Also make sure to check in with the CNAs working also to ensure break coverage and other duties. Good Luck.