So I Just Have To Get Creative?

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Before working in a hospital, I had absolutely no experience with hospitals. Whenever my family member's were ill, I wasn't allowed to go with them to the hospital because they didn't want me to catch anything. No one in my family worked in health care so I had no stories and no ideas as to what to expect. So all this was new to me, prior.

So I get into the hospital, nervous as ever, because in nursing school they keep on telling us that if you don't do x,y,z, then you could lose your license. Everything I do, I panic. If a patient's IV infiltrates around the time I am giving them NS, I panic. The patient tells me I'm a terrible nurse because I didn't give them pain medicine within the first 5 minutes of them calling for it, I panic. If it's 12 o clock and I'm not done all of my assessment/charting for all 5 of my patients, I panic. And above all, if I don't know how to administer a certain medication because the specific method isn't provided (what kind of syringe can I use for this medicine?), panic.

Why? Because I thought there was a protocol for everything that's done in the hospital and as a nurse and I figured that if I didn't follow that protocol to a T, I'd lose my license and my dream of being a nurse would go to pieces within the first 6 months of my time as a nurse. so I would keep asking the simplest of questions for fear of doing something wrong.

Come to find out: Nursing is ALL about being creative, even with things like giving meds and that there isn't really a protocol for everything in the hospital. You just have to come up with ways to get your job done. If a patient can't hold a medicine cup in their hand and you're giving them a liquid like robitussin, you can grab a syringe and insert it into their mouth that way. I had to learn how to walk out of a patient's room and not feel like I'm demonstrating disrespect for not being able to carry on long conversations about their family members and their dogs with them. Or that if I've already signed off on the MAR that I've given a medication and then find out that it wasn't completed because the patient's IV no longer works, that I'm not "lying" when I say it was given and that I'm going to lose my license if I'm discovered. It just means I need to get a new IV restarted and then continue to give that medication.

So basically, my anxiety level has slowly been coming down because I realize that everything in nursing isn't a set up for me to lose my license.

Anyone else have similar experiences?

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Thanks for the info. I am a new grad, and have not started working in a hospital yet. The information is a bit of fresh air. Thank you.

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I felt the same way (still do a lot of the time!!) But I work in Long term care with some 30+ patients. I hate feeling like I'm just throwing pills at them (like you would a cookie to your dog!) But if u don't, u never get anything done in time and get spoken to "in the dreaded office"...kinda makes you feel like your in the principals office, all over again.

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Specializes in Critical Care, Education.

Bravo! OP's analysis is right on target - wonderful description of the transition from novice (rules driven) to expert (principle driven). That is exactly why Critical Thinking is an essential component of nursing education - it is the foundation for nursing practice. Each and every patient encounter is unique. You have to make decisions based upon your grasp of a (huge) body of knowledge rather than following a checklist or how-to manual.

Time management is an outcome... of effective prioritization. Focus on the latter to achieve the former. It takes time, so be patient with yourself.

You can do this.

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That is great that you are finding your groove! I can really relate to that near-constant state of panic because I get that way even in school!

While I think it is probably very unhealthy to stay so anxious forever, it sounds like it made you a very conscientious nurse. You were able to figure out on your own how to get things done and build your confidence level, and no one else can do that for you.

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Yep, "creativity" is required.

Especially in creative charting.

In a few years, you will be a regular Picasso.

Good job.

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Thanks for the info. I am a new grad, and have not started working in a hospital yet. The information is a bit of fresh air. Thank you.

Ditto.

Now I just need to get over my own anxiety even after reading about your experience. :unsure:

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Just be careful for your creativity not to fall outside the nursing scope of practice. Some nurses get carried away. Remember that for some things THERE IS a strict protocol that needs to be followed to a T. Always remember that you need a physician order even for the most mundane medications, like Tylenol and Colace. Nurses start to get comfortable in their practice and start giving OTC meds without calling the MDs. That is practicing medicine without a license, a criminal offense in my state.

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i am new I have no idea abut hospital job

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I'm currently waiting acceptance into my ADN program, but you pretty much summed up my fears for when I do start working some day. I actually like protocols/rules for things, because I like to know exactly what is expected of me. However, its great to know that in reality, a little deviation from protocol is acceptable (if appropriate) if the situation presented itself.

I am completely the type of people who hates to walk away from someone who is telling a "story" or just rambling on about stuff, and I will literally wait until the perfect moment to dismiss myself. I can imagine this would be a hindrance to daily nursing life. What advice would you give about walking away so you can carry on your daily duties, and also not make them feel like you are not giving them personal attention?

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I'm currently waiting acceptance into my ADN program, but you pretty much summed up my fears for when I do start working some day. I actually like protocols/rules for things, because I like to know exactly what is expected of me. However, its great to know that in reality, a little deviation from protocol is acceptable (if appropriate) if the situation presented itself.

I am completely the type of people who hates to walk away from someone who is telling a "story" or just rambling on about stuff, and I will literally wait until the perfect moment to dismiss myself. I can imagine this would be a hindrance to daily nursing life. What advice would you give about walking away so you can carry on your daily duties, and also not make them feel like you are not giving them personal attention?

I think you'd have to come up with your own style to walk away from a person but I've honestly tried a myriad of techniques. What works for me is to simply say, "I'll be back in a bit to check on you and we can continue this then... (I usually don't give a time because sometimes I feel like patients are waiting for me to come back and it's a let down if I don't)" or I'd slowly inch my way to the door.

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Just be careful for your creativity not to fall outside the nursing scope of practice. Some nurses get carried away. Remember that for some things THERE IS a strict protocol that needs to be followed to a T. Always remember that you need a physician order even for the most mundane medications, like Tylenol and Colace. Nurses start to get comfortable in their practice and start giving OTC meds without calling the MDs. That is practicing medicine without a license, a criminal offense in my state.

That I'm learning more and more about as well and it's kind of a relief to know that I can't talk to apatient about procedure results and that it's better to let the doctor talk to them because it prevents me from having my back against a wall when I can't answer them. Honestly, I'm an RN now but I still feel like I could just as easily be a patient asking the same questions my patients ask me. But it's those moments when there isn't a protocol that shock me the most. I can't imagine giving meds without an order. That's too far and I wouldn't want a sudden allergic reaction on my shift or a code/rapid response situation and when they ask, "What did you give?" that I have to answer "I gave x,y,z without an order..."

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