Tommorrow I'm "On my own" !!!

[iridius]

i'm nervous, tommorrow night i am on my own. i have been precepting for my new job in the rcu (respiratory care unit - think icu with hemodynamically stable patients, not long-term care). i am a new grad rn, i have worked as an emt-b and er tech in a small community hospital, now i'm in a large level 1 trauma center. i have had a great preceptorship and critical care course, but i feel like i have so much more to learn (i know it takes time) but i really want to do a great job (avoid avoidable mistakes). i feel stupid, because i worked in healthcare for a year before this, i am a fast learner, and i usually don't stress out... so the fact that i'm nervous... makes me nervous... stupid positive feedback loop.

i saw this from ruby vee on another thread:

if you aren't scared your first six months to a year off orientation, you don't have a good grasp of the possibilities. being scared is normal. relax -- no one expects you to have all the answers -- or even all the questions. all we expect you to know is where to find out -- a mentor to ask, drug reference, policies and procedures, textbooks, a physician who will explain things.

i've been a nurse for a long time, now, and the more experience i get, the more i realize i don't know. that's healthy. it's when you think you know it all, have seen it all or done it all that you're dangerous.

that made me feel better, and i've heard similar from all of my preceptors (yeah i had 4, i'm spoiled) but i guess i just am feeling awkward, because i'm usually not the type of person that stresses out and there are so many things i don't know how to do.

i'm gonna go work out that always makes me feel relaxed.

... oh well. here goes nothing.

thanks for listening to me vent.

[Ruby Vee, BSN]

let me be the first to congratulate you on finishing your orientation and being on your own. of course you're scared -- we were all in your shoes at one time. but it sounds as though you have a healthy attitude. i'm sure you'll do well!

just remember that everyone, everyone, everyone makes mistakes. you will, too. learn from them, and never ever try to cover them up. your patients can survive a lot of mistakes, but only if you own up to them as soon as you realize you made a mistake, notify the appropriate parties and set about mitigating the damage as soon as possible. then take a good, deep breath and forgive yourself. you're human.

good luck!

[himilayaneyes]

Well it's normal to feel nervous. No one expects you to know everything as a new nurse or as a competent experienced nurse. They do expect you to use your resources though (charge nurse, policy and procedure manual, drug guide, etc). Congrats on getting into the RCU. I just started in the ICU...loving it so far...was previously a cardiac tele nurse. Check out the pm I sent you...I think we may work at the same facility...or very similar facilities. Good luck. :)

[tyvin, BSN, RN]

The one area that is not talked about regarding work with new nurses enough IMO is the meds. Most patients can survive this and that but if they are given the wrong meds or miss med treatment etc.., well you know.

Check your meds, know that they are all available, know which doctor has which standing PRN orders available, who are your diabetics etc...this includes prepping medications that need to be given for procedures scheduled the next day so forth and so on. When giving any meds identify what it is, what it's for and why. Also know who ordered it because some people will ask but it's a nice service to do this and makes you look professional instead of handing a bunch of pills to someone and telling them to take them; that is condescending IMO. Be proud of your knowledge and share and hey if they say never mind just hand me the dang things then that's OK as well.

I was not taught this in school but is from personal experience after an accident that landed me in the hospital for an extended period of time. The audacity to tell me that the pills are happy pills and it's not important to know the names of all my little friends. Well; I guess you know what happens next; everyone found out I was an RN and boy did things change but what about the other people? Sorry.............off topic but it's important you involve them in their care.

One thing I would recommend is knowing all your patient code status. Makes it a whole lot easier in an emergency.

It's imperative that nurses do the 3 count they were taught in school. It's done for the simple reason that even though nursing has evolved in many areas medication administration remains the same. Have a good grasp on all your med orders. Know that they all are within range therapeutically, know why the patient is getting the med.......well you know anyway good luck and go get em.

Also if you get in trouble or feel overwhelmed take a breather and regroup and if it warrants additional advice don't' hesitate to involve the charge; that's why they're there.

[canesdukegirl, BSN, RN]

The very fact that you are feeling nervous means that you are already a good nurse. I agree with the previous posters...if you are in a situation that you are unsure of, don't hesitate to ask your charge nurse for direction. You will learn it, and you will feel really good about yourself when it "clicks". I am excited for you! Don't forget to eat lots of protein and wear your TED hose. (Sorry, I know I sound like a Mom.) Also, don't forget to take some "me" time and rest! Congrats to you!

[ob_one]

so the fact that I'm nervous... makes me nervous... stupid positive feedback loop.

I'm gonna go work out that always makes me feel relaxed.

Nothing like a good work out to break that feedback loop.

[DizzyLizzyNurse]

I was not taught this in school but is from personal experience after an accident that landed me in the hospital for an extended period of time. The audacity to tell me that the pills are happy pills and it's not important to know the names of all my little friends. Well; I guess you know what happens next; everyone found out I was an RN and boy did things change but what about the other people?

Seriously??? I would never say that to someone even if they didn't have any health care knowledge.

[iridius]

Well, I made it... tho.... it was.... well.... it was what it was.

I had 3 pts. to start... the normal ratio. Then one was DC'd. 2... I'm happy now... can do all my stuff... I was told I was a god send... which is always nice... and was asked if I'd been a nurse long time (with the intonation... that it was thought that I was) because I was explaining everything to a patient which he said was new and relieving for him.

Then I was taught a bit by a fellow nurse and RT... there are some that love to teach there and I really like that.

Then I get a call from the ER... it starts.... "I'm really sorry, can you call me back at extension..." call back..... "I'M REALLY SORRY" Do I need to explain. Well, with a pt. sitter sent from Heaven I made it though, with q1h cleaning, changing, linens.... more psych/anxiety meds then I've ever seen, and a determined (maybe foolishly maybe not) new nurse that didn't want to put on restraints if it wasn't REALLY needed.... I'm not easily ruffled, I mean in the ER as a tech it was always like that... but for a couple hours... I had it all night. But as I said.... how bad can it be 7am always comes around.

Besides. All my patients we the same or better when I left.

Now I gotta sleep, round 2 manana.