What I call a "hot mess"

Published

Specializes in Telemetry.

Me.

Everyday in clinical I feel like such a mess- disorganized, frazzled, running to and fro and having several 'deer in the headlights-space cadet- brain cramp' moments. The only thing I've gained confidence on is that I know, somehow, every clinical day, no matter how crazy, I get all my vitals, assessments, treatments, meds passed and charting done before lunch (which is our deadline). Somehow, someway, even when I think its impossible, it gets done. And in fact, on my last daily evaluation, on a day I felt particularly disorganized and frazzled, my instructor said I did great with my organization!

Then today happened. In every past semester we would always go get our instructor when we were ready to pass meds. We also got pt assignments the night before. This semester we don't get pt assignments early (fine with me) we have 2x as many pts as ever before, and we have student leaders (other clinical students), and they've shortened the time frame to a half hour before and after for giving meds 'on time'. So this all throws me off because inevitably I'm in the middle of something and like today my leader comes to me all meds in their packages in a cup, MAR in hand, and some vials I have to draw up. Mind you I've barely glanced at the MAR to see what time my first med pass is before I run off to grab vitals and start assessments. As soon as I walk up to start going over them I start getting questioned by the instructor about some IV push meds, how fast to push, and on a sub Q what size needle to use etc. I hadn't even had a chance to see that I have IV push meds and sub q to give... end up feeling completely scattered, and just draw a blank. Normally if I were getting my own meds I would have taken 2 mins to review the MAR and anything I didn't know (like how long to give an IV push) look up. So now I'm feeling REALLY dumb, and even more frazzled and thrown off, go into pts room to do the IV push with instructor behind me, and forget gloves until she prompts me. :bugeyes:

Then when she was standing next to me she thought I was about to make a med error on a pill that had to be halved, but I just hadn't gotten to my check the dose step... I had checked the name of the med, against the time, thought it wasn't supposed to be given at that time, brought it up to the instructor, who pointed out where it was on the MAR in a diff. spot for that time, and so I went to take the sheet and the med back to finish checking it off, and she jumped and said "hey you can't be in such a hurry to get it done, look at that med, you almost gave twice the dose" but I was pulling the sheet back in front of me to look and see what the ordered dose was.

I just felt so scattered and frazzled and 'off' all day.

Now that I've typed it all out it doesn't sound that bad. I was certain I failed clinical for the day though. :idea:

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oh, this sounds so familiar!!! i hated my clinicals!!! they are the only reason why i won't go back to school.....

mc3

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ha ha! i'm a yankee but live in memphis now. before moving down here i had never even heard of the term hot mess. i think it's hilarious! but you're in illinois - you use it up there, too? :dancgrp:

(sorry for the crazy icon - i was looking for a cool smiley face but found this instead. has nothing to do with my original post - i just like it.)

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Specializes in NICU level III.

I think we've all had days like that during clinicals. I think having people watch over you like that makes you really nervous as well. Definately take your time. If I knew some of my pills would have to be cut in half I'd cut them in half, put both parts in the wrapper in case the other half fell on the floor or something of that nature. Just an idea for next time. I know some teachers can be really jumpy about things. Hope your next day goes better! Goodluck!!

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Specializes in Critical Care, Quality Imp, Education.

It sounds like you are doing fine. Wow, we were not allowed to give IVP medications. It was against our school's policy and I thought our nurse practice act (at least that was what we were told). So, you will have a leg up on us regarding IVP medications.

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Specializes in Telemetry.
ha ha! i'm a yankee but live in memphis now. before moving down here i had never even heard of the term hot mess. i think it's hilarious! but you're in illinois - you use it up there, too? :dancgrp:

(sorry for the crazy icon - i was looking for a cool smiley face but found this instead. has nothing to do with my original post - i just like it.)

SO and I are both from the south, and are the only people that I know that use it. lol

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Specializes in Telemetry.

Thanks for the replies. I'm feeling better now after some sleep. Yesterday was just one of those days where I felt like I couldn't get my head together.

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Specializes in LTC, MDS Cordnator, Mental Health.

Just concentrate on each clinical and the learning experience. alway double check the 5 rights. and don't let the clincal advisor frazzel you... and take a deep cleansing breath once in a while. It will soon be over time will fly!!!!!

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Specializes in ER/EHR Trainer.

print out your post and give leave it in instructors mailbox....perhaps she is not seeing how these changes are affecting students. Just an idea.

Maisy

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Specializes in ED, ICU, Heme/Onc.
Me.

Everyday in clinical I feel like such a mess- disorganized, frazzled, running to and fro and having several 'deer in the headlights-space cadet- brain cramp' moments. The only thing I've gained confidence on is that I know, somehow, every clinical day, no matter how crazy, I get all my vitals, assessments, treatments, meds passed and charting done before lunch (which is our deadline). Somehow, someway, even when I think its impossible, it gets done. And in fact, on my last daily evaluation, on a day I felt particularly disorganized and frazzled, my instructor said I did great with my organization!

Then today happened. In every past semester we would always go get our instructor when we were ready to pass meds. We also got pt assignments the night before. This semester we don't get pt assignments early (fine with me) we have 2x as many pts as ever before, and we have student leaders (other clinical students), and they've shortened the time frame to a half hour before and after for giving meds 'on time'. So this all throws me off because inevitably I'm in the middle of something and like today my leader comes to me all meds in their packages in a cup, MAR in hand, and some vials I have to draw up. Mind you I've barely glanced at the MAR to see what time my first med pass is before I run off to grab vitals and start assessments. As soon as I walk up to start going over them I start getting questioned by the instructor about some IV push meds, how fast to push, and on a sub Q what size needle to use etc. I hadn't even had a chance to see that I have IV push meds and sub q to give... end up feeling completely scattered, and just draw a blank. Normally if I were getting my own meds I would have taken 2 mins to review the MAR and anything I didn't know (like how long to give an IV push) look up. So now I'm feeling REALLY dumb, and even more frazzled and thrown off, go into pts room to do the IV push with instructor behind me, and forget gloves until she prompts me. :bugeyes:

Then when she was standing next to me she thought I was about to make a med error on a pill that had to be halved, but I just hadn't gotten to my check the dose step... I had checked the name of the med, against the time, thought it wasn't supposed to be given at that time, brought it up to the instructor, who pointed out where it was on the MAR in a diff. spot for that time, and so I went to take the sheet and the med back to finish checking it off, and she jumped and said "hey you can't be in such a hurry to get it done, look at that med, you almost gave twice the dose" but I was pulling the sheet back in front of me to look and see what the ordered dose was.

I just felt so scattered and frazzled and 'off' all day.

Now that I've typed it all out it doesn't sound that bad. I was certain I failed clinical for the day though. :idea:

You sound very stressed out. I think that you need to take a few deep breaths after getting your assignment, then ask yourself, "what do I need to do now? An hour from now? At 10am?" and then plan your day. Even if you need to write it out on a post it by hour and stick it on your report sheet. "Patient A: 0800 assesment and meds, 0900 am care..."etc. Then stick to it and stay focused on your goal, don't let the small stuff fluster you.

Good luck

Blee

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Specializes in Telemetry, CCU.

I agree with Blee, one thing I've learned is that if you rush around (and I hate feeling rushed) you will be more likely to forget something and have to go back and do things a second time, so its better to just slow down a bit to begin with.

It sounds like you really had people coming at you from all directions. Next time just be honest with the instructor and say "I'm sorry, I didn't have time to review the MAR yet and I need a few minutes to look it over" or whatever the case may be. You are human, your instructor shouldn't expect you to be a super student. And if there is some help or guidance you need with organization and time management, that's what your instructor is supposed to be helping you with.

I'm not sure what your normal routine is, but its a good idea to start your day off by looking at meds and treatments and writing a little "time block" with med times, so you can plan ahead for things like that. Good luck to you in your clinicals :)

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Specializes in LTC, MDS Cordnator, Mental Health.

When i was a LPN in LTC I used a Visual method or time Block. divide the back of my assignment sheet into colums assessments, Meds, accucheks, Ect. It worked well when i did clinicals for RN,

I did just what carebearRN08 said to do, I told my clinical instructor that i needed a moment to look at the Mar as I was unable to look at it as I had ans a light and did my 1st assessment (while i ans the light) she started to look a little perterbed so I asked isn't that good time management? she smiled and said yes it was.

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