I am a new grad RN on a telemetry floor, prior LPN experience x 7 years, which has made my transition into an RN role somewhat easier. I feel 60% decent about going on my own but I am still stumped about how to complete everything in a 12 hour shift when multiple things pop up at once.
For example, a patient needed a transfusion before a procedure the other day. Patient was a difficult stick, IV fell out, and that took up a good chunk of time just getting a new line. Add in having to monitor the patient the first 15 minutes of the transfusion then the multiple re-checks, it took my preceptor and I off the floor into the patients room for an hour.
This was in the middle of a med pass and vital check for the 4 other patients. I ended up leaving my preceptor in the transfusing patient's room to address the other patient's needs.
Where I am looking for advice is how in the heck would I have managed that if I were on my own?! My meds would have been well over an hour late and my patients would have had no nurse. That is just one scenario obviously but I often leave my shifts thinking, "If I would have been on my own, I literally would have drowned".
Obviously you can ask other nurses for help but they, plus our charge, have 5 patients each so they are often too busy. Our PCA's are 1:20, sometimes more, so they have little spare time as well.
I am really nervous about being able to handle things that "pop up" and take a lengthy amount of time and still be able to wrap things up and get things done for the next shift. I don't want to be the nurse that the next shift's nurses hate to follow.
Transfusion vital signs should be delegated. Observe for the first 15 minutes. No way should you be tied up for an hour for a simple transfusion. If the patient was unstable.. while needing the transfusion.. that would be the time to delegate care for your other patients .. notify supervision that your patient is now 1:1.
Been there,done that, ASN, RN
7,241 Posts
Transfusion vital signs should be delegated. Observe for the first 15 minutes. No way should you be tied up for an hour for a simple transfusion. If the patient was unstable.. while needing the transfusion.. that would be the time to delegate care for your other patients .. notify supervision that your patient is now 1:1.