When will I be less task-oriented?

[nursealanarae]

I have been a nurse on a Neurology/Ortho/ Med-surg floor for about 8 months now (including orientation). Although I feel that I have DEFINATELY improved as a nurse and my knowledge and skill has grown, I still feel like an idiot. I feel that I am constantly second guessing myself and feel that I forget a lot during my day and thinking when I give report "why didn't I think of that." I feel that I forgot a lot from nursing school and I am ENVIOUS of the nurses that have been there for even two years and know sooo much about the human body and a lot more than I do. I still make little mistakes here and there (which is expected), but I feel like I am trying to survive my day more than anything. I am still very task-oriented and I feel that I can't break that habit. How can I focus more on the patient's needs and less on the tasks at hand? How can I improve my critical thinking skills? I feel like a crappy nurse most of the time. ugh.

PS- In a 12 hour shift, how often do you do your usual full assmessments of your patients? Do you just do one or more than that?

:redbeathe Thanks! Alana

[ibspider]

I am at a similar point and have had the same question. I've noticed that I get more comfortable with something then pick up on another aspect of nursing that I need to improve or incorporate into my routine - be it a task or way of thinking about things. I am constantly raising the bar on myself so it almost feels like I can't reach the goal. It can feel frustrating. Recently though more tasks have become more routine, my routine is getting refined and I think I'm moving on to more critical thinking and patient focus. I think it just takes time. I know anxiety over the responsibility, wanting to do a good job and feeling overwhelmed at times with workload and frustrated with the lengthy process of learning has hindred getting the tasks and my routine down. My own high expectations and fears get in the way of the my progress. It helps me to talk to other new nurses, read posts and get real with myself about where I am (as you mention - knowing it's expected to struggle). This is a long process and the nurses w/ 2 years are looking with envy at the nurses with 4 yrs experience, etc. I know I can look back at 2 months ago and see I've come a long way. If I have made it this far I will make it the whole way. It's good that we are looking at our process and are motivated to improve. It will happen.

[nursealanarae]

Thank you for your response! This whole process is extremely frustrating. I just want to be the best nurse I can be and, of course, I want to get to that point fast, haha. It's good to know that we are not alone and we have the same frustrations.

[talaxandra]

I think it's great that you're both aware of this and want to change. As the tasks become second nature, and your perspective of what your patients need expands, you'll find yourself anticipating things more. I also think it's helpful to compare your practice not to more experienced staff (nobody starts out knowing what to do) but tothe next intake of grads - often it's not until then that you'll realise what you'll already absorbed and accomplished.

And while a task-based approach is limited, don't forget that all the tasks do need to be done!

[RoyalNurse]

Does the floor you work on have a certification course? Like a Med-Surg certification, PCCN or CCRN? Studying for that helps you see the big picture.

As far as assessment goes: I assess patients all day, depending on what's going on with them. I "lay eyes" on them every hour, and see how they look. If they're coughing a lot or seem short of breath, I listen to their lungs frequently to see if they need help getting rid of stuff or wheezy, and check pulse ox. I feel for pulses frequently if they seem a little faint at the beginning of the shift, or if I needed a Doppler. If they look "off", I assess vital signs frequently (every 30-60 minutes or so) for a couple hours until I either find a problem, or assure myself enough that the patient's OK. I'm also assessing on q2hour turns, med passes, etc.

I don't really have a set schedule for assessing these things, it's more intuition, I guess.

For a full assessment: once at the beginning of the shift, and a modified full at 3 pm (every 8 hours).

I also recommend an assessment course, it helped me a lot with heart sounds, lung sounds, when to assess.

Here's the one I went to, but I think they need to update the website: http://www.stethoscopeskills.com/

[nursealanarae]

Does the floor you work on have a certification course? Like a Med-Surg certification, PCCN or CCRN? Studying for that helps you see the big picture.

As far as assessment goes: I assess patients all day, depending on what's going on with them. I "lay eyes" on them every hour, and see how they look. If they're coughing a lot or seem short of breath, I listen to their lungs frequently to see if they need help getting rid of stuff or wheezy, and check pulse ox. I feel for pulses frequently if they seem a little faint at the beginning of the shift, or if I needed a Doppler. If they look "off", I assess vital signs frequently (every 30-60 minutes or so) for a couple hours until I either find a problem, or assure myself enough that the patient's OK. I'm also assessing on q2hour turns, med passes, etc.

I don't really have a set schedule for assessing these things, it's more intuition, I guess.

For a full assessment: once at the beginning of the shift, and a modified full at 3 pm (every 8 hours).

I also recommend an assessment course, it helped me a lot with heart sounds, lung sounds, when to assess.

Here's the one I went to, but I think they need to update the website: http://www.stethoscopeskills.com/

Thank you!

I took an assessment course in college, but it wasn't as helpful as I would have liked. My assessment strategies are similar to yours. However, I sometimes don't even have time to do a full assessment at 3pm. I think I am going to go for MEd-surg certification, but I need to have at least 2 years under my belt. Your reply was very helpful! I appretiate it.