Shift #2 Preceptorship

Well this shift was great. i did a lot of things that i never did before. i took out a central line, removed sutures, and started an IV. i also relearned that when a pt is in pain you have to believe them and what they rate their pain. we had a pt that was way loopy on her pain meds, but when more were due she asked for them, and the nurse explained that pain is subjective and we had to believe that she was in pain, and treat it.

But now for my goals:

1. I will be able to start, maintain, and discontinue IV access, including programing the IV pump, IV drip medications, IV push medication, and maintenance IV fluid, with minimal assistance by the end of my proctorship.

2. I will be able to know the normal values and causes for variation for a CBC and a CMP, with minimal assistance by the end of my proctorship.

3. I will be able to identify the adverse effects and contraindications of the 5 most common medications given on the 7th floor, with minimal assistance by the end of my proctorship.

4. i will be able to effectively communicate with the physician, in person and on the telephone with minimal assistance by the end of my proctorship.

5. i will be able to carry the entire patient load (3-4 pt) by myself with minimal assistance by the end of my proctorship.

I think that these goals will help me to be able to have a jump on nursing when i start to work after I graduate.

week #1 preceptorship

this week during my preceptorship all of my anxious feeling went away. initially I was really nervous, i did not know what to expect. i had heard rumors about the 7th floor and they were all about how the RNs there had 5-6 pt and they were always really busy. also that the pt were really needy and the RNs just ran around and gave pain medication all day. so after hearing all these things i expected to have a bad clinical day were i just followed my RN around. however it was quite the opposite. i met my preceptor and she is great, we got report, and got started on the pt. we went to see the first assessment together and i volunteered to do the other 2. it was going great, i learned how to find all the medications that pt need and i was able to get the medications for 2 of the 3 pt. as the day went on we went thorough busy and slow periods, during the busy times i was able to get all the medications by myself and then bring them to my preceptor so she could check them off.

my favorite part of the day was when we got a new admit in the afternoon. my preceptor was busy so i volunteered to assess him and do the admit charting and the RN could pick up on things that i forgot to do. the pt was dx with acute renal failure, something that i am familiar with as the floor i work on as a tech specializes in renal pt. i assessed him and was checked the orders in the chart. i went to my nurse to have her be in the room with me as i started the IV, but she asked if the charge nurse could help. so i got the charge nurse and she said that we were not going to start the IV because he was going to get transferred to another unit. actually to the unit that i work on. so i got to call and give report on him to one of the RNs that i work with, so that was fun.

i think that my first shift gave me a glimpse of what it will be like as an RN, and i know that i will love it.

the course objective were addressed while i was there because we had to practice interdisciplinary coordination with the physicians and interpretation.

overall a great day and i look forward to the next one.