For the third day my preceptor was charging on the unit. I didn't receive any info about if my nurse charges until after this shift. I now know that I cannot be at any clinical shift my preceptor is charging which is a third of the shifts. This is going to make it extremely hard for me to schedule because one of the days that I was going to make work is the days my preceptor is charging. The other day I have a stats class that morning and so I am going to see if I can make arrangements to miss that class on that day for a few times in hopes that will be enough to finish my hours.
I think today was a great day for learning. I was able to go over a lot of terminology as well as help the other nurses on the unit for various different tasks. I felt part of the team more this day because I was able to assist with a variety of patients as nurses.
Today I was able to see how some of the prep for a shift and planning goes into a unit. The coordination of everyone and other units was really well done and interesting as well. We talked about my SMART goals as well as some topics for my Issue Paper.
I was able to help several new admits and get their aldrete scores and assessments, watch a portable wound vac be placed, and my charting is getting better as well.
Thursday, March 15, 2012
Second Day
Today we started with four patients. Three of which were admits from my first day so it was nice to be familiar with the background and see the progress. Of the three previous patients the dx were an incisional hernia for one and a ileocecal mass for the another and the last a left pneumothorax. The newest admit had appendicitis and was post op for a lap appy.
It was nice to be remembered by the patients I had in my first day and have them interested in you as much as you are interested in learning about the dx and care planning. We had a lot of expected admits and were expecting to discharge three of the four which we did. It was nice to feel busy and have a little more stress to get multiple tasks done while discharging and in preparation for a new admit. The time really flew by there when we were going from one thing to the next.
There was JP drain in the patient with the incisional hernia that I was able to remove while being observed by my preceptor. The patient was ambulating well and their pain no longer was being controlled by a PCA and was managed well through po meds. This patient was discharged today.
The patient with the left pneumothorax no longer had a chest tube and was being dicharged after a chest x-ray. We spent some time doing some teaching for the follow up visits that the Dr needed for the pneumothorax and further instructions. While this was being done the lap appy/appendicitis pt wanted to leave right then and there and was pressuring us to get out. They had a long drive ahead of them so we did our best to hurry up the process.
During these two discharges a new admit with a lap coly/ and lap appy arrived. I did the initial assessment and aldrete scores. My preceptor even mentioned that my charting was getting better and faster by the end of the day. So I feel I am getting more familiar as well as understanding what needs to be charted and not forgetting other things that take up time to go back and get.
The last admit was a sysoscopy that I also did the assessment and aldrete scores. This patient was experiencing nausea and vomiting coming out of surgery and we did our best to help with some meds for that. Pain management was one of the main priorities for all of our patients to get them ambulating feeling better.
The patient with the ileocecal mass was not expected to leave for a few more days but was able to be taken off the PCA and transition to PO pain and other meds. Helping them stay comfortable and keeping on top of the pain was a priority here. It was nice to transition from PCA to PO pain meds because that means the patient is making progress as well as no longer needing to chart all the PCA checks.
It was nice to be remembered by the patients I had in my first day and have them interested in you as much as you are interested in learning about the dx and care planning. We had a lot of expected admits and were expecting to discharge three of the four which we did. It was nice to feel busy and have a little more stress to get multiple tasks done while discharging and in preparation for a new admit. The time really flew by there when we were going from one thing to the next.
There was JP drain in the patient with the incisional hernia that I was able to remove while being observed by my preceptor. The patient was ambulating well and their pain no longer was being controlled by a PCA and was managed well through po meds. This patient was discharged today.
The patient with the left pneumothorax no longer had a chest tube and was being dicharged after a chest x-ray. We spent some time doing some teaching for the follow up visits that the Dr needed for the pneumothorax and further instructions. While this was being done the lap appy/appendicitis pt wanted to leave right then and there and was pressuring us to get out. They had a long drive ahead of them so we did our best to hurry up the process.
During these two discharges a new admit with a lap coly/ and lap appy arrived. I did the initial assessment and aldrete scores. My preceptor even mentioned that my charting was getting better and faster by the end of the day. So I feel I am getting more familiar as well as understanding what needs to be charted and not forgetting other things that take up time to go back and get.
The last admit was a sysoscopy that I also did the assessment and aldrete scores. This patient was experiencing nausea and vomiting coming out of surgery and we did our best to help with some meds for that. Pain management was one of the main priorities for all of our patients to get them ambulating feeling better.
The patient with the ileocecal mass was not expected to leave for a few more days but was able to be taken off the PCA and transition to PO pain and other meds. Helping them stay comfortable and keeping on top of the pain was a priority here. It was nice to transition from PCA to PO pain meds because that means the patient is making progress as well as no longer needing to chart all the PCA checks.
Monday, March 12, 2012
First Day
For my first shift it was hard to know what to expect coming on to the unit. I was nervous and excited to find my preceptor and to get to know them. In all my clinical experiences working with other nurses' it's been interesting to see how they go about their planning and how they use their time. I was expecting to see how the time management was taken care of as well as how the unit worked together with the patient load.
We had five patients, four of which had PCA's. This was good for me because I have not had any other experience with a PCA. This gave me a great opportunity to get to know the system and regular charting of a PCA. I expected to learn something different from each patient and feel like over the shift that I my confidence increased and that in turn helped me give better patient care. My charting was getting faster but was still fairly slow compared to my preceptor.
During the first shift I wanted build trust with my preceptor and I feel I was able too. I also wanted my preceptor to like me. It may sound funny but I didn't just want to barge in and step on others toes. As much as I want to learn I am making sure that I am still the student and showing that I am eager to learn as much as possible. My preceptor is very knowledgeable and makes things look easy. I felt comfortable in asking questions and my preceptor was able to effectively teach me and answer my questions. I never felt like I was in the way and felt very welcome on the unit.
We had five patients, four of which had PCA's. This was good for me because I have not had any other experience with a PCA. This gave me a great opportunity to get to know the system and regular charting of a PCA. I expected to learn something different from each patient and feel like over the shift that I my confidence increased and that in turn helped me give better patient care. My charting was getting faster but was still fairly slow compared to my preceptor.
During the first shift I wanted build trust with my preceptor and I feel I was able too. I also wanted my preceptor to like me. It may sound funny but I didn't just want to barge in and step on others toes. As much as I want to learn I am making sure that I am still the student and showing that I am eager to learn as much as possible. My preceptor is very knowledgeable and makes things look easy. I felt comfortable in asking questions and my preceptor was able to effectively teach me and answer my questions. I never felt like I was in the way and felt very welcome on the unit.
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