Today was a non stop busy day on the unit. To start everyone was scrambling to get through report because the unit was short staffed for the day. Instead of 4-5 patients on a regular shift we had 6 to start with. Even the charge nurse was taking 3 patients. It also was a little interesting because once again my preceptor was unable to show up because of family obligations and she asked me to work with another nurse on the unit for the day. This is a bit frustrating because the timing for my shifts to finish up is coming up soon and with only 2 more shifts remaining I need to stick to my schedule of shifts I have arranged to meet the deadline.
So with all that going on the nurse that my preceptor assigned me to work with for the day was fantastic. I felt like I was very helpful with the patient load and busy circumstances. Some of the things that I noticed that my nurse was very good with were helping the rest of the staff throughout the shift. Their attitude and approach to nursing was really refreshing. There was a noticeable amount of altruistic and patient centered care that was done in a way that made the busy and stressful day enjoyable and almost easy to deal with.
When I think of skilled nurses I usually think of the actual ability to perform tasks and the knowledge base needed to make critical decisions and accurate assessments. Today was the situation where I witness how a nurses' "other" skills can make a difference in not only the patients care and overall experience but the unit as a whole. Even though throughout the shift we were able to perform and do some great care and perform skills such as removing a JP tube, dressing changes, insert new IV lines, discharges and admits I feel that the I was able to get so much more education on how the "other" things a nurse does and how noticeable of difference it was.
Wednesday, April 11, 2012
Tuesday, April 3, 2012
Fifth Day
My preceptor was back for my fifth day and I was ready and excited for the shift. My confidence was really starting to make a difference as the learning curve of charting and other procedures on the unit were becoming more familiar. I felt like that this shift I was able to ask better questions with the patients in my assessments and didn't forget as much. I also felt more confidence from my preceptor as it was showing that I was more capable and able to do more in less time than previous days.
I had two patients that I was taking by myself and I felt that I was able to do most all of the care and charting with minimal assistance. I felt that the time it was taking me to perform tasks was becoming more efficient with less mistakes or questions.
Today I reviewed all my SMART goals with my preceptor so we could be sure to focus on them. Although I did not complete the goals with a full patient load I was able to do all of the following with my two patients and assist with others during my shift such as: admit a patient, discharge and teaching, review medications, complete all the charting and chart checks.
There is definitely a learning process as you advance in skills and the amount of work you have to do in a certain time frame. I feel that I am getting closer to meeting my SMART goals fully and should be able to by my final shift. I would understand that I am learning a lot and it can be hard to internalize all the information I receive from my preceptor but I do feel that i am grasping on to the main ideas and points of care that will lead me to attaining my goals.
I had two patients that I was taking by myself and I felt that I was able to do most all of the care and charting with minimal assistance. I felt that the time it was taking me to perform tasks was becoming more efficient with less mistakes or questions.
Today I reviewed all my SMART goals with my preceptor so we could be sure to focus on them. Although I did not complete the goals with a full patient load I was able to do all of the following with my two patients and assist with others during my shift such as: admit a patient, discharge and teaching, review medications, complete all the charting and chart checks.
There is definitely a learning process as you advance in skills and the amount of work you have to do in a certain time frame. I feel that I am getting closer to meeting my SMART goals fully and should be able to by my final shift. I would understand that I am learning a lot and it can be hard to internalize all the information I receive from my preceptor but I do feel that i am grasping on to the main ideas and points of care that will lead me to attaining my goals.
Sunday, April 1, 2012
Fourth Day and SMART goals
My SMART goals are:
For my fourth day it had been a few weeks since my last day due to scheduling conflicts. With the time between the days it took a little bit to remember and refresh myself to the unit, charting and staff. My preceptor had to cancel on me last minute and with the limited time I have had with my preceptors shifts I needed to come in. My preceptor asked me to be with another nurse that was trained by them and that was excellent for the day.
I was able to focus on care for two patients on my own with minimal assistance from my nurse for the day. Also for the day I spent some time focusing on SMART goals. One thing I was able to do is look up and discuss medications to meet goal #4. With the medications I wanted to focus on ones that are most commonly used on the unit. With pain control being high on the list of patient priorities I have several pain medications as well as other common medications used in conjunction with or often on the unit.
Also through discussion with my preceptor and with the nurse for fourth day I came to a decision of my Issue Paper topic. I will be focusing on the issues and concerns both with nurses and patients related to patient hourly rounding. I feel that on my unit this isn't always a priority and that there is some great information to discuss about hourly rounding.
The patients that I focused on and cared for in my was a patient post operation recovering from a colon cancer removal. They had been on the unit for a week at that point and was making great progress. Pain was being controlled PCA and later moved to PO pain meds as the diet was moved to full diet. Getting the patient ambulating and controlling pain was a priority. I felt confident in carrying out the orders and care for the patient with minimal care.
For the other patient I focused on was an admit awaiting surgery that was in severe pain. They were not able to go into surgery yet due to some labs out of range. I also focused my care on another admit that came in later that day and was able to do the majority of admit assessment and charting.
1. I will be able to carry the full patient load with minimal assistance from my preceptor by the end of the preceptorship.
2. I will be able to admit all assigned patients to the unit in a timely manner and delegate effectively throughout the admit process with minimal assistance from my preceptor by the end of my preceptorship.
3. I will be able to complete patient charting in a timely manner on a full patient load with minimal assistance from my preceptor by the end of my preceptorship.
4. I will learn 7-10 medications actions, doses, indications and contraindications and educate the patients who are in my primary care about their drugs prior to giving, as well as with discharge, with minimal assistance from my preceptor by the end of my preceptorship.
5. I will be able to give report on all assigned patients with minimal assistance from my preceptor by the end of my preceptorship.
For my fourth day it had been a few weeks since my last day due to scheduling conflicts. With the time between the days it took a little bit to remember and refresh myself to the unit, charting and staff. My preceptor had to cancel on me last minute and with the limited time I have had with my preceptors shifts I needed to come in. My preceptor asked me to be with another nurse that was trained by them and that was excellent for the day.
I was able to focus on care for two patients on my own with minimal assistance from my nurse for the day. Also for the day I spent some time focusing on SMART goals. One thing I was able to do is look up and discuss medications to meet goal #4. With the medications I wanted to focus on ones that are most commonly used on the unit. With pain control being high on the list of patient priorities I have several pain medications as well as other common medications used in conjunction with or often on the unit.
Also through discussion with my preceptor and with the nurse for fourth day I came to a decision of my Issue Paper topic. I will be focusing on the issues and concerns both with nurses and patients related to patient hourly rounding. I feel that on my unit this isn't always a priority and that there is some great information to discuss about hourly rounding.
The patients that I focused on and cared for in my was a patient post operation recovering from a colon cancer removal. They had been on the unit for a week at that point and was making great progress. Pain was being controlled PCA and later moved to PO pain meds as the diet was moved to full diet. Getting the patient ambulating and controlling pain was a priority. I felt confident in carrying out the orders and care for the patient with minimal care.
For the other patient I focused on was an admit awaiting surgery that was in severe pain. They were not able to go into surgery yet due to some labs out of range. I also focused my care on another admit that came in later that day and was able to do the majority of admit assessment and charting.
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