RN Orientation Week 4

I worked Tuesday, Wednesday, Saturday and Sunday this week.

Tuesday seemed to just be a mess. I started out with four patients and all seemed to need a lot of care or had something new I hadn't dealt with before. I struggled getting my assessments completed and my meds given. I swear I was still working on medications and charting by lunch time. It was terrible. My preceptor had to do so much to help me. I wanted to sit in a corner and cry. I discharged one patient and admitted one patient by the end of the day.

Wednesday was so much easier. I knew 3 of my patients already so I only had to learn about one that had been admitted during the night. It was super easy to get my assessments and medications done by 10am. I think I even had my charting completed by then. I felt like a pro because I could actually keep up with everyone. I discharged two patients and got two new patients by the end of my shit, I am getting awesome at doing the discharging and getting way better at admitting. I got lots of practice calling the doctors and feel like I am getting better at actually talking to the doctors, it is super intimidating. I seem to studder a lot.

Saturday was really laid back. I had four patients that were pretty easy. One patient was a little rude and mean but I learned from family that maybe some pain meds were causing some side effects. A little change of meds and I have a wonderful and sweet patient, great lesson learned - don't just give whatever meds are prescribed, always look at side effects, age, other meds, the way the patient is acting... and I can always call the MD and get a new order or have dosing changed. I had a patient that lost something very important during the whole fiasco of calling 911 and coming to the hospital so I spent a little time calling a bunch of numbers and ended up finding the item, I felt like a million bucks for actually finding the item and they were so very THANKFUL !! It was amazing to come through for the patient and family.  I took care of one discharge and my day went fairly smooth. I got almost all my meds and assessments done 10am and was able to catch myself up and the day ended on a pretty good note. My biggest bummer was my failed IV stick:( I really do need to get a few good sticks under my belt.

Sunday was so easy {having your same patients makes things way better because you already know the medications and the illness and how they move} !!!  The day was completely laid back. I had three of the same patients and did not admit a fourth until the very end of the day, like seriously i took report for the patient, did part of the admit process and handed off report to the next shift. I had written down everything I needed to know about my patients Saturday night so that  receiving report Sunday morning went very quickly and I could get my day started right away. I managed to get all my meds and assessments and charting done by 10am. I rarely asked for help. I got to change a dressing and do a few other new things that my amazing preceptor helped me with. I learned that patients can be in amazing condition one minute then be in terrible shape the next moment so I need to check on my patients often, look at vital signs more often and pay attention to lab results. And something amazing to keep in mind is that a lot of meds have tylenol in them so when I want to give tylenol for a fever or pain.  And did I mention I had someone mention to me and my preceptor that they had no idea I was on orientation and I seemed to really know what I was doing.

I am learning a ton every day and feeling more confident with each shift. I am very nervous to be on my own but I am confident I will get any help I need from any of the amazing nurses I will be working with. I just really need to focus on time management. If I can get my meds and assessments completed by 9am or close to it every day I will have time to get almost everything else done.