Am I meant to be a nurse?

October 3, 2016

So I am currently trying to swing my sleep schedule in preparation for my first night shift. I have been working on days to learn a few items about my floor and interact with managers/doctors, but I will stay on nights. I am excited and nervous; my other shifts have not been too great.

I know some people really like nights, but I have never been a night owl. What I am looking forward to about night shift is that it is slower in terms of interruptions, new orders, questions from family members, etc. I am hoping that I will really start to get into my own flow.

Up to this point, I have had only four day shifts. The first one was with two patients. It went as well as first days go. I got majority of my things charted on time, but I missed certain charting requirements because it was my first time being exposed to them. My second shift was with three patients and it went great. I had two of the same patients as the day before and just one more. I was still getting adjusted to the charting, but felt like I was still breathing above water.

After those two shifts went good, I had high expectations for my third shift. It was rough. I was still on three patients, but I did not have ok time management. I was completely thrown off track in the beginning of my shift trying to manage two of patient's pain. I am not comfortable calling the doctor, so it slows me down discussing with my preceptor what to say and who I am really calling. So far all the doctors have been nice to me, it is just me having the confidence in myself. I never really seem to catch up with the day until 1400. What helped was that one of my patients was being discharged. Of course, I knew this meant I was open to receive an admit, but I thought they would send it to another nurse. My preceptor and the charge nurse, however, had high confidence in me and decided to accept another patient. It was not too terrible besides the fact that they arrived on our floor an hour and half before change of shift and I had a handful of charting to complete.

As a student nurse, I never really understood why nurses were always complaining about staying late to finish charting. I did not appreciate the fact that nursing school does not truly expose you to all of the charting. Now I am quickly learning that I need to multitask in my patients room. It is difficult for me because I want to give my patients attention and not be rude and have my back facing towards them. I also know that this is something that comes with time.

My fourth, and finally shift on days, was Saturday, and a complete disaster. I might be exaggerating, but that is how it truly felt. They bumped me up to four patients and I was no where near prepared for it. I have continued going into the hospital at least 30 minutes early to look up my patients. It has helped me get a little more understanding of what is going on with my patients. I also try and see who has meds in the AM. (but I have not been utilizing that organization well)

Once again, I was behind on my charting and barely making it in time for medication administration. I did manage to assess my patients on time, but it was not charted completely at that time. My charting system is not user friendly and I am still figuring out what goes where. Lately I have been trying to chart as much as possible in real time, and make note on what I have a question on to ask my preceptor.

I was late to my rounds, where we update the charge nurse, unit manager, and case manager on the patient's plan of care. I missed (or forgot to remember) what my patient's xrays showed to pass the information on to the night shift. I was spending too much time in my patients room during rounds and not taking breaks for myself.

My patients for the most part have been truly wonderful. It is just that I need to learn better time management and cluster of care. What is funny is that I have read all the tips and tricks. My preceptor has tried to help give me tips on what she does, but I am still lacking. (I seriously welcome any tips you might have as well)

Of course, I know I am still a baby nurse and not expected to have this whole thing figured out. But like any normal human, I have high expectations. I was hoping to just be able to chart my assessments before 1200 and have my sepsis screen completed within 1 hour and my vitals gathered. The nurses are required to grab the first set of vitals which adds to the length of my head to toes.

Overall, I am happy with my progress and excited to see where I grow, hopefully I will get the hang on this in October.

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