 |
||
|
|
BONUS CONTENT FROM NURSING MADE INCREDIBLY EASY! Tips for new nurses I don’t know what I'm doing. That thought raced through my mind many times during my first day as a nurse. No, that's actually not true—I felt that way every day for at least a month. It seemed that almost overnight the training wheels had come off and now I was held accountable for my actions without a teacher to hold my hand. Because I second-guessed myself at every turn, I asked for advice from every nurse with whom I came in contact. Then I realized I knew more than I gave myself credit for. If you're making the transition from student to graduate nurse, I hope the following tips will help prepare you for the challenges you'll face. Unexpected things will happen and you won't always be prepared. Remember, the worst time to learn emergency procedures is during the emergency! Know where your crash cart is located and the position of items in it. Learn the emergency procedures for your facility. If an emergency happens, stay calm and confident. Striving to maintain an aura of confidence even when you don't feel very confident is difficult, but an illusion of confidence can go a long way to alleviate a patient's anxiety. Nursing is a stressful profession, so make sure you have someone you can vent to without compromising patient confidentiality. If emotions begin to run rampant and you feel you may lose control, remove yourself from the situation and go somewhere private. Sometimes all you need are a few cleansing breaths to help return your aura of confidence. Make sure you receive a comprehensive report on your patients before you see them. The report should contain any elements critical to your area of nursing such as patient name, physician, allergies, diagnosis, do-not-resuscitate status, I.V. fluids and flow rates, blood glucose parameters, and so forth. Keep this report with you or within easy access and make sure to protect the patient's confidentiality. Have all your facts together and try to troubleshoot the situation before you call the patient's healthcare provider. Try to anticipate the practitioner's questions. For example, let's say your patient is a 39-year-old woman whose BP is 194/102. What BP medications is the patient taking, and has she skipped any doses? What have her BPs been running? Does she have signs and symptoms of hypertension? Is the patient anxious or fearful of a new diagnosis or surgical procedure? If you're unsure what information the healthcare provider might want, ask another nurse; don't be afraid to ask for help. Read back verbal orders from healthcare providers to make sure the order is complete and nothing was misinterpreted. This is one of The Joint Commission's national patient safety goals; make sure you know all of those applicable to your facility. For a complete list, visit The Joint Commission's Web site at http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals. If possible, spend your first 6 months to 1 year on a hospital medical/surgical unit. Even if you don't plan on working on the medical/surgical floor long term, the experience you gain will be invaluable. Be flexible and learn to prioritize your patients. The patient who has undergone hip surgery and is requesting pain medication is more important than the patient who wants another pudding cup. If you get bogged down, ask another nurse to help you for a few minutes. Watch out for nurses who have the shameful habit of “eating their young.” Most nurses are wonderful, nurturing teachers, but you'll have to interact with some who may not offer a helping hand to new nurses. They seem to enjoy making new nurses feel uncomfortable and doubt themselves. Don't take it personally; seek out those who are interested in helping you. Read your policy and procedure manual thoroughly, and pay close attention to things that are specific to your job description. Nurses must ultimately adhere to their state's practice acts, but your facility's policy and procedure manual can further restrict your actions. For example, some facilities have a list of specific medications that LPNs aren’t allowed to administer via I.V. push, even though the LPN practice act for your state may not make such a stipulation. Remember, it's your responsibility to decide whether you're legally allowed to perform a task, so visit your state's board of nursing Web site and make sure you stay within the scope of your practice. Don't gossip or spread rumors about coworkers. You have to work with these people, and unnecessary tension makes your job more stressful. If you have a problem with a coworker, talk to that person directly in a calm manner. If that doesn't resolve your problem, talk to your supervisor. Know everything about the medications you're giving your patients. Investing in a personal digital assistant (PDA) with a drug book and medical dictionary software installed is certainly a worthwhile way to keep up. You'll find that using a PDA is much easier than lugging around heavy reference books or having to ask coworkers many questions. If this isn't feasible, speak with your facility's pharmacist, or see if the unit where you're working has a current drug guide available for your use. Document, document, document. Remember the wise saying, “If it wasn't documented, then it wasn't done.” You could provide exceptional nursing care, but if your documentation doesn't support it, it didn't happen. Your documentation should also support your patient's diagnosis. Understand that you'll get a great deal of on-the-job training, but you should refuse to do anything that you don't know how to do, are uncomfortable doing, or haven't been taught to do. While you'll have learned a great deal in nursing school and clinical rotations, no one can observe and perform every nursing skill. Ask if you can participate in or watch different activities such as I.V. starts or indwelling urinary catheter insertions. Most nurses and physicians are excellent teachers and are happy to share their knowledge. Ask questions, but take notes so you aren't asking the same questions over and over. Don't be forced into doing something you feel isn't in the patient's best interest. You're the patient's advocate, and it's your duty to speak for him. Most healthcare providers welcome suggestions, so be honest. It's not so much about “how you feel” but about standards of care and what's best for the patient. Selected references Source: LPN2008. March/April 2008. |
|
 |
||
 |