Precepting/Orienting Nurses

A couple of years ago, I was asked to orient a new hire on my floor and was excited as she was a grad from my alma mater, so we had the same frame of reference. She was excited because she had always wanted to work in psych. I felt great knowing she was going to be on a somewhat quiet unit, instead of an acute one, like I did.

So, I began to orient her to the unit, citing procedures, treatments, and daily practices at nauseam. She caught on very quickly, and was doing so well. On our last day together, I turned her loose to do it on her own, and she was excellent!

However.....(you knew there would be something) two days off of orientation, she gets pulled to another unit. Not only does she get pulled, they require her to be a nurse's aid. Not only does she have to be a nurse's aid, they place her with a very psychotic patient. Not good. She begins to cry. They place her with another patient, it does not make her happy.

I guess my spidey-sense went off, even though I had not seen her since orientation. My co-workers began to tell me some troubling things: she is not on the floor very much,  and is seen constantly on her phone. She won't take off orders, help with treatments, or basic patient care. "Hmmmmm," I thought, "maybe she's quitting?" In my typical fashion, I just asked her, "Are you going to keep working here?"  She mumbled an answer about not being a psych nurse the rest of her life, and averted my eyes. Yep, she's a goner. The next day I had asked someone who knows everything at the facility and they confirmed my suspicion that she had turned in her notice.  I took it kind of personally. "Maybe I didn't give her enough training or support?". I found out later that she went to another job and stayed there only 3 weeks before she turned in her notice, too. I felt a lot better after knowing that.

After that experience, I took a precepting course offered by my facility so I would get a little more per hour for training new hires. Over the course of two years, I've probably oriented 10 different people. Some were straight out of school, others just picking up for extra money. I've had a few that were lazy, and some that were very ambitious, wanting to try their hand at every skill, gross or not. My alma mater also has brought me some about to be grads who need to precept their 120 hours with a nurse before taking NCLEX. Those are my favorites! I just love seeing a new nurse with all that positivity in their eyes. And they think you know EVERYTHING! Ha!

If you ever get the chance to precept/orient, take it! I used to think that having a student would be an awful burden and experience, but you learn things from them, too! (I had an orientee that showed me a trick changing ostomies that has keep me from making a horrible mess that I'm forever grateful for.)

What I learned the first semester of RN school

Some things I learned fresh. Others I re-learned.

I've always been a fan of Top Ten lists so here's my list for this past semester:

10.  It wasn't as hard as I thought it would be. I guess going in with 18 months of prior school knowledge as well as almost 3 years as an LPN helped, but common sense kicked in, (which I hoped it would) so those NCLEX type questions were a lot easier to handle.

9.  I still hate ATI as much as I did back in LPN school.  I hate paying for something that I can't fully use. I have subjects I'd like to start working on and they "aren't open" . Well, why the heck not? I have to pay $400 a semester and not be able to use it all? They are trippin'......

8.  I don't stay up all night and study anymore.  Maybe that sounds selfish, but it's true: I'm old....I need my sleep. The one time I did stay up all night, it did me no good, anyway.

7.  Clinical days still aren't fun because no nurse in their right mind wants to have a student for the day. They were nice to me. But I could tell this wasn't on their to do list. To be fair, it won't be on mine, either.

6.  Technology has certainly advanced things. I still paper chart at work, but I got to electronically chart during clinicals. It does seem monotonous though....it's also nice to be able to record my lectures on my cell phone and listen to them back and forth from school to home.

5.  I have forgotten so much about IV's since I don't use them at work. If someone needs an IV at my job, we send them out. Still haven't stuck my first victim...I mean, patient....

4. Working every week-end full time blows.... but when your work is PAYING  6 hours a semester, and you need the insurance, you go.  You hate it, but you go.  I worked every Friday, Saturday, and Sunday. On Mondays and Wednesdays I was in lecture, Tuesdays was lab, and Thursdays were clinicals. I am glad I saved my vacation days to use on the Sundays before an exam.  I'm going to need to bank some this summer for my second semester as well. My schedule will go back to normal starting Monday.

3.  It's still important to make friends in nursing school. After my friend left, I started studying with a guy who had an even weirder schedule than the first one. I found myself meeting him at McDonald's at 5:30 AM to study. Must of been nuts, but we both passed.

2.  It's awful when your BS meter goes off and you notice the teacher not trying. Yes, I am saying she was blowing smoke in a place you don't want to talk about. I'm not that far from her age, so I know she knew, that I knew she was just getting tenure. She read from the book because she didn't know the material. Our last 3 lectures on diabetes, which is fairly involved, she got guest speakers to talk to us. Wow... how lame can you get? It made me want to stay in school to have the credentials to take her job....almost. I'm so done with school.

1. My family is still there helping me through. ( Mostly Hunnybunny) However, they still don't get me on the whole studying thing. I thought maybe my kids would be proud of me. But they think I'm wasting my time. It's okay. While I'd like to have their support and approval, its just not necessary.

Experience is the best teacher

Or so they say, whomever they is....I took my clinical adviser 's advice and got a job as a CNA this summer. It was probably the best thing I ever did for my education. I keep my assessment skills up, and am able to make a buck or two. Not saying where as I don't wish to get into any trouble, but it's a good fit. I'm working 40 hours a week until school starts back up in 7 weeks. Then, I hope they can still use me part-time.
My instructor mentioned to me that working with patients is probably what I need to build my confidence, and she was correct, (as much as I hate to admit it).  Initially, I started pretty green but have been steadily  gaining confidence by using my assessment skills, and getting a feel for what patients go through to be taken care of by nurses.
I'm also looking at this opportunity to see through the eyes of a CNA . It's been tiring but great. And it keeps the goal in front of me ....that nursing is what I want to do.

So....my last post was a little tense....

so, I apologize. And I deleted it.  Stress was getting to me. Still is. A friend told me that she benefited the most from putting lots of time into notes. And I have to admit, she's right. Only I can dig through that text and totally understand what notes I've written. So, if I sounded judgmental, I think I was just feeling unappreciated by those I had shared notes with. They don't want to pitch in, it's really about them.
I had another test today and patiently waiting for her to post the grades.I'm feeling pretty good about it.

Next week, I have vital signs check off and injection check off...both on the same day! As far as being nervous, sure, I'm nervous, but not terrified. I probably should be. But I'm trying not to psych myself out.

I have been really enjoying most of my classes, especially Pharmacology. The teacher is passionate about teaching us the right way, and I appreciate her for that.

We received our new schedule for next semester. Here it is as follows:


Mental Health
Health Deviations
Peds
Pharm II

We hit the ground running with 12-hour clinicals. Thankfully, I got the new Timberland Pros. Aren't they positively "Ooogle-ly"?? But so far, they are very comfortable. I've been breaking them in every chance I get. Clinicals for this semester start very soon, and I'll be getting my assignment for them Monday. Sounds crazy, but this semester has really flown by.

First week of testing in nursing school

 Yes, it's been a fun-filled week in nursing school. I had the privilege of taking three exams back to back in one week. That's right, Friends and neighbors, my brain got a workout.   Fifty or so hand-written pages of notes from my "how to be a nurse" class.  After studying close to 72 hours total for it, all I got for my trouble was a 76. While that would be passing in regular classes, the range for a C is 78- 83 in nursing school. I missed passing it by one question. We covered: asepsis, infection control, nutrition, range of motion, order for putting on and taking off, personal protection equipment, glucometer skills, Maslow's Hierarchy of Needs and how it applies to nursing...I think that was it. It was pretty intense. My teacher told me I did better than alot of people on this test, but there was no comfort in her words.
Pharmacology was much better, I got a B.  And the online Intro to Nursing class I got an A.
I think I realized my problem regarding my studying. I spent all my time dissecting the textbooks and comparing them to the outlines.  Basically, I couldn't see the forest for the trees and made it much more complicated than it needed to be. Not playing on my strengths hurt me, too. My thing is visual learning. I've been trying to rewrite notes,  and use auditory learning with an Echo Smartpen. What did help me were sites like Study Blue, Quizlet, and Flashcard Exchange.  I can make my own study guides and the sites will quiz me on the definitions or theories.

       I saw this on a t-shirt that I want to get. It pretty much summed up my week. Day of the exams, I had gone to bed at midnight and got up at 3:30 AM to study until 6:30 AM. I left early and sat in the parking lot to study. Nobody had on any makeup and nobody cared, either, including me.
        I get to do it all again in 2 1/2 weeks......YEA!  But at least I know now how to approach it.

And for those of you wondering, yes, the bag with the wheels
is working pretty well. I went with the Samsonite because the company is as old as me.....lol! Anyway, it holds about 7 books, nursing that is, 6 or 7 composition books, and two nookbooks, plus all my extra pockets of stuff. Thanks for asking! I would get another one!