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.)

Summer School......really?

Uh, yeah, for the third time in 20 years, I have to take Intro to Computers. For real?? It's not that I mind, it's that I don't think in this day and time it's necessary. What I would have liked to have taken would be that last pharmacology online. It would have saved me time in these last two semesters.

To be fair, the guy is pretty on task. He walks you though it step by step via Youtube and if you mess up, it's your own fault. Easy A. But an expensive one....$500.

Don't laugh, but I went to Half Price Books and bought the previous editions of the textbook for OB so I could get a head start. That class is only 5 weeks, so that means a test every week. Ewwwww....... plus clinicals, which require a stupid care plan. I've already started on those, just to be waiting in the wings for when I'm time crunched. What do you do to prepare for the next semester of nursing school?

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.

First casualty of war

I've been notably silent...which is not like me. That's because all I do is go to work, study, eat, and do it all over again. It's been fine until now. The person who was accepted along with me didn't get to advance to the next 11 weeks. I felt alot like Katniss this past semester.Just jumping through hoops. But the best part is I had a friend jumping with me. We knew no one but each other walking in that first day. And thankfully, the group accepted us pretty easily as they had already made friends in the first semester we were exempt from. He was liked by all, even to the point when we found out he didn't make it, one of the others cried. He never expected to be thought of that highly, but why, I don't know. He has 20 year of LPN experience, and knows his stuff. He just didn't test well. I don't either, by the way. He only missed it by 2 points.
I took it pretty hard the first few days because I couldn't imagine how bad he felt. For our clinical group, it's been like someone has died. But we're coming around.
Hunnybunny didn't really understand. He tried to, but he couldn't really get the whole "nurses in the trenches" vibe. The more he tried to encourage me, the worst I felt. I wasn't trying to make it about me, but I kept thinking, "If HE didn't make it, what makes me think I will?"
So, I'm trying to remember what I did the first time. Pouring over my notes, and finding my notes from LPN school invaluable! Apparently, this particular program doesn't go into too much depth on stuff, so in a sense, we are educating ourselves. And I will revert back to what I said in a previous post: my learning style is my problem. If I can't figure it out by now, what am I doing here?
Y'all are going to have to overlook me....I am just trying to stay realistic.
The ATI demon is back with this program. How I HATE ATI! And if you're reading this and have no idea what I'm talking about, consider yourself lucky. ATI prides itself on preparing you for NCLEX. But all I can see is that its taking us all away from what we should be doing....studying!
I will get off my soapbox now, and take off my black mourners veil and get back to work. Thanks for listening.

Finally have a minute or two to update you....

I survived my first semester of nursing school. While that may seem trite, I think about those students with much younger brains who didn't make it to second semester. And I'm sad for them.  One of my group didn't make it and when she told me she was dropping, I felt like someone died. I wasn't that far behind them as my pharmacology didn't come up as I planned. I made it by .5 for the C. C's are different in nursing school. Mine start at 83 and go to 78. Anything below that range is a D. My other classes I did fine: How to be a nurse 101- B; and Intro to Nursing- A. Toward the last of it, I was getting ready for the head-to-toe assessment, going through clinicals, and getting ready for finals.
I learned a lot during clinicals. Clinicals are great because you have someone to hold your hand just starting out. I was able to connect to most patients, but was even asked to leave another patient's room. Apparently, she thought I talked too much. I remember asking her one question....oh, well. I took it kind of hard at first, but then realized she was in a lot of pain. Many people came and went in her room. She may not have been able to discern that it wasn't me talking. Anyway, lesson learned. Comatose patient: Don't ask anything. Just wait until they are up and oriented. Other than that one experience, it was really good. I was able to give one patient a bath and she had all the good humor that I hope to have approaching  her age. Another patient was  staring death down, and she had this great attitude. Again, I hope I'm like that.  

Other things I learned included what type of learner I am. Apparently, I'm a visual/active learner. Having tried the auditory route, and massive note taking route, I think I'm better going through the chapters myself, and creating my own visual cues. I studied with several classmates, and shared my notes with them. I got the reputation of being really smart, even though none of that was true. I can make these fantastic notes which apparently helped others make A's but for myself, it just didn't happen. Reeks, doesn't it? A re-evaluation of my study methods are definitely in order.

Another thing I have come up against is feeling responsible for helping others study. I know, I know, how crazy is that, right Even the night before finals, I had someone wanting to study with me. She had not studied as she should (neither had I) and was expecting a miracle. The miracle never came, even until 2:00 AM when I had to shut my eyes for a little while. I got up at 5  AM to go over the stuff I didn't have time to go over while she was there. I passed by the skin of my teeth, .5. That's a little too close. If I had failed that course, I would've had to repeat it next semester. I've got to find the balance of being willing to help when I can, but not feeling it's my responsibility to make sure they pass. It is, however, my job to make sure I pass. Any study methods you can pass along would be great! I have a month before the roller coaster starts up again, and with four classes, 12 hour clinicals, I need to figure this out.....SOON!

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!


  

Sticker shock!

  

No, these aren't all my books, but pretty close. Fact is, I'm still buying them. Wow, they told me I'd have to sell a kidney to pay for school, but I don't guess I fully believed them. So far, I am up to $206. That amount was six books I found on Amazon. I still have $500 more to come up with in books and supplies. I hope the subsequent semesters aren't this expensive.

    Thankfully, I had the foresight to get my laptop when I started prerequisites, and even got one of these: 


It's been pretty handy on this traveling thing I've done this year. And it looks like it will spare my back.