Me: Doctor, my patients heart rate has been consistently greater than 110.
Doctor: Ok, lets try metoprolol 12.5mg IV every 6 hours. We give that, right?
Me: Ummm, yeah? Metoprolol 12.5mg IV every 6 hours, correct?
Doctor: Yes.
Me: Ok, thank you.
*hangs up phone and shows my preceptor the order as I had jotted it down*
Preceptor: OH MY GOD! You can't give this! You'll kill someone!!! Are you sure this is what the doctor ordered??
Me: Yes, I'm sure. I read the order back to him. He asked me if we could give this. I didn't really know without looking it up.
Preceptor: We have to get this changed. Call him back and tell him we can give 5mg IV. 12.5mg is a PO dose.
Me: *feeling very stupid and unsure of myself* Umm, Can you call him please?
*medical director peeks head around from the other side of computer monitor where he was sitting about 4 feet away from me*
Medical Director: *in a kind voice* This is your lesson for the day. Never trust doctors. We depend on you to keep us from killing patients.
I think it's time to be scared now.
Showing posts with label preceptorship. Show all posts
Showing posts with label preceptorship. Show all posts
November 06, 2011
October 10, 2011
Cardioversion
It was a hectic day, but I'm loving learning all I can. Today I got to assist with my first cardioversion. The cardiologist in our unit loves to teach and he has spent many 1/2 hour long teaching sessions with me when the opportunity arises.
Today he asked me to come to the room next door when I was finished with my patient. I walked in and they were getting ready to perform a cardioversion. The patient was in A Flutter. The Life Pak was already hooked up and conscious sedation administered. The cardiologist explained everything to me about the process. Even though the nurse educator had already extensively gone over this with me, it's good to have a reminder when you're nervous.
I operated the Life Pak under the direction of the cardiologist. The patient went into A Fib after I had delivered the first shock. I admit, I jumped a little when the patients body jerked slightly with the shock. When I delivered the second shock, the patient sat straight up and said "Ow" before falling back onto the bed. I jumped again. But he was in sinus brady and all was well.
The cardiologist took the next 15 minutes to explain everything to me, review the meds used for conscious sedation and how the patient won't remember any of it. He even made a point to wake the patient up and ask him if he had felt any it, to which the patient replied "no".
It was a good first experience. The people on my unit are very supportive and understanding with new nurses and are quick to include us when there are good learning experiences. I look forward to the day when I can be that experienced nurse helping the new nurse.
Today he asked me to come to the room next door when I was finished with my patient. I walked in and they were getting ready to perform a cardioversion. The patient was in A Flutter. The Life Pak was already hooked up and conscious sedation administered. The cardiologist explained everything to me about the process. Even though the nurse educator had already extensively gone over this with me, it's good to have a reminder when you're nervous.
I operated the Life Pak under the direction of the cardiologist. The patient went into A Fib after I had delivered the first shock. I admit, I jumped a little when the patients body jerked slightly with the shock. When I delivered the second shock, the patient sat straight up and said "Ow" before falling back onto the bed. I jumped again. But he was in sinus brady and all was well.
The cardiologist took the next 15 minutes to explain everything to me, review the meds used for conscious sedation and how the patient won't remember any of it. He even made a point to wake the patient up and ask him if he had felt any it, to which the patient replied "no".
It was a good first experience. The people on my unit are very supportive and understanding with new nurses and are quick to include us when there are good learning experiences. I look forward to the day when I can be that experienced nurse helping the new nurse.
July 23, 2011
Orientation
So I've begun my general orientation for my new job in the critical care unit. I realize that I have alot to learn. Yes, I've been a nurse for several years, and while I have plenty of trach and vent experience, none of it is in acute care. Home health is a completely different ball game from the hospital and I'm worried about my lack of nursing skills. I've never started an IV. I've never even had to do CPR (though I'm quite proficient at changing plugged trachs and bagging with O2 when necessary). I've had minimal opportunity to work with IV meds during my clinical rotations in nursing school. I've completely forgotten all about how to interpret EKG strips. I barely remember the common treatments for various disease processes that are more common in adults. I can't even remember the indications, action, and side effects of alot of the medications commonly used by older adults because I've been in pediatrics for so long.
Luckily the unit I'm on is going to consider me a "new graduate" even though I have many years of experience under my belt. This means that I will get to work very closely with the nurse educator and a preceptor for a full 6 to 8 months. The drawback is that I'm not fresh out of school like the other new grad that started the same time as me. I'm hoping that I didn't forget as much as I think I did, and that as we review the material, it comes back to me fairly easily.
So far today is my second day working with the nurse educator. I really like her. She seems to love what she does, and she is very honest and direct. Her expectations are clear and seem very reasonable. She wants us to succeed and has told us that she will not set us up for failure. It seems that I will get the support and education I need to become a good critical care nurse. The fact that this hospital gives such a lengthy orientation makes me feel good that I can succeed at this.
Luckily the unit I'm on is going to consider me a "new graduate" even though I have many years of experience under my belt. This means that I will get to work very closely with the nurse educator and a preceptor for a full 6 to 8 months. The drawback is that I'm not fresh out of school like the other new grad that started the same time as me. I'm hoping that I didn't forget as much as I think I did, and that as we review the material, it comes back to me fairly easily.
So far today is my second day working with the nurse educator. I really like her. She seems to love what she does, and she is very honest and direct. Her expectations are clear and seem very reasonable. She wants us to succeed and has told us that she will not set us up for failure. It seems that I will get the support and education I need to become a good critical care nurse. The fact that this hospital gives such a lengthy orientation makes me feel good that I can succeed at this.
Subscribe to:
Posts (Atom)