Variables

Preceptorship update:

I am going through the last phase of my preceptorship. The plan is to switch over to nights for a week or two. Nights for 2 weeks won't be stressful. DAYS are typically stressful. I don't know schedule I will be on after my preceptorship. I won't complain too much about nights...

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Variables.

Variables are what most of my ROTC cadets hated when we ran lanes for STX. Variables are unpredictable, can come anytime, and require a mix of creativity and critical thinking. They range from a change in mission from an attack a bunker to a rescue the pilot, being ambushed by a small 3-5 man team, or being slowed down by 2 civilians who are asking for help with moving their cattle across the road you are convoying on. Variables can happen in training, but they can also happen in the real world.

Variables also happen in the world of nursing. During my med-surg preceptorship, I experienced a lot of unpredictable events.

The other day I worked the 0700-1900 shift. The plan was to attend the staff meeting, get fitted for N95 masks (N1H1 protocol), and be prepared for "casualties" during the annual mass casualty exercise. This is not a typical day at the hospital.

After the inservice and mask fitting, it was about 0830. Got report and formulated a plan of action despite losing 1.5 hours of my normal hospital work day. I decided to block my medications and assessments together. This way I can see a patient and give medications/treatments at the same time. I went to each patient after prioritizing them.

I completed seeing my first patient. I felt that this plan was working. The plan was working until I started getting new orders from the doctors about sending 2 patients down for their respective procedures. I hadn't planned on this! In report there was no plan to send my patients off this early in the day. Made a couple phone calls to find out what's going on. I had reroute my priorities: get the patients ready for procedures. My preceptor helped me get my patients ready to go.

Afternoon comes by not fast enough and now discharges are being ordered. Patients are coming back from procedures and now I'm faced with issues: discharge patients or reassess patients from procedures. Discharging is a low priority at this time as they are more stable than the patients that are coming back from procedures.

At the end of the day I eventually got all my charting done, discharged assigned patients, and didn't kill anyone. It was hectic, sporadic, and disorganized, but I got the job done.

My preceptor and I usually have a conference at the end of the week, but we took time out to debrief each other about the day's events. We both knew that lots of other things were going on. It didn't help that resources were taken away from us due to an exercise, but we made due with what we had. Thank God for CNAs! If it wasn't for our awesome CNA staff I wouldn't be able to get through the day.

I told my preceptor about my initial plan for the day. My preceptor then told me about how variables could easily throw me off. It did. It really did today. We came up with new ways to handle the plan of the day, but allow for variables to occur yet be managed.

Variables WILL happen. It's just a matter of REACTING to them. My plan wasn't effective enough, but with some guidance I was able to execute.

Just another day at the hospital...