New job! Excited but nervous about drips. . .

Hello everyone! I am moving to Boca Raton next week and got the first job I applied for (and really wanted) on a neuro-tele floor. I am excited but nervous - I only have 6 months experience as an RN and this floor is high acuity than I am used to. I told my new boss that, and she said that she likes to train new nurses so she is OK with it, but I am still nervous as these patients will be on drips and I have zero experience with drips.

Any advice on how to prepare? I will be taking ACLS next week and they are having me take a critical care course in September, but I would like to do some self-prep, perhaps reading some books? Any book suggestions or on-line courses that you can recommend?

Thank you so much!
1. Do not make yourself crazy.2. Let them orient you - they will train you for everything (we hope!)None of us knew any of the drips when we first started.3. Try to not let yourself become overwhelmed - everything in its own time, at its own pace.4. Keep yourself healthy.

Mamamerlee said it all. Often too much studying of drugs and drips will scare the beejezus out of you. I studied and studied to get my moderate sedation certification. So scared, trying to memorize mg/kg, rate of infusion, reversal agents, etc. I go to work with my preceptor and it was, "here is the versed, push 1 mg, here is the fentanly push 25 mcg." After ten years of moderate sedation I laugh at my over the top fears. Of course the module has to stress the side effects, "dangers", all is important to know, most important is to know your patient.

Congratulations on your new job! contact your new boss and ask her what you should be focusing on in preparation for it. Look over your text books about neuro and tele pts. Don't over stress ( easy,huh? ;0). Take total advantage of your orientation and any education opportunities you are given. Good luck!

Congrats on your new job! You can probably review these drugs online. However, I've been a nurse for a little while and I still have to look up the drugs and check how often to monitor the vitals and what things to expect when administering cardiac drips. The cool thing is our unit has a cardiac drip book that we can refer to, so it has all the information we need. So, you don't really have to try and memorize everything unless you really want to. Good luck. Nursing is awesome!!!

As others said, ask your new manager what IV meds are common on the floor so you can familiarize yourself with them. Even when you are off orientation, you can always double check with a co-worker if you are unsure about anything.

I like all the other members responses. Just take one day at a time. If you have a question you should have a resource nurse, pharmacist, and a drug book. I hope you have a good preceptor who will show you the ropes. Good luck!!!

hey thank you everyone - I think I will just review my neuro chapters and read about some of the most common drips, but mostly take deep breathes and do lots of yoga lol.

are you talking titratable drips? wow, I have never heard of titratable gtts outside of critical care. thats not very fair since you have a higher ratio in tele Im a new RN too and was also nervous about the gtts...and still am a little nervous hehe.I learned the drips by learning the receptors they act on. Also, the ACLS CD has a nice 21 page document about core drugs that includes a lot of drips. The ICU book by Marino is pretty good for gtts too. Then be on the alert for special things about each drug and why doc's prefer em, like how neo is preferable with cardiac disease because it doesnt affect beta 1 receptors, and how levo is about 90% constriction (alpha) and 10% cardiac (beta 1), or how dopamine isnt so good when your patient is tachycardic. Youll pick up alot of this when you are working with them. And for titrating, I go by the order or how wide or narrow the range is to help me decide by what increments I'll titrate. I tend to err on the side of caution. As you are precepting you should tell your nurse, "Im thinking we should go down on the nicardipine because the bp has been trending down...what do you think?" instead of just asking what we should do about the gtt. Then you will feel more confident about exercising your own judgment.Good luck! Id like to hear some more feedback from more experienced nurses too, as I am still learning.

I agree about the titrating on tele units but it depends if this unit pcu/stepdown, how many patients to one nurse, and if each room is set up to monitor patient vitals. The tele unit I worked we was not aloud to start dopamine but dobutamine and with no titration only with Heparin. I have worked this unit for three years and Im ready to upgrade to a intermediate care unit and/or maybe a ICU (Cardiovascular ICU or Stepdown). It depends on the facility and how equip the units. Just a thought.

I was looking at jobs in Boca Raton and was curious to know if they hire new grads in the ICU there? Also are you at BRCH and if so, do you like it?