Quote from stephanie.felder5
While all the night ICCU nurses face the same difficulties, I am getting more overtime than almost anybody else. Granted, I am one of two new grads and nights, and the other new-grad and I do not work together very much, but I need help.
Advice? Strategies? Methods? Any words of wisdom is appreciated. I'm just 6 months in and should be so much better by now!
First ....6 months in and you aren't drowning? I give you a standing ovation!
The second is.....not every single task needs to be P-E-R-F-E-C-T.
It has to be perfect
...but not P-E-R-F-E-C-T...
In the the long these are the kind of ICU's that I prefer.....It drives me NUTS to be incessantly badgered by residents, interns, med students, and fellows. They also usually do the procedural things like IV's and NGT's PA line removals etc. The kind of ICCU you explain was the way I worked in my favourite ICCU of all time and became very quick and independent.
That you are new and having to stay late doesn't surprise me......even experienced ICU nurses have issues getting out on time.
It is a tough environment to be a new grad and "get it all done". The expectation of days and nights doing the baths because nights has "so much down time" REALLY annoys me when nights has far less ancillary personnel to accomplish tasks like orders, admits, and paperwork......for the night crew has no secretary to assist in the order entry or runners to get specimens to lab. Historically...the day and night crew do seem to have "issues" and the night crew is considered "quiet" with a ton of "down time". For the most part I have never seen all the down time claimed by days.
Yes nights has less noise and "chaos" for there are less people around to cause it. Night crews (eventually) end up being very close for they depend heavily on each other. There is no ancillary personnel, management, physicians, PT/OT, and visitors to cause unnecessary noise and havoc that plagues the day crew.
For the most part the patient that was busy/critical on days....is the same on nights in a critical care unit for there is not a real day/night routine change. It the same monitors, same drips, same patients that are on days....just less bodies to care for them. But we are supposed to have all this spare time for extra tasks.....
The curse of the night crew is that the world assumes that while they are sleeping were a sitting around doing nothing......it is something that has annoyed me my entire career. They also assume because they wait til 11am that they can call you because they "waited" for you to get some sleep they are being gratuitous and kind.
Really? How nice of you to allow me 3 hours of "sleep".
If you go to bed at 9pm are you still sleeping at 11pm????
Well SO AM I at 11AM.
You will get faster and better as time goes on. What I used to do in my initial prep for the night I would gather all my "stuff" to be ready for the night. All my drips and tubing I would spike ASAP and label ready to hang. Everything I could possible need I gathered in a flurry at the beginning of the shift on the list I would make at during my initial assessment. I used a wash basin and gathered tubings, drsgs, labels, tubings etc to ready myself for the night ahead of me.
I made up a check list for myself at the beginning of every shift of the things I needed to do and checked them off as I went along....I would then give report with that list in plain sight so that they could see in plain view...In was busy all night.
I don't know if you have a good brain sheet....I used them A LOT at first.....here are a few.
1 patient float.doc
5 pt. shift.doc
day sheet 2 doc.doc
ICU report sheet.doc
Until you get the hang of it and develop your own rhythm.....don't expect a break. I very seldom took them especially at first and I made sure I didn't dwell on what the other staff were doing or how many breaks they took for I knew my patients were getting the BEST care I could give....and may be in all likely hood much better care than those who sat around all shift.
I would place a bath blanket under patients after their baths if I couldn't get any help...I htink the day shift could change some linen. Many times I would change the linen whenever I had help then protect the bed with a bath blanket so that when I bathed my patient all I had to do was remove the blanket. It took me a while to not feel bad but there were nights that all I could do was a pit and private bath with good oral care because really.....where had they been all day? I knew they were not out there sweating and rolling in the mud.
It will come to you in time.....they say the first year is the hardest. I say the first 15 months is when you are in critical care.
I wish you the best!