Quote from RNtobeinSoCal
I cannot get over how often I have cried because of this job. I cannot seem to get the time management piece down, and the only advice I get from other staff is "You have to be faster". Uh, OK... exactly how do I do that without compromising patient safety?
Also, how thorough are your post-TX assessments? Seems like a lot of post-TX assessments are not being performed properly, and that this is the only way to get everything done in a timely fashion from the end of one shift to the beginning of another.
Barbwire- that's exactly it! 2 steps forward, 10 backward. I have been at two clinics with the same company- they use different tubing, slightly different machines. One uses clamps, one doesn't. One enters certain data into the machine, one doesn't. I forget things I should know by now, and what kind of excuse can there possibly be?
Seriously, does anyone have specific advice for time management??
My first six months as a dialysis nurse were beyond horrible. I went home crying almost on a daily basis, and all I dreamed of was quitting. My friend encouraged me to tough it out, saying that it eventually gets better. About a year after taking a bay of patients 50hrs a week, I had finally gained the self confidence and skills needed to be a good hemodialysis nurse.
Even though I'm now a preceptor, it's hard to explain time management skills. I think the biggest part is to establish a set routine, and to already expect the unexpected. I always have extra gauze at the chairside, and I watch my BP's like a hawk taking on some unstable patients every 5 minutes in order to anticipate and treat early...very early a complication. The last thing I want is to have a patient occupying a chair 20min after is off time due to low BP. So, if my patient started with a systolic of 160 and he's down to 110....I usually turn his UF off and let him recoup. I have all my supplies ready about 30min to 1hr before take off. I sometimes chart a couple minutes ahead so that after take off I can strip and clean and restring my machine while they are holding their sites. I have all my supplies and heparin ready to go as soon as my first shift is put on, and during shift change, I only document what's vital in the moment....my last line, and my post treatment vitals. My assessment and such can wait if need be.
For me I guess, preventing complications...low BP, clotted dialyzers are my biggest "time savers" If I have someone that's a known bleeder, I pay close attention to where my gauze and finger are when pullining the needle, and even though my mind is screaming to hurry up...I stay a minute or two holding before I either clamp or pass it off to the patient. I hate bleeding....it takes forever to clean your chair and you have to get control of it and it's a time waster, so prevention is the best solution. While they're holding and I'm stringing the machine or charting, I have a hawk eye on their access. If it even hints of pink, I'm over there taking over.
I know this is all stuff you know though, but it's how I survive, and I'm doing well, and I can even say I love my job.