1:5? Ouch. If fully staffed, we are 1:4 and I usually run my ass off all 12 hours.
I came from an ED that only saw about 400 pts/month to my new job where we see 3500/month. I have only been there since June and these are my tidbits.
Dont be afraid to use your techs/CNAs/whoever you can delegate to. Your time will be better utilized assessing and providing care rather than taking the pt to the bathroom (unless no one else is available to do it, obviously).
Chart in the room, while you are doing the work. Or you will forget.
Double check pt labels, I have had several mislabed urines and been handed the wrong discharge instructions.
Teamwork, teamwork, teamwork. If you have a minute, offer help to others. You will learn in a heartbeat who will help you if you helped them. By the same token, if you are busy and someone is trying to pawn off their work to you, politely decline. Dont let yourself get behind trying to do someone else's work.
Easy ways to **** off the oncoming shift: not labeling your IV lines, leaving your rooms trashed, not having the patients in a gown.
Multitask. You see your patient needs an IV and meds? Grab your meds and fluids, then go in to start the IV and hang meds. Going in once to start in then again a minute later to give your meds is a waste of time.
Lastly, customer service. My patients are much easier to please and leave happier if I can grin and bear it, put on my smile, get them the glass of ice for the visitor, tuck the cover under grandma's shoulders, etc.