Help me help a new nurse - page 2

I have a new nurse on my unit who is just an incredible person. Great personality, takes his time, patients love him. The problem? He is too slow. His time management skills are horrible. He... Read More

  1. by   greatshakes
    Okay I am going to ask you established nurses in Med -Surg a favour.
    Imagine I am coming on to your ward as a graduate RN. I want you to tell me what you expect of me and want me to do. At this stage: I can assess and admit a patient, pass out meds, mix antibiotics and inject through IV or volumentric control unit, set up a syringe driver with some guidance, hook up IV's, take blood by syringe, (cannot do venepuncture). Can do obs, BSL's, Fluid Balances, ECGs, showers, charting, telemonitry, refer to trend care (which is actualising patient staff workload for budget and shift numbers), suction, remove sutures/staples, dress wounds and attend to urinary catheterisation. What else should I be doing and how many people would you leave me to take care of? Would I have a mentor and for how long. Is there anything I have forgotten? I am used to meds charts in bed charts which are paper, not electronic. Our shifts are generally 8 hours in Australia, 0700-1530hrs, 14-30-2300 and 22.30-0715hrs. Any hints excellent.
    thanks in anticipation. Hassled
  2. by   kwagner_51
    To the OP needing advice on the new nurse.

    PLEASE tell him EXACTLY what he is doing wrong!! Do NOT be vague! From my own experience, I didn't find out I was doing anything wrong until I was called into the DON's office to be fired!!

    I was taught to give 7 AM insulin with my 8 AM meds. Do 11 AM accu checks at 10:30 AM Give Sliding scale and their 11 AM insulin together in the same syringe. Also give the 2 PM meds with the 11 AM med pass.


    I was slow. it would take me 4 hrs ours to do med pass. [NH] I kept asking how to get faster and they all said it will come with time. I made med errors. Like not knowing a pt. was on a pain patch. Holding insulin because the BS was 65 and NOT charting that I held it.

    I had a list of all my patients and how they took meds [crushed in AS, Whole in AS, whole. I wrote down EVERY scheduled med they took on my shift and divided it by the scheduled time. In other words, I listed their 8 PM/10 PM meds with their Accu checks] At night we were allowed to pre-set their 6 AM meds.

    I would have to start on the preset at 0300, to be done by 7 AM. In between the med passes, I had to chart on who's BS was too high and who's were too low. Plus in the NH, I had to do pt summary, chart on any that were on A/B therapy, chart on the ones who had a PICC line, chart that the line was patent, that it flushed well, and that there were no s/s of infection/ infiltration. Take vitals on the ones that were on A/B therapy, treat/care for the high/low BS, do the nightly treatments on skin tears, open areas, decubes, etc.

    I was actually getting done within 15 minutes of the end of my shift. However, I still wasn't doing a good enough job. I went in yesterday to talk to the DON and asked her what I could do to keep my job until the 16th. She said there really wasn't anything I could do, because the pts kmew that I had been a nurse and to put me in any other job would scare the pts.

    She did tell me to apply at a hospital and to have them call her personally. She would give me a glowing reference. She also stated that I would have absolutely NO PROBLEMS getting another job!

    Please tell him exactly what he is doing wrong and how to improve. Ask the other shifts what he is leaving undone.

    Thank you for taking the time to help this new nurse! I wish I had had you. I might still be employed!!

    ______________________________

    In His Grace,

    Karen
  3. by   mandana
    You've gotten tons of great advice already, just wanted to chime in to tell you that as a soon-to-be grad, I can already guarantee you that one of my biggest problems will be time management if I'm a floor nurse - and I'm extremely organized. I know several of my classmates are concerned about this as well. I would not be the least bit offended or surprised if my supervisor approached me about this. And if he/she were able to offer constructive criticism to help me manage my time better, I'd be delighted with the guidance!

    Amanda
  4. by   SKE
    you could easily be talking about me. I am always behind despite good skills. I have wanted to follow aroung a very organized nurse--just for one shift and not doing pt care--just watc and take notes about how he/gets assessments in on time etc. I have asked, but I would have loved it if someone would offer to let me do it. It's hard to create good time management if you can't see it done.
  5. by   AtlantaRN
    I have new grads/employees follow me for a shift and see how I do things...

    Alert patients first, confused patients next, cluster meds and IV's...8am meds and 9am meds are given at the same time (and charted as such unless contraindicated), I teach folks to cluster, and my first preceptor taught me to make a list of what patients want, DON't go to the first patient, and they ask you for fresh coffee, and you go make them a new pot of coffee....NO, go see ALL the patients, and once you have seen that LAST patient, then start fulfulling requests, unless it's for pain meds, or emergent issues...

    Sometimes you feel like the folks at the circus trying to keep all the plates moving on those bamboo poles!

    linda
  6. by   UnderpaidNurse
    Quote from ShayRN
    Thank you all so much. I really believe that everyone should be told of their weaknesses and encouraged and shown how to improve. I believe units that harrass and destroy the self esteem of their new grads should be made to go to other units and work for a week. Something completely out of their specialty. Say a NICU nurse should go to a telemetry unit, maybe that would remind them what it would be like to be the new guy, lol. I don't tolerate negative behaviors on my unit and because of that, I hope, it is a great place to work. I am going to talk to my new nurse next week, he wasn't there on Wed. and on Thur there was a staff meeting, I didn't want to put him further behind and Fri I was off, lol. I will let you all know how it goes....
    Wow, I graduate in June of '06 can I come work for all of you. After all the horror stories I've heard about starting off, you all sound like angels.
  7. by   kadokin
    Quote from ShayRN
    Thank you all so much. I really believe that everyone should be told of their weaknesses and encouraged and shown how to improve. I believe units that harrass and destroy the self esteem of their new grads should be made to go to other units and work for a week. Something completely out of their specialty. Say a NICU nurse should go to a telemetry unit, maybe that would remind them what it would be like to be the new guy, lol. I don't tolerate negative behaviors on my unit and because of that, I hope, it is a great place to work. I am going to talk to my new nurse next week, he wasn't there on Wed. and on Thur there was a staff meeting, I didn't want to put him further behind and Fri I was off, lol. I will let you all know how it goes....
    Wow! Aren't you WONDERFUL, and unfortunately, your approach is too rare in nursing. God bless you.
  8. by   kadokin
    Quote from kwagner_51
    To the OP needing advice on the new nurse.

    PLEASE tell him EXACTLY what he is doing wrong!! Do NOT be vague! From my own experience, I didn't find out I was doing anything wrong until I was called into the DON's office to be fired!!

    I was taught to give 7 AM insulin with my 8 AM meds. Do 11 AM accu checks at 10:30 AM Give Sliding scale and their 11 AM insulin together in the same syringe. Also give the 2 PM meds with the 11 AM med pass.


    I was slow. it would take me 4 hrs ours to do med pass. [NH] I kept asking how to get faster and they all said it will come with time. I made med errors. Like not knowing a pt. was on a pain patch. Holding insulin because the BS was 65 and NOT charting that I held it.

    I had a list of all my patients and how they took meds [crushed in AS, Whole in AS, whole. I wrote down EVERY scheduled med they took on my shift and divided it by the scheduled time. In other words, I listed their 8 PM/10 PM meds with their Accu checks] At night we were allowed to pre-set their 6 AM meds.

    I would have to start on the preset at 0300, to be done by 7 AM. In between the med passes, I had to chart on who's BS was too high and who's were too low. Plus in the NH, I had to do pt summary, chart on any that were on A/B therapy, chart on the ones who had a PICC line, chart that the line was patent, that it flushed well, and that there were no s/s of infection/ infiltration. Take vitals on the ones that were on A/B therapy, treat/care for the high/low BS, do the nightly treatments on skin tears, open areas, decubes, etc.

    I was actually getting done within 15 minutes of the end of my shift. However, I still wasn't doing a good enough job. I went in yesterday to talk to the DON and asked her what I could do to keep my job until the 16th. She said there really wasn't anything I could do, because the pts kmew that I had been a nurse and to put me in any other job would scare the pts.

    She did tell me to apply at a hospital and to have them call her personally. She would give me a glowing reference. She also stated that I would have absolutely NO PROBLEMS getting another job!

    Please tell him exactly what he is doing wrong and how to improve. Ask the other shifts what he is leaving undone.

    Thank you for taking the time to help this new nurse! I wish I had had you. I might still be employed!!

    ______________________________

    In His Grace,

    Karen
    My condolences. Were you told the specific reason why you were being let go? I'm curious.
  9. by   jsixxerrn
    i had major time mgmt problems as a new nurse. The only way I ever got passed it was to make a task list at report time. Make a time chart and write what needs to be done at that time beside it. I do not know if it b/c I was a mechanic before but I am very task oriented. This may be his problem. It helps to have a basic outline of what your night is going to be like at the beginning of the shift. I can remember having a night with a medication due every hour througout a complete shift. most hospitals will give 1 hr before to 1 hr after due time to admin a med. From a pediatric nurse that started in a very understaffed hosp. This helped me now i am a very good picu nurse and i still write a task list every night.

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