I know some of you have very large patient loads (7+ patients) and I'm really amazed. How do you handle all that? Where I work the standard patient load is 4. Sometimes we get three if there is really good staffing. Sometimes we get 5 if we get shorthanded. I've been working on the floor on my own for almost 3 months and had to take 5 patients twice. First time I had 5 patients, it was not too bad. Sure I was busy, but the patients did not require to many things, so I was able to handle it ok. The next time I had 5 patients it was crazy! I was already busy enough with 4 patients at the start of shift because all the patients were quite difficult. If they weren't needing pain medications often, they needed a blood transfusion, or they had really needy family members. I was already working my butt off to get caught up, but it was not working. Since I was going between patients and talking to doctors so many times, I barely even got a second to sit down and chart (computerized charting). Later on I got assigned a new admission, making my patient load 5. Fortunately, this patient was not too difficult a patient. I assessed him, got him settled, then I went on to my other patients again. Right before end of shift though, I got bombarded with three patients needing pain medicine, one patient whose blood transfusion finished, one patient whose family needed my attention for something, and one patient who had a foley and wanted it taken out instantly. My head was truly spinning trying to finish everything up. I had no choice but to leave several things for the next shift to do, which many of them weren't too happy about, and I ended up staying an hour and a half later than I usually to do finish up all the charting that I did not get a chance to do during my shift, and I still felt I was not as thorough as I would like to be. My mind was just so fatigued that I could not think as clearly. I did try to prioritize and delagate as much as I could, but the nursing assistants can only do so much and the rest is up to the RN. On an upbeat note though, I finally got the chance to do a blood transfusion though. It was my first time ever, even through nursing school
that I got a chance to do it. I am really wondering for those of you who have those really high patient loads, how do you manage everything? And yes, I do try very hard to organize my shift, and to do as much clustering of care as I can for the patients. There was just a lot of extra things that the patients and/or family members wanted to be done.