Not loving my career choice today

WeeBabyRN



This is my usual day:
- Get report
- Look at pt labs
- Write down what times each pt needs meds given
- Give all pts am meds

From here I lose control and end up behind the entire rest of the shift. .

Here's what works out perfectly for me, to help me to remember my "to-do" list. If there is something that needs to be done at a certain time, such as drawing labs, MRI or neuro checks, or if a doc wants to be called at 3 or whatever, I take all of that and add it to my medication times. For example, on the bottom of my patient's facesheet, I'd write my med timelines, i.e.

7-8-9-12-15-17

Then I'd add in my neuro checks, phone call, MRI with reminder to take off tele, and lab.

7-8-8(n)-9-10(MRI, tele off)-12-12(n)-15-15(doc)-16(n)-17-18(lab)

I leave some space so that if another thing popped up during the day I could add it in. When I get done with that time's thing to do, I'd X if off. If I can not do it for whatever reason, like the patient is in surgery, I wouldn't X it off until I could see it as officially done.

If there was something special that needed to be done before I left, or random things that are of extremely low priority, I'd write it at the end, like

7-8-8(n)-9-10(MRI, tele off)-12-12(n)-15-15(doc)-16(n)-17-18(lab) - 19(special/list)

I have got to say, that since I started doing this, I haven't missed a single time-sensitive task yet. I always glance at my pt's timelines before moving onto new things so it is a constant reminder to keep me on track. I really suggest you try this if you are already relying on the medication timeline as it has been a tremendous help to me.

I've done something similar. We have binders with our MARs in them. I put a sticky note on the front of it since I'm carrying it around all day and and write in the med times for each patient and tasks I need to get done that day. It works out really well for me. They're pretty large sticky notes with lines like notebook paper, so I have plenty of space to write.

I'm the type of person that can't sit down and chart when I feel like there's something else that needs to be done soon - with so many interruptions in the day, it just fits me better to have the charting be near the bottom of my list. If I chart throughout the day I waste more time because I constantly check to see if I remembered to chart something or not.

This is me to a fault. If I chart as I go, I'm going to get behind on meds and other things my patients need. Charting is not tops on my priority list. Like another poster said in this thread, it's about priorities. I would rather wait until the end of my shift to chart and know my patients are safe than do it as I go and miss something important. I will try to make a brief note on my Kardex copy of anything that occured during the day or any abnormal finding. Then I'll chart it later on the flowsheet when I have more time.

Hope this helps somewhat, 6 weeks isn't very long and its a steep learning curve. Things do get better in the sense that you will know the answer to a lot of your questions in the future instead of needing to take the time to think about it and find someone to ask, such as where to go on the computer to order a new IV pump. Are any of these questions something you can research at home, like 'what is this med for'? However, the work load will always remain high (because when it isn't, they send people home). Some of the stress will ease, such as the stress that comes from "I'm going to do my 4th IV!", but honestly a lot will remain because it is inherent in working with acutely sick people. The question is, once that ancillary stress eases, will the pros outweigh the cons? It is hard to say but if nothing else, you are not alone. So many have echoed your thoughts. Please continue to ask questions rather than potentially do something that will inadvertently hurt a patient. Please also utilize your charge nurse for help. They are life savers. Best of luck to you.