SO I'm a new graduate and I'm all done with orientation but I feel like I still can't get a handle on how to start out my shift. Typically I get my pt assignment and make a quick round to say hello and update their communication board/ make sure they are all breathing and not in distress. From there I begin getting report from day shift (approx. 1910 at the latest and depending on if day shift is ready) then once that is done I do a quick run over the paper charts for any important orders and check the PAL (computerized charting component of powerchart) to make sure nothing was missed by day shift or no critical labs. After that, about 1945 I start my assessments with the most critical pts first. Here is my problem. By the time I finish assessing everyone and getting any immediate concerns/issues resolved it's almost 2100, then I have to go pull meds. typically each pt (5-7) has anywhere from 1-5 meds. at 2130 we have "huddle" and it seems to always cut me off half way in getting meds then I never seem to get them all out within that 1 hour window. It really stresses me out when I don't get my meds done on time, especially when it is HS BGL's and insulin too. I know some nurses stop after a couple pts and go pull meds then come back and assessmore, but it freaks me out not to have all my assess charted within that first hour. I have seen a couple pts "go bad" then and not have anything charted on them and it just doesn't look good, nor is it safe. What do you guys do? Maybe I'm totally missing something here? I seem to have the whole rest of the shift down pretty good, but the begining gives me anxiety! What's even worse is getting a new admit in that time frame!