[Dancin'Mom]

Today I got off night shift 1 hour and 15 min. late due to charting and some last minute items that I wanted to take care (I called a Doc about getting weaning parameters for epidural, wrote and carried out order). The day shift charge nurse told me that I needed to get out on time, proceeded to tell me that "all of the other young people get out on time" so I should too. She then proceeded to tell me how she charts to get out on time. She also said she had given me an easier patient load (lesser accuity) knowing that I was knew and "slow."

I am a detail-oriented type (like many of you). I feel my charting needs to be very complete and accurate. That's not saying that I take hours to do it, just want it accurate and complete. We have to chart a "care plan" every shift, stating whether different parameters have been met or not and why. I was doing this at the end of my shift, makes sense if you ask me, but many of my co-workers do it at the beginning or middle of shifts. I'm thinking I will do the care plan in middle of shift to save time at end when it's "rush-rush."

I also like to complete all of my orders for shift myself if possible and not leave for next shift, such as the epidural order I stated earlier. I'm sure this will "bite me in the butt" eventually. I guess I need to learn to leave things, develop boundaries about what I can do and what is acceptable to leave or ask for help.

I probably have already stated what I can work on, but it's good to vent. If anyone has any great tips. let me know. I need to get out on time!

[bughouser]

Do yourself a favor force yourself to chart as you go, delegate what you can. I leave stuff that can wait for the next shift at 530 sharp- next shift starts at 7pm. Its more important to see patients one last time- clean, clean room of hazards, ascertain pain needs ect. ect. the oncoming nurse will love you for that -it gives her time to get started because patients are content for the sheift change. Also, smile. Your helping people.

[ranaazha]

Originally Posted by bughouser

Do yourself a favor force yourself to chart as you go, delegate what you can. I leave stuff that can wait for the next shift at 530 sharp- next shift starts at 7pm. Its more important to see patients one last time- clean, clean room of hazards, ascertain pain needs ect. ect. the oncoming nurse will love you for that -it gives her time to get started because patients are content for the sheift change. Also, smile. Your helping people.

I WISH! If orders (and everything else!) aren't COMPLETE by change of shift, I get reamed by about half the nurse and 1 charge in particular. I'm SOL either way

[jjjoy]

So true! Since you'll get reamed either way, you've just got to go with YOUR conscience and remind yourself that regardless of what others may say, you did a good job and don't deserve to be reamed for that good job - even if incomplete. Either you're new and nothing but time will improve your performance and/or the workload is stacked against you and its no wonder you couldn't complete everything.

It seems so useless to harp on newbies to "be faster"... it's like telling a child to grow up faster!!! There's no substitute for time and experience and until then you will be slower than the experienced nurses. And even if you're the slowest of the newbies, someone has to be slowest! That doesn't necessarily mean that you are lacking. I think newbies have to take much of the "be faster" advice with some big grains of salt. The experienced nurses can't wait til the newbies are up to speed but just like you they *will* have to wait no matter how often they remind you that you're going to need to be faster.

[ranaazha]

I've realized that some of "getting out on time" -- while, yes, most of it obviously has to do with me -- has to do with the nurse to whom I'm giving report. Last night, I gave report to a nurse who listened to everything I said, wrote it down, and went on to her shift. I suppose she's the type that (like me) prefers to do her own assessments with just a slight comparison from the previous shift (i.e., have lungs sounds changed drastically? has the patient finally had a BM? has edema worsened or improved?).

This is in contrast to another nurse who wants to know EV-ER-Y LIT-TLE DE-TAIL. She reviews OOOLD orders to make sure they're ALLL in. UGH! That's what 12 hr chart checks are for! Yes, it's important that the stuff is done, but if previous nurses missed it, and I missed it, and you really want it done, then do it on your shift! (Just a pet peeve I've developed with her...) It takes forever.

The take home message from that is realizing that all nurses give and receive report differently, so prepare yourself for them, and it will help your flow, at least a little.

The other part is totally you, of course. One suggestion above was to chart as you go. This helped me a TON! I used to jot down notes as I went along, hoping to chart whenever I had time. It turned out, though, that I rarely had enough time, and I was almost always interrupted! This necessarily meant it always took me longer -- and I always got out at least ONE HOUR late (that is one hour AFTER finishing report)! It took another nurse's passing comment ("I chart my assessments as I do them") to help me realize there might be a better mouse trap! I've started charting EVERYTHING as I go along, and I can't even begin to explain how it's helped. The best explanation is to say that I RARELY get out after 2000 (allowing 30-45 mins for report) now which is bloody awesome!

In any case, if what you're doing isn't working, then try something else...