[bklynborn]

How do you help new nurses get organized? I have been working with a nurse who just can't seem to get organized. We have been together for ten shifts and for some reason she is not able to look at the big picture and organize her shift. It seems her skills in prioitizing are lacking and she just can't seem to get it together. I have offered her countless tips which she doesn't use. today I will write out an itinerary and see if she will use it. I have also dropped our pt load.
Any ides are welcome. Thanks.

[purplemania]

do you have a self-assessment form she can complete after each shift, or on a weekly basis? We have one that the new nurse, the preceptor and the manager each complete, then meet to compare notes. Sometimes the new nurse thinks it is the preceptors fault, that you don't like her, etc. Try assigning her to another staff member one day so that all of you can get a different focus. Are your objectives for each shift clear? Can she tell you what she intends to accomplish that shift and when? I use a grid with the hours of the day across the top and room numbers down the side. I then write in what is scheduled (dressings, meds, feedings, vital signs) in the appropriate block. Other things, like MD visits, or out of room for procedure, etc. I jot as they occur. It helps some people to visualize how to plan their day. Good luck!

[bklynborn]

I like the idea of a self assessment tool and no we don't have those at work. She worked with another rn on manday and they were an hour and a half overtime due to poor organization. We get along fine, so that isn't a problem. Her critical thinking skills need work and she needs to be more concientious of the next shift by geting her charting done in a timely manner. Her pt care skills are great and her nursing skills are good. It is totally an organizational issue with her. It's as if she can't stay focused .......

[sharann]

She may just be overwhelmed, and frankly, just new. It takes some individuals more time to be able to see that big picture. I know exactly what you are saying. It may just take time. Remember the first YEAR is what turns novice to competent(or expert). Of course there are exceptions to any rule. She may never "get it", but I don't think its fair of us to judge after only 10 shifts. Whats that, about 2 weeks? I agree that she may need a type of form as suggested by purplemania to get started.
I also think its great that you are so concerned about this new nurse and are precepting her. It's nice that you have not let on that you are frustrated with her(inability to get it)

[Maggie in NC]

As a student who also was a manager, I love the self assesstment idea but balanced with an assestment by you as well. There is nothing like seeing you think you're great while others don't think so. It really makes you ask questions to understand how to do things better. (studies show we rate ourselves higher than others rate us). Until you see vast improvement, I'd assest every day.

I wouldn't make her agenda for her-make her do it and show her where she is setting herself up to fail. Teach her how to fish or you'll be feeding her forever. Straight talk over coffee wouldn't hurt either. Some people don't get the underlying message unless you spell it out for them.

You're being super nice and I would LOVE to have you myself!!

[LadyMadonna]

I have always been a slow getting started. As a new nurse, I felt overwhelmed when I was getting orientated. It was all new to me, and some of us just have brains that are easier to overload (like my chemistry class I'm taking now...I'm not getting the hang of it and am terrified I'm going to bomb it...I just keep studying and praying).
But when I got that hang of what I was doing I went to town and am considered a valuable employee by the DON.
Anyway, I just hope you'll give her a chance. If she is trying I can't believe she will not ever get the hang of it. If she made it through school I'll bet she will figure it all out (eventually).

[bklynborn]

I really want her to do well. Anyone who has orientated recently can feel free to let me know what worked best for them. I appreciate your help.

[MandyInMS]

I usually have someone shadow me for a couple of shifts..and I show them my routine..telling them everyone has to develope their own unique routine according to what works best for them..but give them an example of mine to get an idea..then give them a pt..let them get used to the charting, mars,how to call the md, what info to have ready, ect..basic stuff...and add pt load as they get comfortable...encouraging questions along the way...so far has worked well

[nursenatalie]

It helped me to watch a lot of different peoples routines, I ended up taking bits from each and making my own. I am now precepting a lady who is doing great, I encourage her to ask me questions and feel our the what should I do type things, like does the dr want to know this now or in the morning? I have given her some more independence lately and she is doing great.

[DutchgirlRN]

I am the preceptor for my floor and do alot of it. We do written report only at the end of the shift. One thing that has worked very well for me is this: I made up my own form for report on microsoft word and keep blank copies in a notebook that I carry with me. During report I take down all the information on my form. (this replaces my flow sheet and takes getting used to) I write everything you normally do such as Name, Dr, Dx, Consulting Dr, VS, Accuchecks, Diet, IVF's, rate, location, drsg's, Orientation, Lungs sounds, Bowel Sounds etc, etc......Then at the bottom of the are areas that are blank labeled PRN's, Abnormal Lab Values this shift, Procedures done today, New Orders, Miscellaneous, etc, etc..... While I'm doing my morning assessment I fill in the Lung sounds, Bowel sounds, etc. During the shift when I give a PRN I write it down. Also abnormal labs, important new orders and any other miscellaneous information that is important. By the end of shift my report is done. Also when charting I have everything right in front of me like times PRN's were given, lung sounds, etc... I also keep in my notebook copies of all our protocols, Dr's beeper numbers, Hosp Extension numbers, IV compatibles list, Yada, Yada. On the outside spine I have written "Joanna's Brain". The doctors really get a kick out of it. They'll come up to me, where's your brain, can I see that Heparin Protocal or whatever. My brain along with my report keeps me organized and "always" out on time. I have had 1 or 2 preceptees that just couldn't seem to get it together and they are no longer there. I think some people are just not capable of multi-tasking!