Anxious about new agency assignment

[zacarias, ASN, RN]

Hey all,

I am starting to do agency at a nice hospital but I have some concerns. First the good thing is that the ratio on IMC (PCU) is 4:1, never higher. However here is the scary part for me, there are no CNAs. Three sets of vitals overnight for each patient have to be taken by the nurse. Also, any baths are done by the nurse. Everything else too...(weights, emptying urinals, cleaning up everyone).

Now I've done my share of vitals, cleaning up people, that's not the point. I'm just scared to not be able to complete the nursing stuff because I'm running around doing other stuff. There are only 16 beds on the unit. Feasibly you should be able to ask another nurse for help, I'll have to be assertive that way.

We have no money in our bank account and behind on all bills, I have to do this job. My question is, any tidbits of info you can give about how to organize myself or do it so I'm able to be successful at this? Thanks so much!!!

Zach

[taz628, BSN, RN]

That doesn't sound so bad...

I work in a step-down unit at a level 1 trauma center and we also, once in a great while, get ICU/CCU overflow. I've had 3 pts at times with no aids on duty when one of my patients have Q15 minute vitals ('cause of some drip) and on the 7p-7a shift the NURSES, regardless of aids, are responsible for baths. We routinely do vitals every 2 hours on all our patients. We run fully staffed with 7 nurses, but our halls are split with 3 on one side and 4 on the other. Only 1 aid staffed if any are available. Tips for getting it all done? Make your rounds ASAP, assess and give meds first thing. As I'm in each room I explain the plan of care for the night and ask WHEN the pt would like to washed up and assess how well they can wash themselves (which is a VERY rare occurrence on my unit) and, if necessary, I make a deal with another nurse to do a bath-o-rama. We team up and tackle all our assigned baths at once. Are your patients on monitors? All mine are, so that makes things a bit easier. The BPs are programmed by the monitor to automatically be taken every 1 or 2 hours.

Honestly? Just set a mental plan for when you need to do things. If a pt gets messy, get on it fast before it gets worse. Be efficient about things, don't dawdle. and ALWAYS multitask. If a pt calls you in at 1140 for a urinal, grab 1200 vitals before you leave so you don't have to come back. Cluster things together when possible. :)

[Ginger's Mom, MSN, RN]

What was your previous job like? How many patients did you have? How automated is this hospital? From your post you have to live with this assignment so do your best. And it is doable.

[litbitblack, ASN, RN]

Well I have done tpc on 6 pts in med surg. You eventually get a routine down and its doable. Team work is most important thing. Take 10 minutes in the beginning and make a chart of what needs to be done at what time. You can do things 30 minutes early to bunch a few things together. Plan your day as much as you can, sure there will be suprises but overall you should be ok