Any tips for getting organized for a new nurse on daytime med surg?

[guest825264]

Hi I graduated in May and have been working day shift on a med surg floor since September. I am only in my 2nd month of the job and I feel like I am drowning. I am hoping someone can give me some tips to help me organize my day. I arrive at 06:30 to get my assignment and report. I try to look up my patients info before my shift starts, get report, and then 0700 always seems to hit like a freight train with a whirl wind of medpass, vitals, assessments. I am running like a chicken from 0700 until about 1400. I never seem to be able to chart anything until about 1400 but if family members see me sitting at a computer they will pounce on me with questions about care, requests for water or snacks and other needs. "Get her, she's just sitting there." I usually stay until about 2000 trying to finish up charting and other duties that need to get done. Our unit has 24 beds and we are staffed with 4 nurses, 2 or 3 techs, a team leader and a secretary. I feel like we need 4 techs to keep up with patient needs (and family member needs) during the day. I usually take about 6 patients and some days I rarely even see a tech so I am total patient care.

I don't feel like I got a very good orientation period. I was tossed around with different nurses (who all did things differently), We had one day of computer training with HR and when we were not getting it she said; "they will teach you on the floor" I was taken off orientation after 5 weeks because the unit was short staffed. I like being on my own but I feel like "nurse stupid pants" because I am always missing something and I feel like the night shift nurses are always having to pick up my slack. I go home at the end of the night exhausted. I know that the only way I can make this job work is to get a better handle on organizing and prioritizing. Any tips would be greatly appreciated.

[RNperdiem, RN]

It sounds like your orientation was not a priority, which has not helped.

This sounds identical to my first job. I learned the importance of a good breakfast, comfortable shoes and tops with pockets to load up on supplies.

First, at the beginning of shift, find out how many techs are working and who is covering your patients. Say hello to them and communicate regularly. Don't let them get away with slacking off; you really do need your CNAs to survive in med-surg. This is easier said than done, I know.

Is there a more hidden place you can do charting? If there are computers in the room, perhaps there is a nonverbal, not fully conscious patient who won't mind that you use the computer in their room to chart the daily assesments.

The description of putting out fires all day long until around 1400 sounds about right. Daytime med-surg work can be overwhelming. I find that pushing through and keeping up starts to pay off for those last few hours of the shift (unless there is an admission), so I can get caught up on all my tasks to get ready to turn everyone over to night shift.

Probably the most important med-surg skill to learn is how to keep a mental or written list of priorities that constantly change and keep on track with repeated interruptions in your day.

[guest825264]

Thanks for your reply. I really wanted med surg because I felt like it would give me a good well rounded starting experience. I really want to make this job work. Your reply was encouraging, maybe I will get better with time and increased computer skills. I will take your advice about speaking to the tech assigned to my rooms. Some are not so great; but, some are such gifted gems that my day goes much better when they are with me. I think the techs make the greatest difference in quality of care to the patients and I wish the hospital would see that.

I find that I really enjoy doing wound care on the job. I like to see the progress. Perhaps if I can survive a year or two of med surg I will try to get into a wound care position.