Feels Like I'm Drowning... I Can't Seem to Get it!

[CandyGyrl]

I don't even know if I'm a "new grad" anymore. I graduated in August 09, finished orientation in Jan 10 ANYWAYS... I mean I don't even have the energy to type this right now thats how zapped I am. I feel like I'm drowning everyday in my own whirlwind of work. Its just so overwhelming for me and I think its just me and I just can't seem to "get it". I mean some days I've got it! But some days I come in and I'm being pulled 10 ways to Sunday and I cant seem to manage it. I've tried report sheets with boxes for times that I have to do things. I've tried writing a list of things to do from the time I come in until hand off, I've tried using a stopwatch to time myself but it seems like EVERYTIME I go into a patients room to do an assessment and pass meds, it cannot be a 5-8 minute ordeal. It ends up being a 28 minute ordeal because "oh sweetie do you mind, since you're in here I have to go to the bathroom". I don't want to be rude, go and get the nurse asst. who is going around doing their morning vitals, blood sugars, labs, etc. Ok so I help them back into bed, and because our hospital is somewhat like a hotel we have room service food delivery so food must be called in and ordered. "Can you help me call my breakfast order, I'm not sure what to get" all I want to do is pass my meds between the hours of 0900 and 1000. As if this is not enough I can't seem to get all of my assessments charted because I'm constantly being interrupted by the phones, the Nursing assistants and the patients families who all need me so desperately, I have to deal with those matters, catch up with the MD's, the PA's and the NP's as they Zip quietly in and out of pts rooms never to be seen again for the rest of the day JUST so that I'll have an update on the POC for the patient when they or their families ask ''so whats going on"? Or at least pass along to the next shift. To make matters worse this goes on nonstop and the next thing I know its 1500 and I have not charted an assessment, a careplan, I'm running around like a chicken with its neck cut off, I now have 10 patients because 1 nurse had sense enough to say I'm going to lunch. I DON'T take a lunch. I may pee, I may take a couple sips of water I am always leaving an hour maybe an hour and a half later to make sure everything is done. I work dayshift. I have 2 kids and a husband. I got home last night at 9:45 pm and guess what I have to turn around and do it again the next day. Any suggestions?

[CandyGyrl]

Thanks you guys, I am just so frustrated beyond understanding. I mean I try to go over and beyond for my patients, thats what I came into this profession for. Sometimes I find myself so busy, I have not checked on patients (maybe 1 or 2) for hours and although they're ok when I finally do check in on them, I guess that just was not what I'd signed up for. There's plenty more I could go into but I guess thats nursing. I want to get better. I feel like such a failure right now. If I'm so focused on things such as tasks tasks tasks, and covering my butt, when do I start to look at the entire picture. When does that happen? Thanks for the suggestions, and please keep them coming.

[MassED, BSN, RN]

Thanks you guys, I am just so frustrated beyond understanding. I mean I try to go over and beyond for my patients, thats what I came into this profession for. Sometimes I find myself so busy, I have not checked on patients (maybe 1 or 2) for hours and although they're ok when I finally do check in on them, I guess that just was not what I'd signed up for. There's plenty more I could go into but I guess thats nursing. I want to get better. I feel like such a failure right now. If I'm so focused on things such as tasks tasks tasks, and covering my butt, when do I start to look at the entire picture. When does that happen? Thanks for the suggestions, and please keep them coming.

what area of nursing are you in? What kind of floor? If you're checking on general m/s patients, every 1-2 hours is usually fine, unless something acute is happening. What does your facility say for your area and nurse rounding/documentation? For instance, in the ER, I have to document on a critical patient every 15 minutes....

[mudd68]

I work on med surg unit, that encompasses telemetry, osa monitoring, and dialysis, amongst many other types of acute and chronic medical problems. I rotate shifts so I have anywhere from 3-6 patients, most of the time with care assistance, sometimes primary care. I graduated with my BSN in May 2008. I worked as an LPN for 5 years before that in LTC, hospice, and rehab.

If I could sum up how I try to get it all done in one word, it would be, organization. I get to work a few minutes early, get my assignment and prepare/review my sheets (i.e. column for med times, labs collect, labs to check, care plans, I&O, VS, pre&post pains and a space labeled DO/Needs done). I'm also looking at things like my pt's diagnosis, last set of VS, Fluids restrictions and diets.

I then log onto the computer and start filling those columns in. Meaning, I look at the MAR and write down the times I need to be in the room giving the pt meds, or collecting blood (or having the blood collected). Is the pt ordered q 2, 4, or 8 hour VS? This is all before I receive one word of report. That is why you will need to give yourself a little time. Premake some sheets if you need too. I've done that before. This way I feel like I know a little bit about the clinical picture of my patients and feel prepared for BEDSIDE report!

It is a policy on my unit, that the off going shift, checks pt's for their needs within one hour of going off shift. Within reason. This includes checking for water, toileting needs, and pain management.At the bedside, I assess things like IV sites, foley bags, is the pt clean, IV fluids, are they empty? It will take you longer to get going if you need to finish up the work of the previous shift. By the time I am out of report I feel confident that I know where to start prioritizing as far as pt care goes. It is also when I am out of report that I immediately touch base with my CA,NA,CCp, and discuss the needs of the patients as far as accuchecks, toileting schedules, who is NPO, etc. Touch base soon and touch base often.

Of course everyday will bring it's own interruptions and an emergency can happen at anytime but if you can start your shift the same way each day you can add a little consistency and hopefully develop a working pattern that leaves you feeling a little less run down.

:flwrhrts:

[babynurse428]

You are still a "new grad" for at least a year. You sound like me in my first year! I hated delegating because I thought the other nurses would think I was not pulling my weight or using others to do my work so that I didn't have to do the work myself. So I ended up running myself into the ground and being frustrated and exhausted all the time. One of the older nurses took me aside one day and told me that my job is to do my part in the greater picture. Everyone has their part and if I kept trying to do a piece of everyone's part, I would never be able to do my part the right way. I needed to learn how to prioritize my day...take all the things that I was personally responsible for and do those to the best of my ability and to others to do their parts (such as letting the aides do their part, lab do theirs, etc.). It took me a little while, but I got the hang of it and we all worked together. If you have time and want to help someone else, that's fine. You love people and that's why you got into nursing. It will work. Give it time. Find friends among co-workers and talk with them. Ask them how they do it. Most are willing to offer advice on how they do it. Take those pieces and come up with your way. The way that makes you feel most comfortable and in control. We have all had days that go crazy and you get to the end of your shift feeling like the day has been a disaster, but as long as every patient is alive at the end of your shift, it's a good day. There are many wonderful tips here on this page. Weave things to do it your way and do your part and you can't go wrong!

[helper T cell]

I just want to say that your expierence is so normal for what is expected of us new nurses. We just want to do a good job and were taught in school to theraputically communicate and know in our hearts that just spending 6 to 8 minutes in a room is not a safe or effective way to give care. I am like you in that if someone needs something I try to do it. What if the CNA doesn't come and the pt doesn't get the help they need to go to the bathroom and they fall. I've been at it for two years now and it does get better, you get more confidence and you do learn how to effectively delegate better. I don't know if this is an option for you but after a year of days i have spent the last year on nights. It has given me a chance to come into my own as a nurse meaning you can actually spend more time with your pts. Nights can be just as busy as days but in a different sometimes more manageable way. Anyway good luck to you and you will start to notice a difference the more time you put in. Please take care of yourself too!!

[sena]

me too ,l feel as if l am going for firing squad, with my eyes closes, we have not started the classes but there is a huge assignment on the internet, i am getting drown, my topic thouth seem straight forward, but complex,we are asked to compare and contrast LPN and RN rresponsiblilitys,where am i starting from?

[locolorenzo22, BSN, RN]

At least for a year, you are for sure a NEW GRAD!

What kind of floor are you working on? That right there can help us tailor advice for you...

You have to get the assessment and meds down..... One of the biggest things that can put you behind is the extra tasks. I personally can do a assessment in 5 minutes max. Lung sounds, heart sounds, bowel sounds. push the belly"anything tender?", squeeze my hands, lift arms up and down, check pedals, wiggle toes. done. Skin will come when I have to change a dressing or when they have to get up. I personally don't mind helping people to the bathroom, as I can check their back side when they are getting up. But I do NOT wait for them to come back, I instruct them to hit the bathroom light when ready. try to find the aide first, if not, if I come back out and see it is on, then I will go back in. DON'T WAIT! What time do you get on the floor? Go see your patients first, and see if they have anything you can help them with first....(menus come to mind). You can often find progress notes by physicians and social services in the chart.

You HAVE to get faster with charting. Find shortcuts, figure out what section charting is in.

Feel free to PM me, pehaps coming from someone who was there when they first started may help. I also had many tips from CNAs, and I was a CNA for 3 years before I got my license. I was new to days when I started as a RN, but I NEVER clocked out late. Even though people who have been on the unit 30 years still are clocking out 1-2 hours late. Let us know how we can help!

[sena]

I am a student and the assignment have started rolling in even before the semester begins