How long do you stay over shift to finish work? - page 2

I'm still new to the profession and recently ended orientation on a telemetry floor. I'm curious about how long you would stay after in order to finish your paperwork? What things do you make sure... Read More

  1. by   kimogieo
    Hello, new nurse here. I just graduated December 2010 and i started working LTC about 4 days ago. Yesterday was my 4th day of orientation, and since I have no experience, DoN told me I have have to be oriented for two weeks. 1st day of orientation, my preceptor was alright, she didn't talk much but she would answer all my stupid questions. But she didn't tell me anything about charting, admission, what to do in an emergency so I feel like im lacking in that aspect still. 2nd day I was paired up with another preceptor because the other nurse didn't want me.... and she was great, though I did a med error, minor error though, i doubled a multi vitamin tab, but I felt so stupid and careless. I was onthe 3-11 shift and she said I could start doing the night meds, it was already 10:30pm and I was only halfway done with my 30 patients, my preceptor had finished doing treatment and most of the charting. after my shift, I got in my car and started crying, it was so overwhelming for me. I even had so many messed up dreams from the stress of the unit. On my fourth day(yesterday) I got a different preceptor because the previous one was off for the day. SHe let me push cart, we started in the dining area and helped me identify patients since I still dont know them that well. then we hit the hallway. I did most of the patients, she did a few and we were on time. the PM meds, same thing....I was still passing meds at 10:30 but I only had 3-4 patients left compared to the other night when I still had a handful on me.
    But then I was thinking, I had to go over my MAR and make sure everything is signed before the next shift comes in and get the MAR. I also have not finished the treatment book which is fine I guess because I can do it later, plus the charting of patients. It gets a little overwhelming for me and I know I'm still starting but I was setting a goal to do it on time. Next Monday I will be oriented to the other unit, still long term care, but my goal is to take out meds faster than how I did. Then I will ask my DoN to be oriented on the subacute floor...I dont know how well that will go but I'm hoping I dont end up staying there 2-3 hours after my shift, or even if I do it's fine as long as its not still passing meds but charting. Oh and also, I was told by the nurses on my unit about certain doctors that are notorious for yelling at nurses when they do orders. Which im not looking forward to >.> hehe scary.

    That was my first week of nursing home experience. It was a roller coaster, it's also my first job, I'm 22, I was told that I was spoiled because my parents didnt let me work til i finish college. I am also glad that none of my nurses were the ones that "eat their young" except for this one nurse, she's just freakin sad....she...ugh i can't even...it feels like she's gonna eat you alive if you look at her the wrong way. But anyway, I still be nice to her and ask her if she needed any help from me. Thank you for letting me vent.
  2. by   Altra
    Quote from Gieokhae
    That was my first week of nursing home experience. It was a roller coaster, it's also my first job, I'm 22, I was told that I was spoiled because my parents didnt let me work til i finish college. I am also glad that none of my nurses were the ones that "eat their young" except for this one nurse, she's just freakin sad....she...ugh i can't even...it feels like she's gonna eat you alive if you look at her the wrong way. But anyway, I still be nice to her and ask her if she needed any help from me. Thank you for letting me vent.
    Putting on my "mom" hat ...

    You've been on the job 4 days, and nursing home patient loads per nurse are notoriously huge. Maintain your goal of increasing your speed, but realize that no one is as proficient at anything they've been doing for 4 days as they will be when they've been doing it for 4 months ... or 4 years.

    If you have never held paid employment before now you have a short, steep learning curve in professionalism ahead of you. Number one: boundaries. You will not be Gieokhae SuperNurse right out of the starting gate, but this DOES NOT mean that Gieokhae is any less of a person than she was before taking this job. Seriously -- role play with friends and family to learn to adopt a professional, calm demeanor. Work is work. Everyone you encounter -- other nurses, CNAs, physicians, etc. is there for a purpose -- NOT first and foremost to be your friend.

    So there's an MD that tends to raise his voice ... that's about him, and his lack of self-control. Not about you. Will you be doing your patients any favors by cowering?

    Your professionalism will extend to your patients and their families as well. By its very nature, LTC care is a source of guilt and apprehension for many. The elderly have to cope with some degree of loss of independence. Their families can feel guilt, sadness and or fear about the care their parents/elders are receiving. You will need to learn to present a calm, professional, competent front.

    Give your self some time. Good luck to you!
  3. by   KareBear0609
    We are not allowed to stay over. If stay more than 7 minutes past our end time, we get written up. Next time is a suspension. Third time is dismissal.
  4. by   PediNurse3
    It really depends on what it is that needs to be done. I make sure that my patients are freshly changed (if diapered), well sedated (if ventilated), pain has been addressed, etc. Any stat orders that come in right before shift change are at least initiated, if not completed. We get admissions from the OR at shift change far more often than we should and I make sure a note is written about their arrival and an inital assessment is done. Sometimes there is just too much that needs to be done- and I'm not going to stay hours after my shift unless I'm tending to a family during a death, a code, or something of that nature. I will not stay because I forgot that it was line change day or something of that nature, and I wouldn't expect someone who was busy to stay over for something that I could do myself either. I just make sure what needs to be done is communicated, clock out, and let it go.

    It took me several months to figure out how to manage my time and charting best. If I have an especially busy day I might stay over 20-30 minutes to finish charting some of the small things, but the bulk of my charting (phyiscal assessments, education, hygiene) is done at the bedside as I am doing it. With the exception of given sedation/analgesia/paralytics for intubation and other procedures when I absolutely can not be at the computer to chart, I do not give patient's medication without charting it at the bedside as I am giving it, with the eMAR right in front of me, so aside from those exceptions, charting meds has never, is never, and will never be an issue.

    Get what you need to get done done, and defer the rest. There will always be something.

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