Struggling on Medical Floor! - page 3

by NickiJules 9,248 Views | 22 Comments

Can anyone relate? ...... I've been off orientation for almost two months on a cardiac floor, and my confidence is shot way down! New to floor nursing and have just realized that i am horrible at managing time. Constantly... Read More


  1. 1
    I wanted to comment after reading this thread and it is off topic, sorry in advance. But first to the OP, hang in there...it does get better, you simply have to find a system that works for you and you have been given some excellent suggestions here. Your sense of confidence will grow with your experience level.

    Now for my off topic comment...After reading this thread it reminded me of why I originally started coming here. It was so refreshing to read a posting here that did not contain any negative responses. This in my opinion is what allnurses should be about, helping our fellow caregivers and offering if nothing else a sincere "hang in there". So many topics here now seem to quickly turn into displays of negativity towards our profession and each other. I know that being a nurse is hard, frustrating and can pretty much suck some days...but it was nice to see our better side for a change.
    NO50FRANNY likes this.
  2. 0
    Don't worry, in time you'll figure out what works best for you... Trial and error. As for me, the moment I clock in at work I go in the computer and open my Pts chart:
    1. Review my orders. It gives me an idea of what I need to do for my Pts (any pending procedures, specimens to collect , routine vitals or q4, strict I&O, if they're on any protocol like K & Mg replacements, etc). While I'm getting report I verify if there are certain orders that still needs to be carried out.
    2. Look at labs and vitals. Keep a close watch on trends and not just normal values. The pt who previously had a saturation of 98% is now 92% (although still normal is quite a big change) I would probably monitor him closely. Be proactive rather than reactive.
    3. Check your MAR. It'll clue you in on the Pts medical history. And also write down the next available dose for Prns.
    4. Get report and ask for clarification if something doesn't add up (if there's a tele order but pt not on tele, the nurse proly got a phone order but forgot to put it in and just dc'd the tele or could be h/she didn't see the order).
    5. Assess pt according to acuity. I always do bedside shift report so I do a mini assessment right there (very important for neuro pts to ascertain they're at baseline) and then a full head to toe while passing meds.

    This works for me every time.
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    The best thing I can think of is to design a worksheet that works for you. Put down all the pertinent info about each pt and use it as your to-do list. When you check charts for orders q 2h, make sure you add necessary info to your worksheet.

    This may seem cumbersome and time-consuming at first, but once you've developed your own system and made it work for you, you won't look back.

    Good luck to you.


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