hey, i think that time management is one of the most important things to have while working as an RN. as you may know things usually pop up just as your about to do a drsg change... the MD is on the phone wanting to talk to you.. at the same time you need a blood sugar on a patient about an hour ago... and the pt next door needs help to go to the bathroom, and your aid is busy somewhere else..etc... the key for me was organization through a set routine. once you have a routine that works for you, you can change it around to fit most M/S floors. for me to stay organized it also helps if the floor is organized. you can get through it w/ experience.
ok this is what i do on my particular floor now
, its pretty simple, the key is getting to see all your pt.'s in good time. i try to keep the chit chatting to a minmum at this time; it can be hard doing this without coming off rude and insensitive. after getting a timely report (this is not always the case) i assess my pt head to toe.. mentation: alert? oriented?. listen to lungs, heart, abd., feel for pulses in all extremities. ask them (if applicable) if they're tolerating prescribed diet, did they void, did they have a BM. are they having pain/discomfort is an important question. now check all IVF are infusing as ordered. check all drains and assess. quickly look at all wounds and take note. *i usually like to peek at the orders first, but this place is a small hospital and luckily they have good unit secretaries. so i usually forgo this until a little later. i also work nights.
now if you have good memory you can move on to the next pt. i usually write some highlights down on each pt. try to remember each pt's face so as not to confuse pt assessments. remember your assessment is always ongoing, it doesn't stop here
so now move on to the next pt and repeat the process. for me at this time its important to know that my patients have a heart beat and are breathing and have manageable/minimal pain and are safe. *ofcourse this is all dependant on what type of floor you work on, if you have aids etc..*
after you have seen all your patients in a timely manner, if your lucky; for me usually this is the time ALL my patients need something, help to go to the BR, ice for their water pitcher etc... i try to do my best, but some things have to wait--> prioritize
. if you dont do this you'll end up running late on dispensing your meds, which brings me to the next portion of my routine.
ok so you've assessed everybody, and they are all breathing and have a heart err a heart beat is what i meant
now on to the meds. so i look into my mental/paper notes and see who needs pain meds and add that to all scheduled meds. once this is done check your MD orders.
the key is to prioritize for the tasks that are specific to that floor. the above mentioned have resulted from 5 yrs experience. in the beginning i used to stay 1hr-2hr AFTER my shift to get things finnished up. my coleagues would tell me to go home, but i feel bad about leaving things to the next shift. which leads me to my next point. nursing is 24hrs, what you can not finnish up the next shift will do. ofcourse if you spent the better part of your day just getting by, i.e.: slacking.. well thats a different story.
try to recognize the constants on your floor. know when the MD's usually arrive to write orders, know when you have to have your I & O's calculated and documented. w/ experience i know that i have to have a set time to have things done by, so that i get to all my reponsibilities in a timely manner. breaks are important, give your self time to eat and rest your feet.
all the call bells, IV pump alarms and phone calls that occur in between your tasks will eat up your time. so prioritze and organize. it may take some time to try out different sets of routine, i.e.: is it more efficient for you to do this first as opposed to that etc.. co-ordinate w/ your aids, and make a plan, i.e.: who needs a bed bath, you will empy the drains, aids will take all the VS.. so in the end prioritize, organize and communicate! it will all come together. make an active effort to try different routines, so that you can find out which works better for you on that particular floor. *there are other tasks/assessmensts that i have not mentioned. the above is just a template to give you a base on where you can start your journey to organization
good luck. wow sorry for the long post.
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I am in my third semester of an ADN program and feel very incompetent as far as time management is concerned. I would appreciate any advice on staying organized in the clinical setting and managing more than one patient at a time!!