Time management issues - page 2

I have been working for a about 14 months on the busiest floor in the hospital (does everyone say that? haha) where I started as a new graduate. When we first started (I had another new nurse start... Read More

  1. by   Ruby Vee
    my husband and i used to work in the same icu and ride to work together. i'd always get done 15 minutes early; he was always late. sometimes really late. the difference was, he spent a good part of his day chatting. i didn't. are you spending a lot of your day chatting with patients, families, pt, other nurses? if so, learn to chat briefly and move on.

    make an effort to give report on time. once you've given report, you've handed off the patients and shouldn't be asked to go take care of a beeping iv or anything else, except maybe a full arrest. then find someplace to "hide" to finish your charting. if they can't see you sitting at the station, they can't ask you to go take care of something.

    it also helps to chart as you go rather than save it all for the end of the shift.
  2. by   whtepketfences
    When I read your initial post is brougt back memories from more than 20 years ago when I first started. I could feel your stress, but it also brought up fond memories in a masochistic kind of way. You sound like you are on your way to becoming an excellent nurse. Don't lose your spirit just because your a little overwhelmed. Watch and ask for tips in some of the nurses you admire, but don't ever put your patient in danger just to save a little time. And don't ever, ever use the same anything for more than one patietn - YUCK. Please don't give up on hospital nursing just yet - not all hospitals are as disfunctional as yours sounds. Ask for help when you need it and once you have a few years in your nursing shoes you'll be more comfortable, then don't forget to offer help to that frazzled new nurse and encourage her to carry on as well. (and definately hand over the pager as soon as you can get it to the next shift - the have their whole shift left to catch up)
  3. by   BluegrassRN
    Quote from 86toronado
    Also, I would hand my pager over to the night shift, or back to that secretary at 1915. The night shift is there, and has taken over care of the patients at that point. Don't forget that you are the RN, and don't be afraid to put someone who is supposed to be your subordinate in her place.
    No ******* way. You don't give me report, you don't give me the pager or the patient.

    Giving report is a PRIORITY. You won't be getting interrupted with calls and needs from patients if you have already given them over to someone else. This will free up that last little bit of your shift to pick up all your loose ends and still get out on time.

    I must say, this is a pet peeve of mine. I theoretically can't start MY day if I'm waiting for YOU to give me my patients. I start behind then, as well. Give report in a punctual, timely manner. It's disrespectful of your oncoming coworkers AND if causes more unnecessary stress for you because you are still caring for these patients past your shift.

    Your job isn't on the line. Your nurse manager pulled all reports from July. If there truly is a trend of you leaving before 7:45 most of the time in the last couple of months, point that out. Tell her 1-2 items that you feel the charge nurse/fellow nurses/support staff could do to help you out a little; but also take responsibility for yourself. Tell her you feel you are continuing to improve, give her some ideas of how you've improved your time management over the last several months, listen to any suggestions or thoughts she has, and implement what you can.

    And DO NOT come in with a list like you gave us (Nurses clicking off assessments without doing them, etc) unless you have cold hard proof. I click off assessments all the time, and no, I'm not in the room doing them as I have clicked it off; I did it an hour ago, but I didn't have to opportunity to chart. If you're busy doing your own thing, how can you possibly know that the other nurses are somehow skipping their assessments and work and falsifying their charting? That is a terribly serious charge, and unless you are following these nurses around observing them for their entire shift, I don't know how you can possibly know all this.
    Last edit by dianah on Nov 15, '10 : Reason: Terms of Service: please use all *s
  4. by   r.oxymoron
    Quote from SlightlyMental_RN
    Do you organize yourself before heading out onto the floor? Do you use a time grid? Do you chart as you go or save it all for the end? All of these things helped me tremendously in getting out on time. I also use Meditech and work AM's. How I work it is: Get report, figure out which patient(s) to see first. Go and pull up the eMar and get the meds to be given over the next 8 hours, mark those down on my time grid. On the same grid, mark when to do specific tasks for patients (dressing changes, IVs, etc.). Round and get all my initial assessments--this also allows me to adjust anything on my grid (for example, if someone is having an issue that I need to address.) After that 1st round, when I've gone a done my head to toe assessment and given out any meds--I chart. Then, I just keep charting as I go, marking down on my grid any PRN meds given for that patient/or abnormal assessments. It makes giving report so much easier to have everything in one spot.

    Good luck!
    I'd like to see you're chart. The facility I'm presently at isn't yet computerized, so it can be a real challenge. If you'd be willing to email me something like the one you use, I'd greatly appreciate it. It's difficult not to feel 'dumped on' at times; I have some truly amazing charge nurses that can do anything, it seems, but they're on a different floor and I haven't the opportunity to watch and observe they're style. Whew, it can be a jungle out there!!
  5. by   OttawaRPN
    Quote from ruby vee
    then find someplace to "hide" to finish your charting. if they can't see you sitting at the station, they can't ask you to go take care of something.
    ahhh yes, the proverbial "hiding" to chart, i do this all the time and think it's sad that nurses have to resort to such unsophisticated conduct in order to complete an increasingly important function of their duties, but unfortunately it is a necessary evil. regrettably, the good hiding spots are getting harder to find and figure one of these days i may just have to hole myself up in the staff washroom.

    :uhoh21:
  6. by   SlightlyMental_RN
    Quote from r.oxymoron
    I'd like to see you're chart. The facility I'm presently at isn't yet computerized, so it can be a real challenge. If you'd be willing to email me something like the one you use, I'd greatly appreciate it. It's difficult not to feel 'dumped on' at times; I have some truly amazing charge nurses that can do anything, it seems, but they're on a different floor and I haven't the opportunity to watch and observe they're style. Whew, it can be a jungle out there!!
    Do you mean my time grid? It really wouldn't help anyone out if they didn't work in my field/facility--it's just very specific to the work that I do. I can describe it though: I have a column for each patient running vertically. Along the right vertical part of the grid I have the hours listed. For each cell of the column, I have prompts like meds due, IV, PRNs given, VS/assessment due. I highlight those accordingly before my shift.

    Hope that helps!
  7. by   steelydanfan
    Quote from BluegrassRN
    No ******* way. You don't give me report, you don't give me the pager or the patient.

    Giving report is a PRIORITY. You won't be getting interrupted with calls and needs from patients if you have already given them over to someone else. This will free up that last little bit of your shift to pick up all your loose ends and still get out on time.

    Sometimes you can give report and still have things to do that you CANNOT pass on, like a late or forgotten med. It happens to us all, "how did I miis that 0600 Decadron?" Sometimes a shift just gets nuts and you CAN't get out on time. I am a VERY competent nurse, and because of this, I am often given the toughest assignments. When everybody else gets thier breaks, and gets out on time, I am left behind. I can't justify it, because it's not acuity, it's no.s where I work. But I'm not lazy, or suffering from poor time managent skills, I simply get overloaded. It HAPPENS!

    Bluegrass makes a good point here, the oncoming shift just wants report and to get on with their day. HOWEVER, stuff that is unavoidable does happen at 6:55, and you cannot ignore it.

    I must say, this is a pet peeve of mine. I theoretically can't start MY day if I'm waiting for YOU to give me my patients. I start behind then, as well. Give report in a punctual, timely manner. It's disrespectful of your oncoming coworkers AND if causes more unnecessary stress for you because you are still caring for these patients past your shift.
    I repeat, sometimes those calls for pain meds come in at 06:55, what do you do?

    Your job isn't on the line. Your nurse manager pulled all reports from July. If there truly is a trend of you leaving before 7:45 most of the time in the last couple of months, point that out. Tell her 1-2 items that you feel the charge nurse/fellow nurses/support staff could do to help you out a little; but also take responsibility for yourself. Tell her you feel you are continuing to improve, give her some ideas of how you've improved your time management over the last several months, listen to any suggestions or thoughts she has, and implement what you can.

    And DO NOT come in with a list like you gave us (Nurses clicking off assessments without doing them, etc) unless you have cold hard proof. I click off assessments all the time, and no, I'm not in the room doing them as I have clicked it off; I did it an hour ago, but I didn't have to opportunity to chart. If you're busy doing your own thing, how can you possibly know that the other nurses are somehow skipping their assessments and work and falsifying their charting? That is a terribly serious charge, and unless you are following these nurses around observing them for their entire shift, I don't know how you can possibly know all this.
    Not a good idea in my book, either.
    Last edit by dianah on Nov 15, '10
  8. by   steelydanfan
    Bluegrass, somehow my responses to your post came out entertwined with yours. Sorry for that, please correct or disclaim as you wish.

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