Trying to get organized

  1. New GPN here. Working night shift, 12 hours 6p to 6a. I'm finding it very difficult to get all my stuff done in a timely manner. I don't spend much time sitting. I'm going all night long. But I still can't seem to get it all done and there are things I forget or run out of time. I hope I can learn this soon. The routine should be simple enough. Hear taped report, set up meds, pass HS meds, treatments, of course there can always be interruptions. Weekly skin assessments (a few residents each night), meds and/or treatments at 2400, 0100, 0300, 0400. Check and fill humidifiers (clean them 2x weekly). outputs, blood sugars. check lift slings for wear, check fridge temps. Lots of little things to remember. The 0600 medpass at 0500. Charting and taping report. Then of course, there are those who call in frequently.
    I'm not looking for pity. I'm trying to unwind. I'm troubled and I don't know if I can sleep well today so I can try to do this all again, and do it better, tonight than I did last night.
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  2. 8 Comments

  3. by   luckyladyore
    Get some books on time management or search the web Im sure its some great websites.
  4. by   CoffeeRTC
    HOw many residents do you have? Sounds like our routine..How many med passes and treatments do you have to do? Maybe some can be eliminated or combined? We try to wake the residents as little as possible. I do treatments when passing meds if I can. Not sure if this helps
  5. by   aimeee
    The biggie here is getting a handle on what all you have ahead of you each night and organizing for it to minimize the running back and forth to the nurses station, supply closet, nutrition room. Not only does it save you the time running, but you are less likely to be interrupted because as you have probably discovered, every time you return to the nurses station you are likely to get snagged by somebody and sidetracked. As you internalize the routine, it will get easier to do this. The more you can get out of the way early with the 8 pm med pass, the better, as it will free up the night hours for charting and dealing with organizing for your big morning push.

    You'll also get to know your residents habits and can plan ahead for them, IE Mrs. X who always turns on her light at 8:30 and asks for a can of soda pop, Mr. B who always denies pain during the med pass but then needs a pain pill half an hour after lights out time...etc. When you anticipate these needs you can fulfill them as a part of your routine instead of them interrupting your process.

    Does your med book have the flagged dividers? You can make your own code for the flags to remind yourself of residents who have BS, treatments, etc. If you spend a few minutes at the beginning of the shift pulling out all the flags for anybody you need to do things for, then as you go along you can push them all in again and this really helps to keep track of what is done and what is not. If you don't have the nifty flagged dividers, you could devise your own.
  6. by   aimeee
    Oh, another thing that really helped a lot was when I convinced nursing administration to let us keep the narcotics ON the cart. We went to having a supply of narcotics in the lock box in each cart. This eliminated countless trips back to the nurses station each night and also improved each nurses accountability because if your count was off at the end of the night it HAD to be your problem since nobody else could have been in your narc box. It also eliminated the bad habit some nurses had of signing out narcotics from the cupboard at the beginning of the shift and then just tossing them in the cart until they were needed.
  7. by   Betty_SPN_KS
    There are 30 to 40 residents. There are flag dividers in the MAR. I use it to mark res as I go through the med pass the first time through. Because some take their HS meds earlier than others, and I use it to mark those I haven't finished yet. Also there are flags for prn med follow ups, new orders, and odd time meds. The first few nights I made out cheat sheets. Last night I didn't get any skin assessments done or the humidifiers cleaned. Someone got sick and I had to call the doc. It's someone who likes a lot of attention. But this time she really was sick.
  8. by   DG5
    Sounds like your facility needs to increase their staffing or change their staff mix. The facility where I work have just hired on three new LPN's into the mix for the first time. Its taking quite a while to get it all streamlined but already the workload is lightening up for all of the RN's on all shifts. The LPNs (all part time so far) rotate alternately working 6 hour days and 6 hour evenings and take some of the night load off, by for example doing the 0600 blood sugars at 0700 on dayshift instead, and taking some of the treatments. They'll soon be doing the med turnover which is usually the night staff's job. They also do the rinsing of the nebs, humidifiers too.
  9. by   jyoung1950
    I'm a CNA so I can't comment on organization for a nurse.

    However, our facility recently had its state inspection and we were cited for not getting meds out fast enough.

    Get this. They cited us because they decided that an AGENCY NURSE they followed was taking too much time.

    Has State lost all common sense? An agency nurse doesn't come here every day, is unfamiliar with the residents and how they respond to getting meds.

    So now our nurses have to record how much time it is taking to get the meds out. From what I've heard, state thinks (for instance) that 4:00's should be done by 5:00.

    On my unit there are 40 residents. Tonight my nurse has the whole floor to herself.

    This is in Pennsylvania - I don't know if it's this picky in other states.
  10. by   donmomofnine
    Quote from jyoung1950
    I'm a CNA so I can't comment on organization for a nurse.

    However, our facility recently had its state inspection and we were cited for not getting meds out fast enough.

    Get this. They cited us because they decided that an AGENCY NURSE they followed was taking too much time.

    Has State lost all common sense? An agency nurse doesn't come here every day, is unfamiliar with the residents and how they respond to getting meds.

    So now our nurses have to record how much time it is taking to get the meds out. From what I've heard, state thinks (for instance) that 4:00's should be done by 5:00.

    On my unit there are 40 residents. Tonight my nurse has the whole floor to herself.

    This is in Pennsylvania - I don't know if it's this picky in other states.
    We just finished our survey. Our nurses have 22 residents to give meds to and they weren't getting done on time, so I had the first half of the assignment with med times of 9-1-5-9 and the other half of her assignment with med times of 8-12-4-8. That helps a lot!

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