How to Deal with the Chaos of Med/Surg

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  1. This is a discussion on How to Deal with the Chaos of Med/Surg in Medical-Surgical Nursing, part of Nursing Specialties ... I'm a new grad nurse and I started on my unit this past August. I've been off of orientation since...

    by Jan 10
    I'm a new grad nurse and I started on my unit this past August. I've been off of orientation since mid October. On my unit there's a 4:1 patient ratio and I work the 3-11 shift.

    Since I've gotten off orientation I'm really struggling. I find it so difficult to focus on what needs to be done and get anything accomplished because I feel like I'm constantly pulled in a million directions at once during my entire shift. Literally from the minute I start my shift to the minute I'm done, I feel like all I do is run around like crazy as one thing after another comes up. I know we are supposed to be prioritizing and planning what needs to be done during our shift blah blah, but I never feel like my plans to accomplish tasks actually work.

    For example, I'll decide...I'm going to go see pt in 203 and take in all his meds, do my assessment, change his fluids, reposition him, assess for pain, and then get out. Well it just so happens this pt is in isolation and while I'm in there a doc calls to speak about another pt (who I haven't even seen yet) and now I have to leave this pt and talk to the doc. So then I get off the phone with the doc and then the NA comes and tell me pt in 204 has a BG of 70 and the pt in 205 is in pain and wants meds...and so on. This is what I deal with almost every shift and it drives me crazy. Throw at least 1-2 admissions/discharges into the mix and I think you get the picture.

    Does anyone else feel like this? How do you deal with the constant chaos and everyone needing you? I just feel like I'm pulled in a million directions constantly. It makes it so challenging for me to focus on anything I'm doing and sometimes I have to stop and think, ok wait which pt is this again, what was I doing before? I'm so scared I'm going to make a mistake (like with meds or treatments) because as soon as I'm focused, it seems another issue comes up like the previous scenario.

    I'm beginning to think med/surg nursing isn't for me. Maybe I would do better in an ICU where the ratio is 1:2 max and I can focus better on those pts?

    Anyone else feeling like this or have any suggestions? Thanks!
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    by RachelRN89 Jan 10 8:35 pm
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  2. 6 Comments so far...

  3. Jan 10 by
    Umm this is THE norm on med-surg units with ratios as high as 1:7.. I would KILL for 1:4..
    Savvy20RN, heydelilah, and MJeanRN like this.
  4. Jan 10 by
    Unfortunately, I agree with the previous post. I was also surprised to hear that you have an NA, which along with the low ratio is rare on my MS unit. I am always feeling like I am drowning and looking for ways to improve my time management, so I will be watching the replies as well. Good luck!
  5. Jan 10 by
    Some days will be better than others. Do the best you can. Try to cluster care as much as possible. Say rm 205 needs pain Meds? Md called on 204? See what md wants (I hate to put md needs over pain but they called first.) and call them back. See 205 and get pain Meds, go ahead and do assessment and other Meds while your in there giving pain Meds. A blood sugar of 70 is above our hypoglycemia protocol so I wouldn't worry about that at my facility unless pt has symptoms. What I'm trying to get across is, fight fires as they come and roll with the punches. Try to cluster care as much as possible while your in the room. Hope that helps!
    RNJill and kona2 like this.
  6. Jan 12 by
    Rachelrn89 I must say you are not the only one that feels that way & it's common to feel that way, however you do have to roll wit the punches, and just do the best you can while you're there. Your time mgmt will get better and prioritizing will also. I worked night shift on med-surg unit as I am a new grad and on nights it's a lil slower and you have time to gather thoughts mgmt and prioritize but I start days next week and I'm very nervous about that because it is busy and you have a lot more going on,but I already have a made up mind to do much best and that's it! And I'm sticking to it! Hope you have experienced nurses who may help you with suggestions on how to prioritize and use gd time mgmt, because I can say that I do have a lot of nurses that I can go to who will be willing to help me out with questions & that really does make a difference! Gd luck to you!
  7. Jan 13 by
    I still feel like that someday and I have been at it for almost 2 years! I bunch everything! When I go see my patients I bring their meds anything else they might need and also do all of my charting at the bedside. Bedside charting (if available), saves a lot of time from trying to catch up later on in the day! Which is sometimes hard if you have a very busy day!
  8. Jan 13 by
    1:4 sounds great! Still it is easy to get overwhelmed and fall behind. Are you delegating appropriately? I found that to be hard but it's all about teamwork. Ask the aid to take the low bs a snack. Cluster care when possible. You're only one person and can only do what you can do. Prioritize and things will improve =)

    ~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~

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