A strategy that's almost always worked for me is to invest some quality time in the most "challenging" patients at the very beginning of the shift, especially if they're new to me. A lot of times, that ten minutes or so of sitting down with them, discussing their goals for the day, and actively listening
to them saves a thousand steps later when they're not
hitting the call light every 5 minutes. It also shows them that their concerns matter to you; and when they believe they've been heard, the vast majority will calm down, feeling more confident that their needs will be met and thus becoming less anxious.
I'll never forget one woman, a thirty-something frequent flyer who came in with vague abdominal pain for which no cause was ever found. She was notorious on our Med/Surg floor for being a PITA---on the call light constantly, yelling at nurses and aides who reminded her that she could not have Pepsi when she was NPO, freaking out when she got a roommate and so on. I'd never had her before, but I drew the short straw one evening when she'd just arrived on the floor and needed to be admitted.
So I went in right away, put the paperwork down and pulled a chair over to her bedside as if I had all the time in the world. She was suspicious at first, but quickly warmed up to me and then proceeded to confide some of her darkest fears. By the time fifteen minutes had gone by, I'd earned her trust and a pretty good concept of what her real issues were; and do you know, she rang that call bell maybe four times all night---a couple of times for pain medication, which I gave promptly, and once or twice to ask questions. That was it. My co-workers noticed and asked me how much Ativan I'd given her, because they'd never seen her that mellow; but she didn't need any at all during that shift.