With an admission that complex, I wouldn't have gotten out on time either. In fact, I rarely get out at 3:30. Usually I get to work at 7 AM (I used to get there early but I got lazy), get my cart prepped with Ensures, insulin, ice water and anything I know is running low or things I know I'll need. I rarely get a full report because I work every day so I just ask if there's anything critical I need to know. I take narcotic count from the previous shift and get out on the floor by 7:20 (ideally). First thing i do is my blood sugars, then pop out a few people's meds before the breakfast trays come up around 7:45. Nurses have to check the trays to make sure allergies, textures and diets are all correct. Once the trays are up I give insulin.
Then I continue going room to room giving meds until about 9:30 ideally. Sometimes if it's a heavy med pass or my side is full, I don't finish until 10:30 (at the latest). Then it's time to do treatments. At my facility I have fantastic CNAs who will apply most protective creams and put on Teds to those who need it. I verify that Teds are on, hearing aids are in, dentures are in, and creams have been applied. I put on any creams that are medicated creams, do dressing changes, etc. in this time. Basically I try to get done with ALL of my treatments before the lunch comes up, because you never know what the afternoon holds. Usually I am successful but it depends on who is down with Physical Therapy because sometimes the pt is gone for too long. Around 11:45 I check blood sugars again, give out any pre-meal insulins or Omeprazoles, then check the lunch trays. At this point I take a 15 minute lunch break and will fill out mindless Medicare documentation. Once lunch is finished I'll start my 2PM med pass around 12:45 or 1:00. That's usually done by 1:30 (not too many afternoon meds) and if everything is going perfectly, I'll stock my cart again and start notes.
We're very lucky in our facility to have a 4th nurse on 99% of the time. So two med/treatment nurses, 1 charge nurse (to do MD orders, make appts, do labs), and one extra nurse to either help with treatments, help the charge nurse, or do admissions and discharges. She enters all the orders, verifies things with the doctor, and sometimes even does the head to toe assessment. The only thing I sometimes have to do is the head to toe and note. You are fully justified in working 1 extra hour to do an admission of that depth. That would take me probably 3-4 hours to do!
Even on a perfect day with no emergencies and no admissions, I still work overtime. I think there have been 2 days that I haven't worked overtime in the entire time I've worked there.