This is going to be a serious vent session... Well, needless to say, I got in trouble for staying 4 hours late at work consecutively for the past 3 days due to have terrible nights... I have struggled with time management a lot due to the fact I am new RN and have only been on my own for 4 months now! My vent is...
I have 7 patients... We 7 different needs.. Medications.. Pain medicine.. Neurovascular checks.. Neuro checks.. Multiple things going on considering I am on a med surg unit with post surgical patients anywhere from a vascular surgery to an AV fistula being placed...
I want to know WHY is it such a big deal for me to stay late? I mean charting is very lengthy! And every shift for the past two weeks, it's always something.. I come on shift and CVP is leaking.. Not to mention its been leaking all day but I am the first person to truly acknowledge the issue.. Tell the on call doctor about it and I have to start peripheral IV of course......... Well also this same patient had colostomy bag come off at the same time! Naturally... So I have to get all the essential things I need for that.. A new bag, some paste, and the donut protection barrier.. So by the time I start an IV and finish that its like 2045.. Not to mention I have another patient who is calling out for cereal... milk.. diet coke every 5 minutes.... And my techs NEVER help or if they do, they act like its annoying to me told what to do?!!! I say please...... The night after I had a patient who became disoriented wondering why?! A seasoned nurse looks and sees that the patient has been off xanax for 2 days now and the pt takes it every day at home... Now this patient is refusing everything.. IV abx and PO meds.. And naturally both IVs that the patient goes bad.... So I end up having to restrain this patient eventually (calling doc of course) not to mention getting kicked twice! It took 5 of us to get the IV in.............. Then the weekend before I had patient with no pedal pulse after a vascular surgery that the day shift nurse got report on from PACU yet when they came up to the floor didn't check pulses.. so I had to call on call doctor.. and the doc wanted me to check pedal pulses every hour times 4 then every 2 hours times 4.. I have 7 patients to take care of.. Can they seriously think I will be caught up on charting??!!!! I am just so frustrated.. I am frustrated at nurses who don't give two craps and walk out ON TIME every time.......... Not happy at all.. I love my job because I love being a nurse but the charting and the way some of the staff is ridiculous.. and I just want to cry because I look so incompetent bc I stay late so much......... I just want some comforting is all..... I just feel like I am just never gonna get it
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I mean if these techs are mothers how do they think at home? do they forget how to think when they get to work?
It is only logical that the techs who are mothers would care more about their own children than the hospital patients to whom they have no emotional attachment whatsoever. So, yes, people change their thinking when they get home.
I understand and I am not a new grad. As for delegating the unit I am on has no one to delegate to. We have no secretary so we do our own admissions, putting chart together, stocking, pulling linen, cleaning bed spaces, cleaning equipment, monitoring visitors, etc. We do all of our own patient care, we do not have techs. We transport our patients if they need to go for CTs stays, etc. We draw our labs. We start our IVs. We do our teaching. We answer our own phone. We get in trouble if we get out late. Most days it is an impossible task.
I understand and I am not a new grad. As for delegating the unit I am on has no one to delegate to. We have no secretary so we do our own admissions, putting chart together, stocking, pulling linen, cleaning bed spaces, cleaning equipment, monitoring visitors, etc. We do all of our own patient care, we do not have techs. We transport our patients if they need to go for CTs stays, etc. We draw our labs. We start our IVs. We do our teaching. We answer our own phone. We get in trouble if we get out late. Most days it is an impossible task.
You have all that to do and they have the nerve to c/o about you getting out late?. Obviously they are not the ones walking in your shoes. They get to go home at the end of their shift after sitting behind their desks all day doing nothing.
Possibly your charting could be more concise. Unless a major incident has happened, you should be gone within 15-20 minutes of your shift ending. There is some excellent advice on this thread.
I understand and I am not a new grad. As for delegating the unit I am on has no one to delegate to. We have no secretary so we do our own admissions, putting chart together, stocking, pulling linen, cleaning bed spaces, cleaning equipment, monitoring visitors, etc. We do all of our own patient care, we do not have techs. We transport our patients if they need to go for CTs stays, etc. We draw our labs. We start our IVs. We do our teaching. We answer our own phone. We get in trouble if we get out late. Most days it is an impossible task.
Ironically, just last week we had no techs at all.. No secretary.. NOTHING. We do the same thing. We put our charts together, order IV pumps if needed... Just this past week I had only 5 patient but a patient that was a MESS! Screaming and just acting out bad and we had to ensure they had a sitter. We had 3 patient's on our floor that were 1 on 1's and they took all our staff to do so.. So no techs or secretary.. I miraculously got out by 0845.. We are extremely understaffed on nights.. I cried last week because a nurse yelled at me and said it was ridiculous that I wasn't giving report until 0730.. (ironically this same nurse is one the day shift tends to complain about.. and then had this other nurse.. yeah one that likes to eat the young.. And likes to point out my mistakes every time.. Literally.. Very demeaning towards me.. And that is something I absolutely CANNOT stand.. Yes, direction is admirable because I am new.. But to continually appear to me purposely poking at my mistakes is just not enabling me to learn.. It hurts my character really... I am unfortunately someone that is very gentle, very caring.. I can take constructive criticism just not the kind that is "sassy" in nature.. The day shift does not understand I feel like.. if a patient has pooped purposely on the floor, yes this happened to me.. This is my responsibility to clean up.. I have no tech to delegate it to.. If i am unable to get blood, I have to get another nurse for assistance who also has patient's.. Honestly, I know my time management is lacking.. I feel like I am improving already with taking my computer in the patient's room while assessing.. but staffing is problem.. If another floor needs a sitter at night, our staff gets pulled.. Its insane..
Ironically, just last week we had no techs at all.. No secretary.. NOTHING. We do the same thing. We put our charts together, order IV pumps if needed... Just this past week I had only 5 patient but a patient that was a MESS! Screaming and just acting out bad and we had to ensure they had a sitter. We had 3 patient's on our floor that were 1 on 1's and they took all our staff to do so.. So no techs or secretary.. I miraculously got out by 0845.. We are extremely understaffed on nights.. I cried last week because a nurse yelled at me and said it was ridiculous that I wasn't giving report until 0730.. (ironically this same nurse is one the day shift tends to complain about.. and then had this other nurse.. yeah one that likes to eat the young.. And likes to point out my mistakes every time.. Literally.. Very demeaning towards me.. And that is something I absolutely CANNOT stand.. Yes, direction is admirable because I am new.. But to continually appear to me purposely poking at my mistakes is just not enabling me to learn.. It hurts my character really... I am unfortunately someone that is very gentle, very caring.. I can take constructive criticism just not the kind that is "sassy" in nature.. The day shift does not understand I feel like.. if a patient has pooped purposely on the floor, yes this happened to me.. This is my responsibility to clean up.. I have no tech to delegate it to.. If i am unable to get blood, I have to get another nurse for assistance who also has patient's.. Honestly, I know my time management is lacking.. I feel like I am improving already with taking my computer in the patient's room while assessing.. but staffing is problem.. If another floor needs a sitter at night, our staff gets pulled.. Its insane..
I agree with the responders...you are new and you will get better as time goes on. Will there still be issues that come up and you need to put the other patients o"on hold" for a short time. Your aides need that push to do what you request, review their job description, explain what you are asking them for is part of their job descriptions, and then follow up with them that they did their job. I have found when I ask an aide to do something for me I freq find that I have to say, "I'll check in with you in 20 min to get the results of...(BP, I&O, spec collected). This way they know that not only am I serious about them doing the requested job but I will also be checking up on them...I also thank them when they have done the requested job. Does your hospital have bedside report? If so, when you are in the room doing report do a quick look at the patient and make sure s/he is clean, the IV is working, the ABC's. If there is a problem, politely and professionally point it out to the previous shift that the patient and room is not acceptable and needs to be corrected before they leave to go home. With your vascular surgery patient without pulses, if the pulses had been checked during bedside report you could have asked how long there hasn't been pulses and again politely and professionally tell the nurse that they are responsible for calling the physician. He will have questions that you won't have the answers for and that nurse will have those answers, and it makes her/him accountable for their actions. I have done this for the past 3 yrs that we have been doing bedside report. The previous shift is not always happy that they have to fix/correct issues that are found with the patient but I stand up for myself (doesn't make me popular) and I'm being a patient advocate!!!!
I'm in my MSN program for nurse educator, and I love it. Theory has its place...and it's about to happen in this thread. Hold onto your hats boys and girls...
From Benner's original 1982 article. I'm sure it will sound familiar...
A preceptor describes her own evolution to the stage of competent, planned nursing from her earlier stimulus-response level of nursing:
I had four patients. One needed colostomy teaching, the others needed a lot of other things. Instead of thinking before I went into the room, I got caught up.... Someone's IV would stop, and I'd work on that. Then I'd forget to give someone their meds, and so would have to rush around and do that. And then someone would feel nauseated and I'd try to make them feel better while they were sick. And then the colostomy bag would fall off when I wanted to start teaching. And, All of a suddenthe morning was gone, and no one had a bed bath. Now I come out of report and I know I have a couple of things that I have to do. Before I go in the room, I write down the meds I'm supposed to give for that day, and then walk in there and makesure that everybody's IV is fine....I know what I have to do, and I am much more organized.
So, no, experienced nurses don't always cut corners; they just know how to competently get the job done more efficiently. But you won't be able to see that if you're a Beginner or Advanced Beginner.
This is just what I needed after a long day at work! Ended up staying several hours late to chart and decided to google my topic on allnurses.com, which never lets me down. Found some great advice as well as the feeling that I am not alone in my search for learning time management as a new nurse.
And this past week has just been miserable.. Some days with 7 patients I leave at 0730.. BOOM perfect.. Just these past 3 days I have been leaving late because of chaos.. And we chart on EPIC.. The girl who preceptored me was very thorough on charting so I super OCD about getting a green check mark by the patient's name before I leave... Also, I have came on as night shift and none of the medications on the PTA have been reconciled or wrong dosage.... When I go to pass medications and call out what I am giving, uhh no ma'am I don't take that or are you not gonna give me this? So I call the doc to get Geodon ordered for a patient who HAS to take it and get chewed out for calling about reconciliation of medications at 2200.. I really don't care about doing all these things.. It's just I am going to be late if I have to do tons of things like that so I feel like.. Oh well, I guess.. I know over time perhaps it shall get better.. I love taking care of people and I guess being speedy gonzales is not really how I would like for it be but just how it has to be lol
That was not a girl that precepted you. That was a seasoned nurse.
If you are requiring 4 hours to chart, you need additional training on charting.
The nursing assistants are walking all over you. Look them straight in the eye, and request a specific task to be done. If they do not, write them up.. each and every time. They will come around.
TheCommuter, BSN, RN
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