Advice for new grad getting ready to go solo!

[iloveny68]

Hello - I am a new grad on a med surg unit at a teaching hospital. My clinicals were at a much slower paced community hospital. What is the best way for me to organize my day? I get there 20-30 minutes before clock in to do my telemetry strips, read h&p, labs, vs, and then get report and hit the floor running. These past two weeks I have had 6 pts, and I feel like I am running for 12-13 hrs straight. I'm not complaining - this is exactly what I wanted and I love my unit. I just feel like I need to periodically regroup and collect myself. I feel as if I am just doing tasks, and not seeing the whole picture the way I should be. Being new, I know things take me a bit longer to do, and it seems like every time I enter a room to do something specific, I find a bunch of other things that need addressing, which throws me off schedule. Any and all ideas and advice are appreciated! I really do love this job and my patients and co-workers - and I want to be an asset, not a hindrance!

[amarilla, RN]

First thing: congrats on the job!

I am a fellow new grad; I've been on my own about four months or so now on a med-surg floor. I think we all organize our shifts differently, according to unit routine, preference, and shift. That being said: do you use a brain sheet? Make a to-do list throughout the shift? How are you trying to organize your day right now?

I have a simple brain sheet to fill out at report; I fill in more details about history, tests and lab values as I chart check. I also make a to-do list - a large handwritten sheet divided into 6-8 squares for my patients - which lists meds, tx (dressing changes, vac placement, new IV to be started, checklist to be filled out for AM, etc), and notes for the oncoming nurse as they happen, (pt refusing meds, hold heparin in the AM, etc). I jot down the meds and times they're due; I then go to the med room and make sure everything is there. If not, I send a missing dose request to pharmacy asap.

I check off the to-do list as I complete the tasks and keep it with me to be able to look at it and group tasks. I also tape check my IV bags, CBI bags, suction canisters and the like when I first round to monitor them; I'll write down the levels remaining in IV and CBI bags on my list so nothing goes dry. I talk with each patient on the initial assessment to tell them the plan for my shift: meds at this/that time, test in the AM, any questions that I can answer or concerns to share; I've found it helps patients to be much more cooperative when we're on the same page and they're on the light less when they know what to expect.

I too was finding that I was running in and out of rooms repeatedly - went in to give meds, found IV bag nearly empty, returned with IV bag only to have pt say that IV is hurting, return with start kit only to find pt's tubing needs to be changed anyway, return with tubing only to have pt ask for kleenex, !@#@^!@, etc. Make a list and try to group your tasks; you might not be able to do them all, but if you knock out 2-3 things, you'll have more time.

I know how you feel about feeling like you aren't seeing the big picture. I felt (and feel) that way too sometimes, particularly when a doctor asks me a question about something I hadn't even considered, (talk about duh!.) You can't know everything, though, and you know that; you have to just get through every day, learn something from each patient, and keep asking questions to keep learning. We're only going to learn by seeing, doing and asking as we build our time and experience on the floor, and most of your co-workers realize this, (I try to thank them often for their patience!).

Hang in there! It gets better. :heartbeat

[Up2nogood RN, RN]

You'll get quicker at doing tasks and this will give you more time to constructively think about what and more importantly why. In the beginning it's easy to be focused mainly at the task at hand but with practice you'll be able to look around and piece together info that you're processing while doing your task and even talk to your patient too!

[spongebob6286, BSN, RN]

be organize and proper time management