Any tips you can give me for managing time?

Nurses LPN/LVN

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Hi, this is my first thread even though I've lurked around for some time now. If this helps with describin the situation, I'm an LVN, graduated in July 2010, got licened January 2011, and just got hired 2 weeks ago. I train at 2 facilities under the same company

Training at the facility is a lot to take in but i'm surviving so far..

I got to make my first Telephone physician's order yesterday and chart about it afterwards.. If you put your ego aside and learn to take it when you hear agitation in the physician's voice on occasion.. along with having a pen and paper in handy to write new orders, It's not as bad as it seemed when I was in school.

A lot goes on. Sometimes people distract you when you're doing something like charting.. You're multitasking between phone calls, people talking to you at the nurse's station , and charting.. so it does throw you off and mess with your time management.

Patients outnumber PM nurses at least 32 to 1.. I've been making friends with CNAs and hanging out with them as my peers, because I know I have to get that Captain and crew mindset with them to make my job easier. I've actually offered assistance to patient transfers with some so I can try to build good karma and get some unit cohesion.

Med pass feels like the thing you spend the most time doing with 32 patients to a nurse. I'm still in training but I really want to get up to speed before they put me out there.. Trying to get more organized.. I'm considerably better than I was when I first started but I was wondering if you have any tips for me on how to get faster med passes.. I really don't want to be somebody who falls behind at passing meds, and omits treatments i should've given. I've seen it happen with other nurses.

I want to get the task done in reasonable time but not at the expense of increased risk for medication errors . I know that my med passing techniques need work to find that balance. I'm trying to do my own homework to try to make me quicker at the med cart, while remaining accurate at medication pass.

I don't like the idea of leaving people in the room alone on Nebulizer treatments. But at the same time. It doesn't seem practical to keep them company. I get this guilty feeling when I do that like the other nurses do :(

Any tips you have will be appreciated. Especially with time management in this type of environment :)

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Specializes in LTC, AL, Corrections, Home health.

Med pass is still my greatest time comsumer, and it's tough to make it any faster (with out cutting corners/being unsafe). It helps if you can be in one unit or hall consistantly especially when you are new, but of coorifice they want you to be well rounded and flexible because you are new. The first thing I do is grab two pieces of paper and write down a list of all of the b/p and pulses (so I don't forget), that I need related to medications. Luckily I work on one of two halls on a small unit, so I even have them pre-made up and just add new folks/changes. The second is a blank sheet of computer sheet where I write myself notes; things I am asked about but unsure of, something I want to check on, or whatever else is requested of me but that I do not prioritize above my med pass. This ensure that I will remember but keeps me from leaving my med pass 20 times for relatively insignificant things that can be done at a later time. About leaving residents with breathing treatments and stuff, depending on their orientation it can be appropriate, the more you work with residents and get to know them you learn who you can trust. If a CNA (that I trust) is coming in to provide care of get them ready for bed or something I will ask them to watch after them.

It is great to help out your CNAs, they will appreciate you for it, but only volunteer when you have the time. There is nothing wrong with being friendly but you have to keep it all in prespective and hold them accountable, because ultimately it falls back on you: why didn't your CNAs do their charting, take out your shift's trash, etc. With this said there is health balance, CNAs don't like to be micro-managed either. Assuming proper training, everyone knows their job if they aren't fullly fulfilling part of their duties, tell them. Be positive and uplifting rather than negative when telling them to do something, treat them with respects. Never forget the power of praise and appreciation; everyone likes to hear they are doing a good job. Remember we are all human, give them the benefit of the doubt but don't let anyone take advantage of your kindness.

I have only been at this a couple years, in long term care about a year and a half. I can tell you that it gets easier the long you do it.

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Specializes in Emergency Room.

I usually start by trying to make sure that I have everything I know I will need done ahead of time to make things go smoothly as possible. I'll give you the general gist of my shift this past Friday evening. I had 18/21 patients of this unit and am familiar with all of them.

2:25p: Arrive on unit. Patient wants me to call doctor to get her a pass for Sunday. Promised I'd do it the day before but I was too busy so took care of this immediately. Finished doing that by 2:30p

2:30p: Get keys from nurse I'm relieving, he's too busy to help me count so I count while he sat at the desk and it was good so I kept the keys.

2:35p: I go around to all my g-tube feeding patients and remove their old g-tubes and throw them in the soiled linen/trash room.

2:40p: Grab some folded scrap paper and a prescription refill order sheet

2:40p: I know I have 8 heparin injections I have to give on my shift so I pull them all up ahead of time and leave them in the top of the cart (Keep your cart locked when you're not by it, if state comes in the building discard the syringes immediately)

2:55p: gather alcohol pads, glucose strips, finger prickers (bleh forgot what they're called), and alcohol wipes

3:00p: Get the blood sugars for my 4pm accuchecks, record them in the MAR, and flag any insulin doses I'll have to give during my med pass.

3:20p: Run to supply room on the other side of the building where we keep our feedings. Shove 2 diabetic boosts in one pocket, 6 feeding tubes in my other pocket, have 1 Diabetasource feedings under each arms and 2 in each hand. Balance my way back to my unit.

3:25p: Place feedings on cart and look at the desk to see Admissions left me an re-admission. Yay! (ugh)

3:25p: Fill out the necessary paper work for my CNA for the admit, get my short report sheet filled out with as much info as I've been given so far so Im' ready when the nurse calls and leave it at the desk

3:40p: Label all my g-tube feedings with patients names,dates, rates prime them and hang them in each room so they're ready to be connected. 6 of them so it takes me about 20 minutes.

4:05p: Start my med pass. I finished around 5:45p which was about the time the admission came and also got 2 more accuchecks for 6pm. And I got report from the hospital she came from in between then.

6pm - 8pm: Trying to reach doctor, working on admission paperwork, assessing admit, calling the pharmacy, DCing foley, getting ABT from convience box, stopping another patients feeding at 6, giving dilantin at 7, restarting the feeding at 8pm

8pm: Start my 9pm med pass.

9:15pm: Finish 9pm med pass

9:15pm - 10:30p: Get RN to hang PICC (LPN's can't hang PICCs in IL) for a patient's ABT's, finish admits paperwork.

10:40p: Night nurse arrives to relieve me and I give report.

If you mentally run through some of the things you know you'll need to do, even if it's something thrown at you last minute you'll find your much better equipped to manage your time when you get things out of the way ahead of time. Pulling up those syringes, getting my accuchecks, and hanging all those feedings probably saved me another 30 - 40 minutes on my med pass. Not to mention the time I would have lost to work on my admission.

Good luck with your management skills. It's a process developing them but you will:)

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Specializes in Ambulatory (Urgent care) & Home Health.

Hey! I saw u on YouTube, I'm taking NCLEX-PN soon and your videos have helped me tremendously. Thanx;-)

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Specializes in LTC.

Hmm I have 36 patients on my shift. I used to have 40 but I complained til I got 4 taken off my load. I have a heavy hs pass and I usually have at least 16 charts to chart on. I do skin audits and txs too plus chart checks. When I worked on 8 hr shifts I used to go in get report and count then I'd put all my charts in order where I sit so that I wouldn't forget one. I'd not notes and times on sticky notes and flag my mars with them so I'd remember that I had to go back to that person. I would try to do all my charts within a certain time so I could get that outta the way . It really helped me. Having all my supplies was a help too . It's time consuming to go back and forth for stuff you should already have on hand. Speed will come later. Accuracy is more important. As for the nebs, when you have 30 pts and 5 get nebs all due at the same time it's not feasible to stay with each one for 15 mins . I stay closeby during mine and then go back because in 15 mins I can get severL other things done. Of course it's different if the pt has sob etc and I need to hover a lil bit. This is what school doesn't prepare nurses for. You'll get your own style that works for you and your pts.

As for cnas mine know what I expect for the most part.some are better than others but I'm the only night nurse who doesn't have a problem getting my vitals BM list etc . If I have to ask twice I start getting I'll and they hate that. I've seen improvement in that area..

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Hey! I saw u on YouTube, I'm taking NCLEX-PN soon and your videos have helped me tremendously. Thanx;-)

Ahaha! you're welcome lol

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Thanks, guys. these are all really helpful. I have a PM shift and i'm trying to get a strategy to take on PM shift. Luckily I'm still in training so consequences are less evere than when I'm the nurse on the floor.

I am assigned to diabetics, Cooperative alert/orienteds, Dementia Patients (some cooperative some not), patients who are all around grouchy and take up time to get to take their meds, a picky one who wants their meds on time

2 med passes but I'd say after report..

after i prepare the med for patient who is all around picky about their time...Diabetics I'd say are priority 1 since Hypoglycemic shock and diabetic coma can be some pretty serious stuff to happen

then I'd go for Easier going patients as priority 2 because it'd be easier to get them out of the way

3. Most likely the noncooperative people since it takes some time to get to them if they don't refuse..

That's where i'm at so far but i'm still coming up with a strategy through trial and error to take on PM shift.

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