Hello all!I am a brand new nurse. I just completed my orientation. I work on an inpatient surgical unit. We get ortho patients, other surgical patients, and medical patients as well.I am overwhelmed by the struggle to balance safety and time management. I come on shift at 7, have todo my own vitals (aides are not allowed to do them on my floor), get my assessments done, and pass 8 and 9 o'clock meds within my first few hours. We have a great link to MicroMedex to look up meds, but I can't seem to find the time when everything has to be done in those first few hours. I try to be familiar with the meds that are passed most often on my unit, but the medications for the medical patients are overwhelming, especially one patient with TPN through a medi-port with a PCA and other medications piggybacked into it.I am trying to learn to be proactive; clustering care and learning to push through assessments when a patient want to share personal stories or things irrelevant to their current hospitalization. More often than not, we have no aide at night. I can't say no when when a patient has to go to the bathroom when I came in to do their assessment. I can get them to the bathroom, have them pull the call cord when done, and try to get partway through another patient's assessment in the meantime.We have phones that our patients can call directly and we are tracked on how often we answer call lights, etc. I am afraid to ignore a patient call as it could be important, but I am often in the med room when I get a call that a patient can't get their TV remote to work or something as trivial (although I know it is important to the patient and customer satisfaction percentages).When everything has to be done "right away" and when my co-workers are often busy pushing through this beginning of shift rush as well, what can I do? Also, how can I encourage patients to be more self-sufficient? I don't mind helping a fall-risk patient to the bathroom, but patients who could care for themselves at home a week ago are suddenly "unable" to adjust their own pillows. I came into nursing because I wanted to help people. I am quickly starting to feel that often times I am not.