Desperately need time management tips!

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Hi all,

I'm on a busy med-surg floor, day shift (yuck), which is unusual for a new grad. I would have preferred nights but oh well, this is what I'm stuck with until I quit, which will be sooner rather than later. In the meantime though, I desperately need to figure out how to manage my time! There's one senior RN who's always begging me to go eat or take a break, and I always say I can't because I'm always behind, and we don't get paid for overtime so I want to get out as fast as I can at the end of the day.

Things start out ok at the beginning of the shift but things get nuts and I feel so stressed. I've been modeling my preceptors' behaviors and they way they do things, but it doesn't work for me. This is their routine, and the model I've followed:

  1. Do AM chart checks. This is where we check the previous shift's charting to make sure orders were entered into the computer and/or carried out by the previous RN.
  2. Get the labs for each pt from the unit clerk, report any critical labs to the MD.
  3. Go to the MAR of each chart and on the report sheet, jot down the times of the meds due for each pt.
  4. Pull out the MAR for the first pt and their meds. Administer that pt's meds, and then do the assessment.
  5. Repeat #2 and #3 for the rest of the pts (usually all 5 pts have their first meds due at the same time, i.e. 9AM)
  6. Chart all the assessment findings and a short narrative on the nursing flowsheet. If any pain meds are given, document on the pain mgmt flowsheet and follow-up with the pt 10-30 mins later to re-evaluate their pain), and chart on the re-evaluation
  7. Enter pt acuity in the computer system (must be done by 11am)
  8. Near the end of shift, do final charting on the nursing flowsheet.
  9. Close charts (do 8-hr chart check, if any new orders done after 14:30, endorse to the PM shift).

It doesn't seem like much on paper, but I find it so overwhelming. This is how all the experienced RNs do it and they always have time for breaks and lunch, yet I struggle and am always behind despite the fact that I never take breaks or lunch, or even go to the bathroom. Factor in all the other crap that goes on during day shift, like dealing with all the MDs, case managers, social workers, phone calls, etc., I don't know how to manage my time.

At 15:00 I stop to give report to the PM nurses, and then I have to go back and finish all the charting I didn't finish during the day! I wish they taught us time management in school but maybe this is just one of those things you can't teach. If anyone has any pointers though, please share them.

Thanks so much!

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Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

There are many ways of organizing a day. I consider myself very time efficient...here is how I schedule my day.

1. Do a quick head check on all the patient's directly out of report.

2. Complete head-to-toe assessments on each patient, jotting quick notes on my brain sheet.

3. Begin AM med pass. As I am passing meds I am writing down the med times for each patient for the rest of the shift. Also, check the vitals as meds are being passed.

4. Begin charting (usually around 0930). This includes checking labs, looking at orders, calling the docs about necessary issues, and charting the assessments on each patient.

5. Take a lunch.

6. Pass noon meds.

7. Tie all loose ends together, go over chart making sure not to miss anything.

In my opinion, the reason new nurses or nursing students get behind is because they look at the chart before looking at the patient. I make it my top priority to check on the patient and do an assessment on each patient as soon as possible in the shift.

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I'm a new grad in last month of orientation. Time management is something that I need a lot of work at, but I have found that clustering tasks is useful. If I have a pt w/ 0800 med & a 0900 med - I get those meds ready at 0800, do vitals/assessment and give both meds at 0830 (0800 med half hour late and the 0900 med half hour early). That way I don't have to keep coming back in the room. I guess that doesn't always work - there are reasons why sometimes you do want an hour between meds - but for most part, it's helpful.

Good luck to you...:balloons:

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Specializes in NICU.

I've been off orientation since April and I usually manage my time very well. So I'll tell you what I do...

1. Get out of report and go see my patients. I introduce myself, see what their vitals are (CNA gets them), I ask them if they are in pain or if they need anything. I tell them I will be back shortly with their AM meds and if they need anything before I return just use the call light. (This way they know I might not be back for a bit and this keeps them off the call lights until I get back). Also I can bring pain meds with their AM meds.. saving me a trip down the hall.

2. I then check charts and labs.

3. I pull meds

4. Pass meds, do assessments and chart.

5. Check charts

6. cover 1130 blood sugars and give 1200 meds

7. go to lunch

8. give any 1300 meds, chart, check charts....

9. Do 1500 assessment

10. then check 1630 blood sugars, cover them, give 1700 meds

11. Tape report

12. Tie up loose ends

Of course there are many interruptions. Sending pts to xray, discharging patients, admissions. ect... Sometimes I can't follow my routine.

My main advice is to go see ur patients first thing! Because then you know they are okay and you have time to do everything else....

You'll get better with time!

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