Enough time in a shift to finish work

Esme12, ASN, BSN, RN · Dec 21, 2014

It is better than LTC but it is still a struggle to finish....sigh

sallyrnrrt, ADN, RN · Dec 21, 2014

amen Esme12 said it best

Libby1987 · Dec 21, 2014

I wish they would walk a shift in your shoes and then see if they manage to get it all done.

RunBabyRN · Dec 21, 2014

AAAAAAND this is why I left my SNF job. Or was one reason.

I don't (yet) work in acute care, but I'm able to get my work done in a reasonable manner in my other jobs (health fairs, home infusions, and freestanding birth center).

vintagemother, BSN, CNA, LVN, RN · Dec 21, 2014

I'm in psych. We pretty much have enough time to get our work done. I worked in an ALF and have SNF experience, so I'm very grateful for my current work conditions.

Gooselady, BSN, RN · Dec 21, 2014

Most of the time yes, but some days, no, not enough time, and I'd stay over and do minimal standard charting.

I hate staying late so much that I got fast at doing what needed doing and charting what needs charting. Something has to give, and usually, it was my fifteen minute breaks. Some nurses NEVER get done and have overtime more shifts than not. What I found was they were just OCD enough to reread their charting, chart every bowel sound in a patient with pneumonia, re-check their assessments and get lost in deciding the right word to characterize sputum, and verbosely contribute to the care plans I never got a complaint about my minimalist care plans. I felt twinges of 'guilt' as I watched my OCDier friends agonize and write paragraphs.

If you have a good team, you can delegate to the charge nurse, who's job it is to help you finish your work and get it out on time. If you ARE the charge nurse and carry such a patient load as you do in LTC, it's either find new and creative ways to manage your time AND complete the required work. Is your manager giving you trouble over the overtime? If not, there you go, you are covered. I hated staying a second past my shift's end, and it was five patients in acute medical oncology, including chemo and teaching. I rarely needed to stay over, even though our manager was forgiving, it was more ME hating it.

Pangea Reunited, ASN, RN · Dec 21, 2014

I'm in California, and our acute care ratio is a strict 1:5. I only stay overtime very occasionally ...either because something huge happens right before shift change, or the oncoming nurse(s) are late.

When I have more work than I do time, I chose the highest priority tasks to complete. The lower priority tasks get rolled over to the next shift or left undone. Doing a good job is important to me, but I feel no pressure or obligation to be superhuman.

PacoUSA, BSN, RN · Dec 21, 2014

Depends on the acuity and the overall flow of your unit. My last staff job, I would often stay to finish charting because there never seemed like enough time to do it during shift due to all the tasks. On my present travel assignment, I get out on time 98% of the time. I'm convinced now that my last job was a mess and did not delegate enough tasks for others to complete. Things are more streamlined where I am now.

kbrn2002, ADN, RN · Dec 21, 2014

I work in SNF and usually have no problems getting everything done. I have about two hours of "down" time between med passes, plenty of time to finish up treatments and assessments, process any orders the rounding wrote and get most of the charting done. There is about another 30 minutes, sometimes more at the end of shift to finish up. I don't write novels like some of the nurses do, the problem with narrative charting is some nurses seem to think it's not good if it's not wordy.

caliotter3 · Dec 21, 2014

In extended care home health, my nurses' note and any necessary additional documentation, such as a physician's supplemental order, can be completed during the shift 99% of the time. Only rarely will I be totally tied up with a change of condition situation or a transfer to the ER, that has me involved with direct hands on tasks while leaving the job of documentation until later, when the dust has settled.

firstinfamily, RN · Dec 21, 2014

When I worked SNF it was on the sub-acute side, so our pt to nurse ratio was less. When I did get pulled to LTC it was very overwhelming to be responsible for 30-40 patients. Yes, they were not as sick as the sub-acute ones were, but, still they needed care. Giving meds to elderly can be daunting because they take longer to take their meds, not only because they have so many to take, but they are slow in taking them. They need time to swallow!!! I never really was on LTC long enough to get a good feel, but when I was pulled there I could not see how everything got done. The one charge nurse on a particular unit I would be pulled to was very good about delegating and she made sure the nursing aides were helping each other, that they did not use the nurses for everything, and the nurses worked together very well in that they would ask each other if they needed help or where they were in their tasks, if there was anything they could do etc. It depends on how you approach your work load. Is everyone working together for the better outcome of the patients? Or, is the work load being loaded to just a few? Do you feel you have to do everything yourself so that you know it is done?? If you are the charge nurse, you need to put a system in place that "assigns" everyone their tasks, hopefully considering acuity levels and how much care certain patients may need so that the work is distributed equally among the workers. Who will be doing treatments, who will be doing meds, who will be rounding with the MD?? What is your staffing to patient ratio? Does it meet the needs of the floor? How much is it worth to ask for more staff? Does paying you overtime outweigh the cost for another staff member??? Try to implement a new stratagy to see if it will distribute the work load more evenly, try to delegate things that do not take a nurse, set a goal for yourself to have a certain number of tasks done by a certain time of day. Chart as you do things, do not save it for the end of the day. You might see if your manager has any ideas for you and talk to her about the overtime if you have not already. Now days it seems managers do not want anyone accumulating overtime nor do they want to hear that more staff is needed. I always felt that it seemed day shift had to do everything whereas other shifts did not have as heavy a work load. Perhaps some of the tasks can be divided up between shifts. A daily dressing can be done on evenings, not always on days, or it could be done in early am on night shift. Divide up the tasks between shifts!! Good Luck!!