i feel so tired...

iluvivt, BSN, RN · Dec 11, 2008

1 You will get better at juggling.prioritizing and organization. Try to group your activities with each patient so YOU can get better control of your night.

2. Find out what your protocol is for medication administration In some facilities you have an hour window to give medication.

3 On your initial assessment anticipate what you will need for any procedure timed for later in the shift. I used to do this all the time and it really helped me stay organized. So if you have a dressing change at 2000....get all the supplies you need and set them aside in the room...then when you go back to pass your meds or whatever, the stuff you need is there.

3. Try to anticipate what your residents will need

4 Evaluate your routine and see if you can devise some tools to help yourself. This can be anything such as making your own worksheet...delegating to the CNAs or suggesting any improvement

Hang in there been there and still there!!!!!

LASLPN · Dec 11, 2008

LOL.......I can relate so much to what you are saying. Unfortunately, there are going to be so many days/nights/evenings like that!.............nursing in general is mental and physically draining. I am type A so I have to have EVERYTHING in order which drives me crazy, lol... in a perferct world the cna's would go the extra mile and the nurses would all do everything that was written on the MARs and TARs plus...........Admin. would get OFF the carpet every now and again w/out STATE behind their heels! Supplies would be plentiful and WHERE they belong,hence everything would be in place to help all of us help the patient.... who should be the ONLY unpredictable part of our job. BUT!........but, I fear it will never be this way.I can tell you it is exhausting to strive to be the best but what choice do we have? PLEASE, do not cut corners. Take a look at your MARs, ask your UM if you can get any orders changed by the MD to group some of the meds together.....EX: vitamins,,,,HS meds on patients that are in bed at 7pm...ect. I try to have all my PO meds out and in before they fall asleep because it is too hard to get them to wake up to take them. I try to only have to go back at 9p for BS and those things that have to be given 12 hours apart and so on. In our head we know that giving a remron at 6-7p is not harmful and this may be where you see nurses cut corners... I say to get the order changed to protect your orifice. EX: if it is scheduled for 9p get it changed to 8p and give it at 7p............:) Help the MD's remove anything that is not needed, I once had a patient (tube feeder) on a appetite stimulate! I ask you... NOT NEEDED, lol! FSBS 4x's a day on a patient that is never over 150 is not needed....ect. The DOCs are not going to change this stuff on their own we have to ask them firmly...wink-wink. as far as the paperwork.....that is something you never want to minimize it is way too important, trust me.....nurses are mean and w/ a lil power they are worse(not all). I was talked down to by several nurses because I called the doc to change a PRN to routine on a patient that has been asking for pain med every 6 hours every day for months....obviously she is dependent on this stuff ( vicodine 7.5/500) the reason I did it was for 1 it looks bad on us if we are giving an as needed med ....routinely and she may need something else... anyway- the doc weaned her off.ya know by now that the patient had a cow! well the other so called bosses(fellow nurses) expressed i was starting trouble.............um, im confused! work smarter/not harder is what I thought I was doing....and looking out for the best interest of my patient...ah well... stick to your guns...:) Thanks for letting me vent too! :banghead: :wink2:

Spritenurse1210, BSN, RN · Dec 11, 2008

!!!
I love LTC, and i love the old people..but I feel like a top..my head is always spinning...i really try to give my all and more, but it's like always not enough

Rest assured, most people who work LTC feel that way. That is why I only work night shift as a nurse!!!!!! Hang in there, you'll get it.

momdebo, BSN, RN · Dec 12, 2008

Bless all you who work long term care. I did it as a CNA, went back after being an RN. I tell ya, I worked just as hard in the long term as I ever did in cardiac ICU. I remember well, the cascade of unforeseen, unplanned emergencies, the low sats, crazy blood sugars, skin tears etc, etc, etc. I never found a way to "prioritize", was always working after. Finally went back to ICU where I had more control! Sounds crazy but for me it was true. Hang in there and God bless ya for the work you do. You sound like a fabulous conscientious nurse, don't change a thing.

achot chavi · Dec 12, 2008

You're doing great and I applaud you, take a deep breath and remind yourself that youre only human- 2 hands, 2 feet, one set of eyes and ears etc. Try to stay calm when the storm hits, your boat will make it to the shore- I promise you. Ask your CNA's to try not to bother you in middle of med pass- unless its an emergency and if possible bring the pt to the desk so you don;t have to run back and forth. If you can't - don't answer phones when you are busy- say - call back in an hour- if the pt wants to chat- tell him you'll come back and set a time for him- when you know things are calmer. Try to catch up or prepare when things are calm so you're better prepared when the storm hits.

We all feel this way- just take it one emergency at a time. Natural Adrenaline is good thing- but it leaves you depleted at the end of the shift- so plan a personal reward- a bubble bath with candles and a glass of wine, or just a cuddle on the sofa with your cat and a good book, a steaming mug of hot cocoa and a movie- whatever- just know that some personal reward is waiting for you!

YOU DESERVE IT!!!!!

wishiwereanurse, BSN, RN · Dec 12, 2008

I cannot NOT look at the MARs. The nurse i share the shift with says she's got the meds all memorized so she doesn't need to look at it. I just cannot do that. Signing the MARS over and over again during the med pass takes a lot of time too...sometimes in the middle of the night I'd remember that I did not sign something and I'd really lose sleep over it.

Lately treatments aren't being done by nurses because we just don't have time , they decided to put the treatment sheets in the MARs... so I also wish the treatment stuff is in the medcart. I am unsure if its ok to take treatment stuff with me and put it in my cart, or leave it in rooms...

Can i bring my own pulse oxi at work? Because we only have one, and it's annoying that I still have to borrow it from the other medcart. We told the DON there should be a pulse oxy at each cart... until now we only have one.

I am just glad that CNAs are talking to me, I'd be more scared if they're not telling me things...The nurses, man..they're a different breed. They talk behind your back. I would rather be with a nurse who seems b***hy but are actually intervening to make things right (I'm human too and I make mistakes)

I make my own HS list because some people want their meds at a certain time at night. Like this one resident, she knows she gets one medicine in the afternoon, and two medicines at hs. One of the other nurses tried to give all 3 meds at 4pm, and she spit them out, saying she only takes one at 4pm.

achot chavi · Dec 14, 2008

i cannot not look at the mars. the nurse i share the shift with says she's got the meds all memorized so she doesn't need to look at it. i just cannot do that. signing the mars over and over again during the med pass takes a lot of time too...sometimes in the middle of the night i'd remember that i did not sign something and i'd really lose sleep over it.
you must check the mar when preparing meds- your friend is wrong. no such thing as relying on memory. waking up as you do is normal - just prove you have a conscious.
lately treatments aren't being done by nurses because we just don't have time , they decided to put the treatment sheets in the mars... so i also wish the treatment stuff is in the medcart. i am unsure if its ok to take treatment stuff with me and put it in my cart, or leave it in rooms...
ask your don, i think its ok but i don't know if your policy is otherwise. if it weren't ok then why is the treatment listed in the mar?
can i bring my own pulse oxi at work? because we only have one, and it's annoying that i still have to borrow it from the other medcart. we told the don there should be a pulse oxy at each cart... until now we only have one.
i would chekc accuracy at the start of the shift with the facility one and if it works the same i would allow it- we have nurse who bring their own bp machine. again check with your don
i am just glad that cnas are talking to me, i'd be more scared if they're not telling me things...the nurses, man..they're a different breed. they talk behind your back. i would rather be with a nurse who seems b***hy but are actually intervening to make things right (i'm human too and i make mistakes)
i make my own hs list because some people want their meds at a certain time at night. like this one resident, she knows she gets one medicine in the afternoon, and two medicines at hs. one of the other nurses tried to give all 3 meds at 4pm, and she spit them out, saying she only takes one at 4pm.

again :yeah: