Gee...thanks nurses! What excellent feedback! I'm learning already, and will implement the few good tips here that I had forgotten about since last working nursing. See how coming together helps others here at this sight! :kiss
Up until now, I have continued to stick to the "time management" plan one of my preceptors uses. The "plan" works if people would leave me alone to do the plan.
Thus....the need for additional tips which you kind people are sharing here!
I work on a floor that has one hall med/surg telemetry, and the other hall strictly cardiac patients.
I miss the cardiac side of the house which is where I was oriented the most, but as soon as my orientation was over, I've been literally "stuck" on the med/surg side of the house which is a very very very heavy hall to work on. Although we get five patients on days, the PCTs are stretched so thin, they barely can keep up with all the different patients, so many times primary nursing becomes the rule of thumb...at least for me anyway. I have good PCTs...thank the Lord...but they are very overworked and stretched to care for several nurses patients (ten to fifteen at a time) and those patients are NOT a piece of cake for them or the nurses if they are on the med/surg side of the unit.
The way I begin my day is:
Pull up labs
Pull old med sheets off the bedside charting and write down the meds I have to give taking note of when the patients next pain med is due.
Assess my patients passing meds due at the same time.
Now.........that sounds good in print right????
This is how "my plan" gets screwed:
The phone we must carry at all times rings incessantly! Everybody wants this or that, staff wants this or that, doctors want this or that, and gosh darn it........the darn acuities must be in before........ If they aren't, my phone rings again telling me to put in the acuities. Then, it's a phone call to 'update the board'.
Visitors want and at our hospital visitors must get what they want. Patients want and patients must get what they want. If you disappoint a patient or visitor by trying to be a professional and prioritize your care so priorities are met first, you get reported and disciplined.
Our floor is not "user friendly" for the nurses, so I'm having to go up a long hall to the next hall to constantly get pain meds out of the pyxis (only one on the floor and it is now on the cardiac side of the hall which makes it rough for med/surg side of the hall where the patients use the most pain meds). Bright idea right???
Then, there aren't cups, straws, sodas, water, ice chips, linen, etc. the patients want NOW, and the PCTs are already running ragged to meet as many needs as possible, so I find that I am having to do these things to avoid "PR" issues...can't have that.
Then, IVF runs out constantly on our floor, and the stock is poor most days so must order the fluid I need.
Constant runs to pharmacy for meds that are due but not present.
Then patients going for test must be prepared at the same time patients discharged want to go home NOW or you'll get reported by them, and they come first remember...if not, a "PR" issue arises for the nurse caring for that impatient patient.
Constant calls to the docs for change in meds, especially pain meds, because the patient and family want what they want and by gosh you'd better give it to them.
Also, we are NOT allowed to limit our patients visitors, so nurses have to find a walking path to the patient in the room to do what you got to do. Not allowed to ask them to leave.
There are soooooooooooooo many more things I could mention that interfere with "The Big Time Management Plan" that could work if the support system were better on our unit.
How do I deal with all this and still get out on time, and go to lunch on time.
The other day I worked eight hours straight before I could go to lunch because of the kind of day I had.
That shouldn't be........but it was.
Frustrated isn't the word I am feeling as a nurse. It's much worse!