Getting out on time!

I am a new nurse and work in dayshift in LTC/rehab. "My" floor has 50 beds and most of the time just 2 nurses. We do not have a dedicated unit clerk either so the nurses have to answer the phone, take off new orders, respond to incoming faxes, and etc while doing meds, treatments, talking to families and doctors, and responding to emergencies and issues that pop up. My hours are 7-3. There is just no way I can get out at 3 since the oncoming shift begins at 3. I usually do not get out before 3:30 and most days not until 4 or even later. Two days a week there are a bunch of interns that visit and they always show up at shift change. Then there are the other staff that show up to do their own thing with the charts. Our nurse station is rather small so needless to say it is a zoo there at least two days a week.

Yesterday had the potential for extraordinary chaos. The residents showed up at 2:30. We had a scheduled readmission at 3:30 and a new admit for 4:00. At 3:00 we still did not have any information for either admit to begin the paperwork of getting orders, etc. There were only two nurses on the 3-11 shift and one of them was there till only 7:00 leaving the 2100 med pass and finishing up the admission stuff to just one nurse. I left at 3:30 and there still was no charts for the two admissions other than a barely legible order sheet for the readmit faxed by the hospital. I told the full-shift nurse to call me at home and I would come back to help. She said she would not because I would probably get in trouble.

This type of thing occurrs regularly and if I was that 3-11 nurse I would make it a point to talk to the ADON or DON. This is a dangerous situation if you ask me.

I have never been reprimanded for staying past 3 and don't expect to be but if I were to be reprimanded you bet your bottom dollar I would give them an ear full.

I am well liked and have had comments from other nurses, the ADON, and DON that I should not seek employment elsewhere. Well if they dumped on me like they do that 3-11 nurse I would quit in a heartbeat. I can afford to live close to a year without a job but can't afford to put my license in undue risk, so if it ever becomes bad enough I will resign on the spot. Nursing jobs are widely available where I live.

The bottom line is do not feel bad if you have to stay past your scheduled time until management says something to you about it. Do your best to get everything done but if you cannot you owe it to your patients and license to stay until you can safely hand over the reigns to the next shift.

Any advice/suggestions for getting out on time?!

For some reason things seem to happen all at once right before change of shift. I keep an organized flow sheet with me so I always know what I'm up against, but for some reason I always get hit with the unexpected things that come up within the hour before I leave. Or last minute discharges!! Now come on, how can I pass off a d/c to the next nurse when I've been with the pt?! I've had a few of these lately & have stayed to process the d/c, call report to rehabs/home health, etc.

I have been staying late & becoming frustrated to the point where I'd love to hand in my badge (won't do it...but have thoughts :) )

HOw much is too much to pass off/leave? There is always something, right? I try to have everything done, but I suppose it is not reality--the pt keeps on being the pt--they don't stop for shift changes!!

I guess I just work my butt off ALL DAY, constantly running, & the thought of handing over any loose ends to the next nurse really bothers me. I don't want to leave the impression that I've done nothing. So my choice is to leave things I'd rather not, or stay late & do what I can to help out (I always choose the latter).

Do I expect too much of myself? How do you all feel at the end of your shifts? I'm trying to do the best I can for my patients & wanting to make the nurses happy coming on too--but I'm so exhausted trying to please everyone & in the meantime I feel terrible!

Thanks for listening,

-Realizing that I'm not a SuperNurse

Your post is the exact thing that I was discussing with my manager yesterday. Her response is always, "This is a 24-hour job." While I am very well aware of that, it doesn't change how I feel. Plus there are certain nightshift nurses who will practically have a fit if an admission is left for them. Two nights ago I was walking out with a co-worker and I just started crying. She told me I was being too hard on myself and that I was trying to be supernurse. The unit clerk yesterday also said the same thing. I know it's probably true, but it's hard to be comfortable with leaving things for the next shift. Really hard. The thing that happens on my shift, almost every shift that I work is that I get an admission at 5:30 pm or 6 pm. If the pt is complex, more time is needed. I know the priority is to get the MD orders processed, but I also feel compelled to get the complete unit admission done, which can seem like an eternity if the pt is chatty or a poor historian, or nonverbal, or if the family is around. Ugh. I get so tired of the running like a madwoman at the end of the shift (not to mention all day long), to the point that I feel like you: I want to hand in my badge. To top it off, our unit has also added like 4 new forms to fill out for new admissions. As if there wasn't enough to do already. The thing that I really need to work on is not letting it be seen that I am hurried. I don't want my pts to think, "What kind of freak do I have for a nurse?"

When I leave work, I am all keyed up, and have a a bit of a short fuse. When I talk to my husband, I get cranky towards him. I know that I need to work to change this. I cannot gripe my husband out when I am overwhelmed with work, and I don't want to do any harm to my pts, or put them in a position of thinking they cannot ask me for anything, b/c I am too busy at the end of my shift. Someone told me that part of it is being a new nurse, and things will get better with time. My goal for next week is to try to 'roll with it' and try to accept that I will probably get a late admission, and things will go nuts.