Help Me Work Faster

[mharrah]

I just started a new nursing job at a LTC facility. I'm on the transitional care unit. I have 21-25 patients with three trachs and two enteral tubes. I work three 12 hours shifts per week. Last night was my 2nd night on the TCU. Was supposed to be with a mentor, but she was pulled away to help with other things, so I did the 9pm med pass alone. I started at 8pm and ended at nearly midnight. I really need to speed things up. Any suggestions?

[kathy313]

It does get easier, you become more familiar with your residents, meds and their routines. Lots of times it's just nerves, trying to get everything done properly and timely. I've had to stay late and finish things, I've seen other nurses do it too. Sometimes it can't be helped.....especially if it was just your second night on the floor. Deep breath...relax.

[imintrouble, BSN, RN]

Be kind to yourself. Rome wasn't built in a day. Most of us didn't start out at the front of the pack, but eventually we all get there together. Best luck to you. LTC is a hard place to work.

[NurseGloria]

If it is possible to go with a nurse who has done that med pass many times to observe how she does it? You will save steps and save time.

If the experienced nurse sees you as a new grad who will be critical of her methods and write her up for not doing everything the way the new grad's teacher told her to, she probably won't help you much.

There is more than one right way to do most things, even in nursing. Once you know the basics of nursing, such as infection control, you can learn to become more time efficient without comprimising care.

An example of why experenced nurses fear new grads is as follows. I had been hired just prior to Thanksgiving to work in the hospital of a small town. Because I was on probation as a new hire, I worked Thanksgiving, Christmas Eve, Christmas Day, New Years Eve and New years day.

This happened the second week of January. I had a full assignment and was trying to keep up one night when a new grad who had been employed for over 90 days came to me for help. She had a man for a patient who was "out of control" in her words. He had a tranquilizer IM ordered for agitation.

Her patient was definitely agitated and could not be calmed. She asked me to give him the med while she and other staff tried to get him to stay still for the injection. After observing the patient and the staff interaction for several minutes, I could see that he was not going to stay still for the injection. It was my professional opinion that either the patient, the staff, or both were going to be injured if this patient did not receive the ordered medication and did not respond to it.

In twenty years of nursing, I had never given an IM injection without cleaning the site with alcohol in little circles and looking for the "landmarks". This situation was different.

When I was a nursing student, I had once seen a psych nurse give an injection through clothing. The patient did not get an infection. So I waited for this patient to be distracted by the staff and not moving. I hurried up behind this patient who had beed declared to be incompetent years before due to his mental illness, and injected him with the medication through his cotton pajama bottom in the ventral gluteal area.

The patient calmed down, and all seemed well. The patient did not get an infection. Nobody was injured.

But a week later, the DON called me to come in during the daytime. The new grad had written me up for not properly giving the intramuscular injection according to the textbook. My employment was terminated.

Management had gotten their holiday coverage with a safe, experienced nurse on the floor with the new grads. Their regular night supervisor had gotten her holidays off. Good deal for everybody. Right?

New grads, listen to experienced nurses and don't be too quick to judge. If you are lucky, you may be an experienced nurse someday.

[mamamerlee, LPN]

They were CRAZY to fire you for that - - I had to do that in an acute situation, thru pajama bottomes, with 6 people holding the guy down. And everyone was thrilled when he finally calmed down.

Someone should have told her that there are times when things just can't be done 'by the book' - such as when the lives of the STAFF are at risk.

[JenniferSews]

I'll be watching this thread for tips on organization and time management! I only (did I really just type "only!?") have 18 patients but am so lost in the weeds on passing meds and it throws my entire day off. Someone on my second day told me "welcome to the jungle, it gets worse here every day" which I had texted to my husband on my first day a few hours after my preceptor left. Everyone says it will get better once I know the residents and patients?

[dorrybnursing]

As you get to know your residents you will get faster, however try not to compare yourself to how others are working. Work as fast as you feel comfortable working, and don't worry about when your co-workers finish. I stop and help residents and CNAs, talk to the residents, feed them a bite or two during my med pass, if it takes me longer, so be it. When I finish my med pass I feel good about my patient care and that's all that matters.