I am having a hard time. I'm in a new grad program where I rotate to different units first before my placement. I rotated in pediatrics and MICU and now am in a neuro/tele step down. I thought this would be easy compared to the specialty units, but I have more patients and I'm falling behind. The PCAs are not taking my patients' vital signs or BS or cleaning them if they have a BM or transferring them from bed to chair or feeding (I feel better doing the transferring and though), etc. I am doing all that but this week I had a discharge and admission and I fell behind in meds. When I have blood sugars and see the food trays arrived and I'm stuck cleaning poop I don't know what to do. The PCAs haven't been helping me I think because they see we're 2 nurses here. But I'm in my 2nd week and doing the full assignment myself now, my preceptor checks my charting.
Anyway, could you all give me tips or advice please about prioritization? for example the other day at work:
1. Had AM BSs and insulin to give. So I pulled everyones meds, and since everyone was a BS, I didn't know if I should have given all the meds to each patient, or just went around for the BSs first then gone back to do the rest of the meds. 3 of my patients had PEG tubes for food/meds so that takes me a little longer crushing them and stuff. So what I did was give the insulin first then went back and did regular meds. Is that what you all would have done?
2. by the time I was done with morning meds, it was 11:30, BS time again. I took that long because I also did my physical assessments, set people up to eat, transferred , mouth care etc.
3. At noon, wound care arrived and wanted my help with setting up a wound vacc, then the pt pooped, so I was in there for a while
4. one of my patients was getting d/c so I was giving report and getting that ready then another patient had a BP med issue I ended up calling the resident 4 times, bc the BP meds he kept giving would lower her HR and she was off tele and pharmacy I checked said she couldn't be
5. meds again, pt cleaning up, transferring, and I finally did my shift assessments, I was also behind in my q4h neuro checks now
6. Admission from ICU, had to change a person's room because this admission was a climber and she was being put in a room I couldn't have her in because too far from nurses station
7. Dinner trays came, I hadnt done BSs yet, more BMs had happened
ok that was about it what can I do different please?
edit - ok I read this over and it sounds like I'm complaining or something. Really I just want help to not fall behind any advice? TIA
You need to learn to delegate. Not just to the PCAs but to your preceptor. That’s what she is there for. I personally do blood sugars with my meds so it’s all done at once. It sounds like you check more frequently than I do, though. I do twice a day. Sounds like you are three, before meals I’m guessing?
You cannot do it all. You just can’t. Delegating appropriately is part of being a nurse. Be firm, don’t waver, and show confidence. Be very specific with what upu need.
LovingLife123
1,592 Posts
You need to learn to delegate. Not just to the PCAs but to your preceptor. That’s what she is there for. I personally do blood sugars with my meds so it’s all done at once. It sounds like you check more frequently than I do, though. I do twice a day. Sounds like you are three, before meals I’m guessing?
You cannot do it all. You just can’t. Delegating appropriately is part of being a nurse. Be firm, don’t waver, and show confidence. Be very specific with what upu need.