Help with time management

Nurses New Nurse

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Specializes in Telemetry.

Hi fellow nurses :nurse:. I graduated in August and got my license in September. I started an internship on tele at the end of September. My internship was 4 months and I had a preceptor the entire time.

I am now on my own and have 4-5 patients. I am having serious issues with time management and am looking for help. I work late every shift. I get to work, get report, assess my pt's, look at labs, stock my cart (while waiting for vital signs to be put in) and start passing meds. We are frequently short with CNA's because of sitter cases, so when pt's ask for things that could be delegated, I feel like I can't call the CNA because sometimes it is 1 CNA (2 at most) for 32 patients. After meds, I try to start charting, doing the care plan, etc. and can rarely get through more than one patient at a time because of interruptions or patient status change. I also have to do chart checks, rhythm strips twice per shift and I & O sheets. I'm not really sure what I'm doing wrong, or what I need to do to improve my time management. I am feeling so overwhelmed and discouraged.

Any advice would be appreciated and considered!

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Specializes in Medical Surgical Orthopedic.

I've had to learn not to be shy about delegating. There are never enough CNAs and they are never not busy. I just make sure to help as much as I can and to let them know how appreciated they are.

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Specializes in Cardiac ICU.

Sounds like my dept. Right when I get to work, I have to admit and discharge (at the same time), gown up and down for isolation patients, walk someone to the bathroom and back then cleaning them; MD's, CT, MRI, lab staff calling my phone off the hook, etc.; families asking for an update, etc. (SOUNDS ALL TOO FAMILIAR, RIGHT?)

I try to get my assessment charting first. As soon as I see the patient, I start charting in the room. Then I check to see if I have any new orders. It's easy for me since we have a computer system for charting.

Once I've done this, I pull out meds and lock them in my cart. EKG strips I usually save until I have time. Note: at least glance on the monitor to find out what their rhythm is; you can just print these out later.

Whenever leaving the room, tell your patients approximately when you'll be back, ask them if there's anything else they need before you go, and assure them someone will help them if they need it. I find this to be very helpful in reducing patients' 'call button' use.

I tell my CNA's if they can bring along a pitcher of water once they stop by to take their vitals. So they don't need to make the trip to the room twice.

Do you have a resource RN that can help you?

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Specializes in Telemetry.

I know the CNA's are always busy, but they get upset when I call them. I should probably just be a little more assertive.

Heatwave, that sounds like the epitomy of my unit! I have the charge nurse for help. I work Fri,Sat, Sunday though, which means that our unit director isn't there and the charge nurse has to round on all 30+ pt's. Some charge nurses are more patient and willing to help than others.

How long did it take for things to get better? Hopefully soon!!

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Specializes in Cardiac ICU.

When I was a new grad, my assigned preceptor hated when I had to work with him. I was more of a burden than a help. He actually passed me down to another RN. Sad isn't it? They even told the charge RN that I was very SLOW.

I've only been at my job for about 19 months, but I work 40hrs/week sometimes more. So I actually have more days of working and more days to get the routine down. It took me about 8 months to get the routine down and another 6 months to actually be comfortable. I'm not a fast learner, I can tell you that. There are still some days I work when I feel like I'm back to being a new grad. But most days, I know I can do what is expected of me.

My *preceptor* gives me report now. He's ending his shift and I'm coming in. I caught him do numerous mistakes. Instead of writing him up, I simply tell him the next day what he did wrong. (OK I wrote him up once, but it was one of those mistakes that can go very wrong). He thanked me for catching these. Then I realized, I became an asset, instead of a liability.

CNA's are busy--but so are you. Don't be afraid to ask for help.

It will get better I promise you. Just know your resources if at all you get bombarded by your assignment.

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Specializes in Telemetry.

Thanks for the encouragement!!

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I am in the exact same boat. I am a new grad as well. I feel like there are just not enough hours in a shift to get everything done, and while people say they are there to help me, when I ask for help I get the "Why can't you do it by yourself?" look, and then I feel bad. I am constantly asking my charge nurse for help, and I wonder if this is just what has to be done, or if I will be fired soon because I just can't handle my full patient assignment. But then I see seasoned nurses struggling and drowning as well, and I start to think that maybe the issue isn't even time management at all, but that there really IS just too much to be done. Nursing is crazy, and the responsibility alone is enough to break someone. But throw onto that a broken system that doesn't have enough CNA's and a whole shift of nurses that are maxed out on ratio's, and it's no wonder we are having a hard time.

I have to say, I'm glad to hear that it's not just my floor. I figure, I'll do a couple years of hospital nursing and then get the **** out. It is ridiculous that we are put in this work environment. When even experienced nurses are crying and stressed out - something is very wrong.

Thanks for sharing, and you are not alone! Also, just start telling people what you need done. Eventually, someone will help you.

Thanks!

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I am also a new grad (LPN only) but I work in an assisted living facility with typically 50 residents. We are not allowed to do much more than pass meds, handle emergencies and paperwork. Hospice nurses are hired for foley's wound care etc. I thought this would be a great way to start and was thrilled to be offered this position. But I too always run late...typically by an hour or so and usually its the unforeseen events that throw me off. Falls, strokes etc. throw my routine off no matter what. I am the only nurse on duty and struggle each shift to get done and not leave everything a mess for the next nurse. I have been there for almost 5 months and can't imagine doing a skilled unit yet.

I pray daily that it gets better :p

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