HELP...2 wks left of orientation and I'm still SO slow!!!

[Kim, HHRN]

I need to vent. I'm on a med surg floor and take care of 5 patients. I still can't get all of my work done that I need to do. I have tried to identify the problem (or make excuses, whatever you want to call it).

I know I have improved but maybe not to the point of most people within the same timeframe. In my past jobs, I have taken more time than most but I am also more thorough in what I do, too. I just hope I don't get let go because of my slowness and I just hope that my nurse manager is patient with me.

I'm curious to know how others have survived training on a med surg floor. Any suggestions to help me speed up or work more effectively/smart?

[classicdame, MSN, EdD]

checklists-----make a grid that tells you what is due every hour for every room. This way you can see the overlaps and ask for help when needed. Remember to assess the ROOM and the patient to see if you can accomplish more than one task while in the room so you are not running back in before next round. Remember you are not perfect - that helps.

[spongebob6286, BSN, RN]

at first expect that you will work slower than expected but eventually the more work u do the faster you can do it because you tend to practice the routine and know it by heart.

[delvenia]

OMG!! i thought it was only me!!! These are my last 5 days on orientation. I too am up to 5 patients and what makes matters worse is my preceptor acts like I am way too slow and I feel like I am a burden. i have the same concern. i have had 5 patients for 1 day but i am going to request that i go to 6 on the day that was supposed to be my third day on 5. i am so scared that i wont be prepared and i feel like there is still so much i dont know. it is so frustrating. my hospital is a Magnet with everything electronic, so we already print out a nursing dashboard that gives us a generic schedule for each pateint. i try to pass all of my 8 and 9's together, 10 and 11's and so forth, but it is still hard.

i thought i was doing okay until the day i went to 5 patient's. it blew my confidence. I had 5 very acute patients. 3 of which had GI bleeds and one that had started bleeding again. i kept having to pull labs and all of my patients but 1 had meds every hour. It was horrible. couldnt sit down. my job is really good about making sure you take you breaks, but the breaks went too fast!! i feel like a failure!!

[Ace587RN, RN]

same here. i have 3 weeks left on orientation then i have 2 weeks on my own before i go nights. i feel very slow and i was told already by the nursing director to speed things up or else... i dont know if ill survive at the end of orientation.

[husker_rn, RN]

Make yourself a to-do list and follow it; make sure you prioritize things on the list. And THE most important piece of advice I can give you is to learn to do it right, then learn to do it fast.

[cncplus3]

checklists-----make a grid that tells you what is due every hour for every room. this way you can see the overlaps and ask for help when needed. remember to assess the room and the patient to see if you can accomplish more than one task while in the room so you are not running back in before next round. remember you are not perfect - that helps.

i made a graph that really helped me organize my time i am not sure if i can attach it but will try, maybe it will help.

[color=white]name

[color=white]patient name

[color=white]patient name

[color=white]patient name

[cncplus3]

well it didn't post the way I wanted,

basicly I made 4 columns ( our ratio is 4:1)

each column has pt name and then under it wrote the hour 7-1900

if they have a med at a certain hour I circle it, if they have a test or going to surgery I write that, i also use it for when I call the dr or change a dressing etc... I write next to the time what I did. This way if 1. I don't get to chart right away I have the info, 2, if the drs call and ask me a question I have it what I did at what time, like labs, ct scans etc.

organization is the key

[joannedianeubalubao]

i love nursing

[spongebob6286, BSN, RN]

maybe u can request for an extension of your orientation

[Kim, HHRN]

maybe u can request for an extension of your orientation

Thanks for the suggestion, I actually almost got one, but in my last week, I really picked up the pace....don't ask me how cuz I don't even know. I have been off of orientation for one week now, with 5 patients, and acutally able to keep pace. I am very happy with that! I still feel like I am running a marathon but I feel in another month, I will be doing better than I am now.

The funny thing is, as soon as I went OFF of orientation, everything went MUCH smoother! It was getting to be a HUGE pain when I was on orientation because the techs would come and give my preceptor the finger stick data but would not report them to me, which in turn, I would have to waste time hunting them down, etc......not fun. It also seems like it's easier to do things "my own way" instead of having to answer to someone else with my every move. My preceptor was WONDERFUL , I think it was just time for me to spread my wings and go it alone and I am SO glad I did.

[LifeGoesOn]

I oriented on a unit, felt insecure, changed units and oriented again. Getting off orientation was the best thing ever.

I feel so much more confident pacing myself, prioritizing tasks as it makes sense to me, gathering my own data and following my own train of thought to conclusion. I've since been told that I'm a really strong clinician.

Sometimes, preceptors wander off and just pop in whenever to see how you're doing and then disagree with this or that. I think preceptors should either be required to stick with you every minute or sit in one location so the orientee can find them whenever help is needed. Also, if the orientee is falling behind, this is the time to roll up their sleeves and help, not judge, or criticize, or give long-winded well-meaning advice. Leave that for after shift. HELP NOW.