How do you do it? Advice/Tips

[EMEddie]

Hello everyone-

I am a new grad, 4th week on my orientation on a Step Down MICU. The ratio is 1:3 and currently I have had the 3 pts since 2 weeks ago. My preceptor has 1 pt and is still there to answer questions, etc.

12 hrs dont seem enough to get everything done. 3 pts might not seem a lot, but being a step down icu some of these pts are very complex. Another thing is we do a lot of transfers and admits t/o the shift.

We need to have the main charting [Assessment/POC] done by 9am, we start @ 6:30am. At 10, we need to chart on any new changes on our patients and do the same @ 2pm and 4pm. With all these charting and medications its hard to find the time to stay on top of things. Meds for the most part are 8am, 12pm, 2pm, 5pm, but some pts required constant prns, drips, etc.

Apart from the above calling the MD/DOs, answering questions for families, preparing pts for procedures etc its just very busy. I know time management should come with time and experience, but it just feels so overwhelming at times.

I would appreciate any advice, tips, words, anything you can to assist me and other new grads how to handle or better this issue.

Thanks in advance.

[iluvivt, BSN, RN]

You are going to be very busy the first few hours so you need to very organized and have a good plan. Looking at your time constraints for assessments and charting,this is how I would do it if I had the 3 pts and this time constraint: I would assess pt 1 them administer any medications due..then the same for pt 2 and 3..so assess then medicate. I would also look at all my drips and IVFs. I would get any drips or IVFs soon to be empty close by and any tubing needed to be changes at hand. Meet any needs of the patient that are know to cause frequent interruptions such as pain and bathroom needs and safety issues. You need to be charting on all 3 of the pts by 0815-0830. That will give you 30-45 mins to chart and allows for a few short interruptions.

Check your policy on time frame windows. Look it up yourself in the hospital policy to be absolutely certain! Ours is 1 hour so we can administer ours an hour before the scheduled time and an hour after.

[solneeshka, BSN, RN]

We nurses spend too much time nursing the charts and not enough time nursing our patients. Sigh...