How Do You Manage To Clock Out On Time?

jnette, ASN, EMT-I · Jul 23, 2003

Guess nobody clocks out on time, Renee...... don't see this thread being stampeded with responses.. hee hee !!! :rotfl:

altomga, ADN, BSN, MSN, DNP, RN, APRN · Jul 23, 2003

nursing is a big TIME MANAGEMENT job........it also depends on how many pt's you have to take care of at once.

Me...I work ICU stepdown and have a 1:4 ratio.....my first scheduled med is at 2200..next at 2400....well, policy states that I can give meds 1hr late or 1 hr early..thus I take both with me....

I go straight in and do my assessments as soon as report is done.....then go straight to my charting..

give my meds and do the extra care that may be needed (dressing changes, peg dressings, trach care, skin care, etc.) I cluster my care together...this also allows the pt time to rest inbetween meds and minimum of q4h vitals.

If it's a busy pod (I usually am charge)...I go and help the nurse..give her meds, turn her pt's, help the ANA clean the pt's up, whatever....I can't chart for her, but I can give her time to chart!

Try to figure out how you are (lack of a better word) wasting time....

do you find yourself talking when you could be charting?

is the floor "user friendly" or do you have to walk around to get supplies? This wastes a lot of time!

The fluff and puff has to wait until you have time and finished the priority stuff....

What can wait until later?

Make visitors abide by visiting times (they can take a lot of time away from you by asking for sodas, food, more chairs!! ETC>>>)

If your "master plan" get's interrupted don't fret....and number one...DON'T BE AFRAID TO ASK FOR HELP...it's not a sign of weakness....it is actually a sign of STRENGTH!!!:)

AHarri66, BSN, RN · Jul 23, 2003

I rarely get out on time, but I aim for it every day. As altomga said, it depends on the # of pts I have, and their acuity/needs. I do try to cluster my duties, and I try to chart as I go; ie. meds and assessments together, then charting as soon as I leave the room. It doesn't always work, but it keeps me organized so that I spend my time constructively.

sjoe · Jul 23, 2003

The quick way:

Decide to say "NO" to those frequent additional tasks given you by one and all (most of which entail doing parts of someone else's job). Decide to say "NO" to excessive patient loads. Decide to say "YES" to your breaks and lunch hours and quitting times.

Know your limits, set your limits, enforce them. Nobody else will do it, I'll guarantee. Remember:

ptnurse · Jul 23, 2003

Well put Alltomga. All very good points. The only thing I would add for you Cheerfuldoer is patience. I know you are just getting back into nursing, and I know how it is to be out for awhile. You have to give yourself time to get back into the groove. You will find your shortcuts with a little time. Hang in there. I always chart as I go and I try to be selective in my charting. I leave out of my charting any interaction with a patient that does not have a significant impact on the overall care of the patient. Good luck and hang in there.

TEXASWAG, MSN, RN · Jul 23, 2003

Hey Cheerful, time management is a must. I also have a personal rule for myself that nursing care is 24 hours. There are times that I cannot get everything done during my shift. If some orders role over into the next shift then so be it. But of course these are not stat orders. Take care.

Tweety, BSN, RN · Jul 23, 2003

Delagating tasks to appropriate people is the most important way to manage time. As sjoe said, if it's not your job and you don't have time to do things say no. If a secretary, charge nurse, or CNA can help, ask.

I don't get out on time much when I work the floor either, it's the blasted charting that throws me behind. I spend too much time with patients and not enough on paperwork, so I'm a fine one to ask.

live4today, RN · Jul 23, 2003

:) Gee...thanks nurses! What excellent feedback! I'm learning already, and will implement the few good tips here that I had forgotten about since last working nursing. See how coming together helps others here at this sight! :kiss

Up until now, I have continued to stick to the "time management" plan one of my preceptors uses. The "plan" works if people would leave me alone to do the plan. Thus....the need for additional tips which you kind people are sharing here! :)

I work on a floor that has one hall med/surg telemetry, and the other hall strictly cardiac patients.

I miss the cardiac side of the house which is where I was oriented the most, but as soon as my orientation was over, I've been literally "stuck" on the med/surg side of the house which is a very very very heavy hall to work on. Although we get five patients on days, the PCTs are stretched so thin, they barely can keep up with all the different patients, so many times primary nursing becomes the rule of thumb...at least for me anyway. I have good PCTs...thank the Lord...but they are very overworked and stretched to care for several nurses patients (ten to fifteen at a time) and those patients are NOT a piece of cake for them or the nurses if they are on the med/surg side of the unit.

The way I begin my day is:

Get report

Pull up labs

Pull old med sheets off the bedside charting and write down the meds I have to give taking note of when the patients next pain med is due.

Assess my patients passing meds due at the same time.

Chart.

Now.........that sounds good in print right????

This is how "my plan" gets screwed:

The phone we must carry at all times rings incessantly! Everybody wants this or that, staff wants this or that, doctors want this or that, and gosh darn it........the darn acuities must be in before........ If they aren't, my phone rings again telling me to put in the acuities. Then, it's a phone call to 'update the board'.

Visitors want and at our hospital visitors must get what they want. Patients want and patients must get what they want. If you disappoint a patient or visitor by trying to be a professional and prioritize your care so priorities are met first, you get reported and disciplined.

Our floor is not "user friendly" for the nurses, so I'm having to go up a long hall to the next hall to constantly get pain meds out of the pyxis (only one on the floor and it is now on the cardiac side of the hall which makes it rough for med/surg side of the hall where the patients use the most pain meds). Bright idea right???

Then, there aren't cups, straws, sodas, water, ice chips, linen, etc. the patients want NOW, and the PCTs are already running ragged to meet as many needs as possible, so I find that I am having to do these things to avoid "PR" issues...can't have that. :rolleyes:

Then, IVF runs out constantly on our floor, and the stock is poor most days so must order the fluid I need.

Constant runs to pharmacy for meds that are due but not present.

Then patients going for test must be prepared at the same time patients discharged want to go home NOW or you'll get reported by them, and they come first remember...if not, a "PR" issue arises for the nurse caring for that impatient patient.

Constant calls to the docs for change in meds, especially pain meds, because the patient and family want what they want and by gosh you'd better give it to them.

Also, we are NOT allowed to limit our patients visitors, so nurses have to find a walking path to the patient in the room to do what you got to do. Not allowed to ask them to leave.

There are soooooooooooooo many more things I could mention that interfere with "The Big Time Management Plan" that could work if the support system were better on our unit.

How do I deal with all this and still get out on time, and go to lunch on time.

The other day I worked eight hours straight before I could go to lunch because of the kind of day I had.

That shouldn't be........but it was.

Frustrated isn't the word I am feeling as a nurse. It's much worse!

HELP!!!!!

funnygirl_rn · Jul 23, 2003

Don't have much to add other than what the above posters mentioned. I also don't get out on time as well...sometimes, when I am ready to roll & get out on time...the nurse that is supposed to relieve me is late. Last night this same nurse was 50 minutes late! It is not fair...but, they do nothing about her tardiness.

purplemania, BSN, RN · Jul 23, 2003

The last unit I worked in made team work a part of the culture. If one person was behind, someone helped them catch up. We all walked out together and on-time. If one person was consistently bringing up the rear, peer pressure usually was sufficient to handle that or we would write her up if she was not pulling her weight AND not getting help or delegating. The charge supervised this all during shift so we tried not to get behind. Sometimes things got left for the next shift. Oh well----

babs_rn · Jul 23, 2003

When I worked in the hospital, I always pulled the nurses' notes and carried them with me....no sense writing stuff twice (a reminder and then the note). I charted at the bedside that way, and then it was done...no trying to remember when what happened to write it down later. RARELY ever had to stay late to chart. Also, during shift report (with the kardexes) I made out a little page (in pencil so it could be changed prn) with hourly blocks and I would write what patient needed what during that hour...be it meds, dressing change, vitals, etc. Helps to keep organized that way. I would cross it off when it was done and so I didn't have to worry about what I had or hadn't done. I kept it on my clipboard with the nurses' notes that went with me everywhere.But, now as far as lunch goes, good luck to ya there...that's always when everything happens. More than once I've had to eat lunch with one hand and take report with the other. That's just a fact of life in nursing...especially in the hospital. Personally, I am glad to be out of inpatient care altogether...you couldn't drag me back into it for anything in the world.