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How do you get out on time?

Posted

Specializes in Medical Surgical. Has 15 years experience.

How do you get out on time???? I hate working over shift, yet am forced to do it every time. I come in early, get right down to business, work hard, don't take breaks and yet can never get done. Every one else is in the same boat and have to stay over too. Our staffing is not bad, about 5 pts. per nurse on a med-surg floor and we have techs, RT, phlebotomy, ward clerks. It is so discouraging. Last night it was theoretically "quitting time" and there were two units to hang, charting to do, meds that needed giving that were late including 2 IVPs, a dressing that didn't get changed. Yes, I can pass some of it on but that is really unfair to oncoming shift who are trying to get oriented to their patients. I can't figure out a way to get everything done. I really felt sick and actually thought I was getting the flu it was so demoralizing. :(

What are your scheduled hours?! Just curious. I work M/S as well and I'm usually there 1/2 hour to 45 minutes after shift on a busy day. Our unit is pretty accepting of nurses handing things over because we all know it's a zoo. lol You have to be willing to hand some things over or you'll never get out of there. It sounds like you are a hard worker so help a bit so that you don't leave the next nurse really behind but also know when enough is enough and it's okay to go home.

juraviel

Specializes in SICU, NICU, CCU, CIC, ICU, MICU. Has 10 years experience.

There is more then one shift for a reason. Giving late meds is one thing, but starting the blood should be passed to the next shift. In my experience those who are always late are that way for a reason. Ofcourse everyone gets slammed once in awhile, but more likely then not if your late everyshift you have a time management issue. I'm sure I won't be popular for saying that, but if you honestly evaluate yourself I bet you see I'm correct.

pink85

Specializes in School Nursing, Pedi., Critical Care.

That is the first thing I think of also. Time management. What do you feel is taking a better portion of your day? What generaly causes you to run behind? The nurses that don't run behind, do you know what they are doing differently? Are there things that you can cluster together so you don't have to keep going back to the patients room. Say for instance give all of your 0800,0900, & 1000 meds at once? Just some suggestions.

eriksoln, BSN, RN

Specializes in M/S, Travel Nursing, Pulmonary. Has 15 years experience.

"How do you get out on time"?

I dont.

I worked as a staff nurse for two years and was just getting to the point that I left right on time, oh........once or twice a week (worked 4 days.........two 12 hour shifts and two 8 hour shifts).

Dont do what I did and take it as a "bad mark" against your work. I took it personal and was hard on myself for having to stay late almost every day. I even talked to my friend/former preceptor about it. She pointed this bit of wisdom out to me:

"When nurses are new, they tend to get out on time for the wrong reasons. They think they have done everything, but in truth have not. As our experience begins to show in our work, we find things that are wrong with the pt. care and handle it. These are often things we never gave a second glance as a new nurse, not because we were lazy, but we just didnt realize its weight at that time. As we become better nurses, we often are slowed down by things we wouldnt have noticed in the past but do now, and we spend a lot of time fixing them. Its natural for a nurse with a few years experience (between 2-5 years experience) to take longer with the same set of patients than it used to take them when it was all new to them".

Makes sense to me. Now, I never get out on time cause I'm a travel nurse and I only spend 13 weeks at the facility. I dont get into the routine I used to have as a staff nurse. By the time I know the unit well, the assignment is over.

they always say one patient at a time

Fairemaid

Specializes in med-surg 18 months, respiratory 3.5 year. Has 5 years experience.

When I was a new grad I worked on a med-surg floor and always left late. Part of the problem was my own time management skills, which have improved. The other problem was that the unit I was on was newly renovated and was 2 nurses stations and one very long hallway in between. Each nurse would routinely be assigned to patients from both ends of the unit. I remember taking orders on the phone on one end, and having the CNA running down the hall to tell me I had another MD on the phone on the other end who wanted to give orders.:banghead:

My solution was to transfer to another unit, which also has 2 nurses stations, but they would never dream of assigning one nurse to both sides. I am really happy that I transferred to my new unit, and I mostly always leave on time:yeah:

Don't give up, the grass might not be any greener, but the lawn could be smaller...

Rebecca

mzloco

Specializes in ED. Has 17 years experience.

Say for instance give all of your 0800,0900, & 1000 meds at once
. This is a time saving technique. Just make sure that none of the meds are incompatible.

I have been a nurse for 17 years and pride myself on excellent time management. Since I now am an ER Nurse I am always out on time unless a trauma or code is in progress. When I worked on the floor I gave myself a certian stop point so that I can close my charts and tie up loose ends. if there were orders on charts that couldn't wait I took care of them when I was done.

Day shift was 530pm ( for a 7pm end time) @ 530 I would be done with 4's and 6's meds. Dinner insuling given and time for me to close charts and tie up loose ends. Learn how to delegate. I always tried to help out my techs as much as I can so when I asked them to chart my vitals and I&os I never got any grief. Utilize the floor volunteers as much as possible.

You should not feel bad or get grief as to passing stuff on to the next shift. if a Nurse gives you grief politily tell her that you did what time allowed so your sorry but SH*& happens.

Good Luck...it does get better.

Riseupandnurse

Specializes in Medical Surgical. Has 15 years experience.

I am certainly willing to improve my time management skills; I don't take the attitude that I don't have a lot to learn, even though I have been on the same unit for 15 years. I work evenings, BTW. But EVERYONE, on all shifts, is there one to two hours over shift every single time we work. A lot of is the management directives and new protocols and equpment that require double-checking, witnessing, return to evaluate at designated times, hourly rounding, etc. We can't combine meds because it's electronically recorded when we give them and there's a narrow window. I feel as though I am spending a lot of time spinning my wheels, doing a lot of formalities that don't contribute to patient safety or effective care but are monitored closely. I feel like I'm running an obstacle course when I work, and the goal is to actually accomplish some patient care DESPITE all the rules and time-directed activities. I have the suspicion it's like that a lot of places because a good chunk of this seems to come from Joint Commission directives. Nursing just isn't fun anymore, and it is aggravating and dispiriting. Does anyone know what I mean?

I am certainly willing to improve my time management skills; I don't take the attitude that I don't have a lot to learn, even though I have been on the same unit for 15 years. I work evenings, BTW. But EVERYONE, on all shifts, is there one to two hours over shift every single time we work. A lot of is the management directives and new protocols and equpment that require double-checking, witnessing, return to evaluate at designated times, hourly rounding, etc. We can't combine meds because it's electronically recorded when we give them and there's a narrow window. I feel as though I am spending a lot of time spinning my wheels, doing a lot of formalities that don't contribute to patient safety or effective care but are monitored closely. I feel like I'm running an obstacle course when I work, and the goal is to actually accomplish some patient care DESPITE all the rules and time-directed activities. I have the suspicion it's like that a lot of places because a good chunk of this seems to come from Joint Commission directives. Nursing just isn't fun anymore, and it is aggravating and dispiriting. Does anyone know what I mean?

From the sound of it you should look for a unit that is a better fit for you.

pink85

Specializes in School Nursing, Pedi., Critical Care.

How about a unit tht is just better organized...

RN1982

Specializes in ICU/Critical Care.

When I go in to see my patients and do their assessments, I try to get the smaller things out of the way like changing the I.V. bags that are almost empty, changing I.V. lines that expired, making sure the patient is not soiled. If my patient has tubefeeds and being that I work nights and we change the tubefeed bags at night, I bring in 3-4 cans of the tubefeeds and a new bag that way its in the room when I need to change it. I spend a good half hour in my patients room. It doesn't take long to do a thorough assessment and to chart.

When I worked stepdown and had four patients, we had facesheets for each patient each shift. On the front, I would write down what times I needed to give meds, you could do this on a sticky note or make yourself a brain sheet. Brain sheets are wonderful thing. You have to remember that somethings don't get done on your shift. So if your shift ends at 7pm and the doc orders a unit or two of PRBCs to be transfused at 6:45pm, but you have meds to pass and a dressing to change then it can wait until next shift. You could help your co-workers out by priming the blood-tubing and having it ready in the room.

Be willing to pass things on to the next shift.

Accept help when it's offered.

Do in advance whatever you can.

Cluster care.

Anticipate pt needs.

Offer help.

Exchange favors, like shift swaps.

eriksoln, BSN, RN

Specializes in M/S, Travel Nursing, Pulmonary. Has 15 years experience.

OMG, Yoda as an avatar. I'm a huge Star Wars fan.

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