I'm still new to the profession and recently ended orientation on a telemetry floor. I'm curious about how long you would stay after in order to finish your paperwork? What things do you make sure that you complete and what things would you let pass to the next shift for them to complete?
I'm mostly asking this because I was assigned 7 patients and several were quite time consuming patients. I didn't have time to go to the bathroom none-the-less get any paperwork done before the next shift was arriving (I work the night shift). I stayed a little over 2 hours past my shift to get the meds lists done and to get my nursing notes done for each of the patients. These I know are things that I must have done. I'm just still unsure of what things are able to be passed along. Many of the other nurses will get done what they can with new admits and leave some for the next shift when the new patient had come to the floor near the end of shift. I had a few issues with a couple nurses about this and I'm not sure if they are just walking over me because I'm new, or if I was doing something wrong. I was getting conflicting information from different charge nurses.
It's not that I make a practice of not completing my work, because this was actually the first time that I hadn't had everything done before end of shift. In fact, I hate the idea of leaving any work unfinished. But shouldn't there be a line somewhere for how long I should stick around to get things done? Thanks.
ITA with pelsmith (?) who said, don't work for free. Don't clock out and then stick around working.
I quit working about 6 months ago, which has given me some clarity on the issue that I didn't have when I was the "chicken with my head cut off" trying to get the impossible workload done.
Here is my new clarity: Take care of yourself. Take your breaks, go to the bathroom. Eyeball your patients, give their meds and sign off immediately, assess fully ASAP (emphasis on possible) and write up immediately. Stay after if patient needs help during a medical crisis. Otherwise, develop a thick skin and an unflinching stare. Tell the oncoming shift what you didn't get done, and don't apologize.
Guess what? If you are doing your best, and you're not a bozo, and you can't get all your work done, it's not b/c there is a problem with YOU. It's b/c there's a problem with the WORKLOAD. Sometimes it seems like nursing is based on what a few brilliant, experienced, perfect people can do-- and then everyone is held to their standard. If you're smart, caring, and doing your best, then what you get done is your full day's work. Not what someone else could do.
And I think you'll get less bitching if you seem less apologetic. It is what it is. And don't work for free, whatever you do. You're not a slave and this is America. Take your lunch, go to the bathroom, and you'll be a better nurse and maybe won't get burned out like so many.
P.S. I plan to go back to work one day (right now it's best for my family as a whole to be a stay-at-home mom) and when I do, I won't be afraid of getting fired. I am constantly getting calls and mail from prospective employers, LOL. They want me bad! And one day, if they treat me right, they'll get me. I'm a good nurse, btw. But if another nurse was able to get more done, I just say God Bless her or him. Way to go. Nothing to do with me.
Hello, new nurse here. I just graduated December 2010 and i started working LTC about 4 days ago. Yesterday was my 4th day of orientation, and since I have no experience, DoN told me I have have to be oriented for two weeks. 1st day of orientation, my preceptor was alright, she didn't talk much but she would answer all my stupid questions. But she didn't tell me anything about charting, admission, what to do in an emergency so I feel like im lacking in that aspect still. 2nd day I was paired up with another preceptor because the other nurse didn't want me.... and she was great, though I did a med error, minor error though, i doubled a multi vitamin tab, but I felt so stupid and careless. I was onthe 3-11 shift and she said I could start doing the night meds, it was already 10:30pm and I was only halfway done with my 30 patients, my preceptor had finished doing treatment and most of the charting. after my shift, I got in my car and started crying, it was so overwhelming for me. I even had so many messed up dreams from the stress of the unit. On my fourth day(yesterday) I got a different preceptor because the previous one was off for the day. SHe let me push cart, we started in the dining area and helped me identify patients since I still dont know them that well. then we hit the hallway. I did most of the patients, she did a few and we were on time. the PM meds, same thing....I was still passing meds at 10:30 but I only had 3-4 patients left compared to the other night when I still had a handful on me.
But then I was thinking, I had to go over my MAR and make sure everything is signed before the next shift comes in and get the MAR. I also have not finished the treatment book which is fine I guess because I can do it later, plus the charting of patients. It gets a little overwhelming for me and I know I'm still starting but I was setting a goal to do it on time. Next Monday I will be oriented to the other unit, still long term care, but my goal is to take out meds faster than how I did. Then I will ask my DoN to be oriented on the subacute floor...I dont know how well that will go but I'm hoping I dont end up staying there 2-3 hours after my shift, or even if I do it's fine as long as its not still passing meds but charting. Oh and also, I was told by the nurses on my unit about certain doctors that are notorious for yelling at nurses when they do orders. Which im not looking forward to >.> hehe scary.
That was my first week of nursing home experience. It was a roller coaster, it's also my first job, I'm 22, I was told that I was spoiled because my parents didnt let me work til i finish college. I am also glad that none of my nurses were the ones that "eat their young" except for this one nurse, she's just freakin sad....she...ugh i can't even...it feels like she's gonna eat you alive if you look at her the wrong way. But anyway, I still be nice to her and ask her if she needed any help from me. Thank you for letting me vent.
That was my first week of nursing home experience. It was a roller coaster, it's also my first job, I'm 22, I was told that I was spoiled because my parents didnt let me work til i finish college. I am also glad that none of my nurses were the ones that "eat their young" except for this one nurse, she's just freakin sad....she...ugh i can't even...it feels like she's gonna eat you alive if you look at her the wrong way. But anyway, I still be nice to her and ask her if she needed any help from me. Thank you for letting me vent.
Putting on my "mom" hat ...
You've been on the job 4 days, and nursing home patient loads per nurse are notoriously huge. Maintain your goal of increasing your speed, but realize that no one is as proficient at anything they've been doing for 4 days as they will be when they've been doing it for 4 months ... or 4 years.
If you have never held paid employment before now you have a short, steep learning curve in professionalism ahead of you. Number one: boundaries. You will not be Gieokhae SuperNurse right out of the starting gate, but this DOES NOT mean that Gieokhae is any less of a person than she was before taking this job. Seriously -- role play with friends and family to learn to adopt a professional, calm demeanor. Work is work. Everyone you encounter -- other nurses, CNAs, physicians, etc. is there for a purpose -- NOT first and foremost to be your friend.
So there's an MD that tends to raise his voice ... that's about him, and his lack of self-control. Not about you. Will you be doing your patients any favors by cowering?
Your professionalism will extend to your patients and their families as well. By its very nature, LTC care is a source of guilt and apprehension for many. The elderly have to cope with some degree of loss of independence. Their families can feel guilt, sadness and or fear about the care their parents/elders are receiving. You will need to learn to present a calm, professional, competent front.
It really depends on what it is that needs to be done. I make sure that my patients are freshly changed (if diapered), well sedated (if ventilated), pain has been addressed, etc. Any stat orders that come in right before shift change are at least initiated, if not completed. We get admissions from the OR at shift change far more often than we should and I make sure a note is written about their arrival and an inital assessment is done. Sometimes there is just too much that needs to be done- and I'm not going to stay hours after my shift unless I'm tending to a family during a death, a code, or something of that nature. I will not stay because I forgot that it was line change day or something of that nature, and I wouldn't expect someone who was busy to stay over for something that I could do myself either. I just make sure what needs to be done is communicated, clock out, and let it go.
It took me several months to figure out how to manage my time and charting best. If I have an especially busy day I might stay over 20-30 minutes to finish charting some of the small things, but the bulk of my charting (phyiscal assessments, education, hygiene) is done at the bedside as I am doing it. With the exception of given sedation/analgesia/paralytics for intubation and other procedures when I absolutely can not be at the computer to chart, I do not give patient's medication without charting it at the bedside as I am giving it, with the eMAR right in front of me, so aside from those exceptions, charting meds has never, is never, and will never be an issue.
Get what you need to get done done, and defer the rest. There will always be something.
Nursing On The Run
30 Posts
ITA with pelsmith (?) who said, don't work for free. Don't clock out and then stick around working.
I quit working about 6 months ago, which has given me some clarity on the issue that I didn't have when I was the "chicken with my head cut off" trying to get the impossible workload done.
Here is my new clarity: Take care of yourself. Take your breaks, go to the bathroom. Eyeball your patients, give their meds and sign off immediately, assess fully ASAP (emphasis on possible) and write up immediately. Stay after if patient needs help during a medical crisis. Otherwise, develop a thick skin and an unflinching stare. Tell the oncoming shift what you didn't get done, and don't apologize.
Guess what? If you are doing your best, and you're not a bozo, and you can't get all your work done, it's not b/c there is a problem with YOU. It's b/c there's a problem with the WORKLOAD. Sometimes it seems like nursing is based on what a few brilliant, experienced, perfect people can do-- and then everyone is held to their standard. If you're smart, caring, and doing your best, then what you get done is your full day's work. Not what someone else could do.
And I think you'll get less bitching if you seem less apologetic. It is what it is. And don't work for free, whatever you do. You're not a slave and this is America. Take your lunch, go to the bathroom, and you'll be a better nurse and maybe won't get burned out like so many.
P.S. I plan to go back to work one day (right now it's best for my family as a whole to be a stay-at-home mom) and when I do, I won't be afraid of getting fired. I am constantly getting calls and mail from prospective employers, LOL. They want me bad! And one day, if they treat me right, they'll get me. I'm a good nurse, btw. But if another nurse was able to get more done, I just say God Bless her or him. Way to go. Nothing to do with me.
Take care.