How is it possible to be in 5 places at the same time?

indigo girl · Oct 10, 2007

I would probably be tempted to come in early, even off the clock if necessary, if

I knew who my assigned patients were, until I got a handle on how other nurses did this. I know nurses in LTC that do this, but perhaps it is not feasible in a hospital

setting.

At least then, I could check the labs, and even get vitals and quick assessments

done before getting report and, dealing with meds that have to be within an exact time frame.

Bless you day nurses, I do not know how you do it...

oldiebutgoodie, RN · Oct 10, 2007

I agree with you. "Time management" is a phrase used by nurse managers to try to justify too great a work load.

Just like "body mechanics". However, finally hospitals are starting to realize that no matter how your body mechanics are, you will still get hurt transferring a 300 lb patient to the chair without help.

Oldiebutgoodie

leslie :-D · Oct 10, 2007

i'd get the labs when i was at the desk.

vs/assessments

fingersticks/coverage (can be done w/breakfast tray)

prilosec, prevacid

i think it's most important to have data ready for when docs do their rounds.

you'll get this down, sue.

anything new is overwhelming.

thinking of you...

leslie

deeDawntee, RN · Oct 10, 2007

Just a suggestion, but I would ask that your labs be printed for you when you come for report. Perhaps you have a HUC who could do this for you or you could implement it as part of your routine, come into work, find out who your patients are, print their labs before report. It should only take a minute or two. Then at least you would have them in front of you while you are getting report. The docs should be able to look up their own labs when they come in as well. They have certainly been trained to use your system, the big babies. All I can say, is at times you will have to depend on the assessment that you are given. If I had a patient who was not doing well, then I would definitely personally assess them. You do the best you can. It is a juggling act, that's for sure.

:mad: :mad: :mad:

SuesquatchRN, BSN, RN · Oct 10, 2007

Thanks, all.

I think a big problem is I'm on orientation and can't do anything without my preceptor, and she can't give a Prilosec in under 10 minutes. Can we say, "Anal"?

*sigh* I can't wait for this to be over so I can go to evenings. I hate days. I just have so much to learn, still.

RNperdiem, RN · Oct 10, 2007

I hear your frustration, and have been there. By the time my 6th patient had assessments done and charted it was after 0900(if all went smoothly). Doctors, breakfast trays, assessments/vital signs, blood sugars, and patients needing help to the bathroom when the 0600 dose of Lasix kicked in, made mornings crazy busy with constant interruption.

My only advise is to eat an energizing breakfast and just slog through the first few hours until things lighten up. I felt a change in my attitude once all assessments had been done and charted and the am meds given. Once that big hurdle had been taken care of, I let other concerns in.

leslymill · Oct 11, 2007

I agree have someone print up your lab slips. Do the fingersticks and the Prilosec with the initial assessments and V/S. Just do a thorough head to toe glance ask questions . Come back at med pass to do a more thorough bilateral pulse,bowel, lung and skin assessment. Half the time management is gone with the walking around being task oriented.

starcandy · Oct 11, 2007

I have never been able to get a handle on "Nursing Time Management" I have searched books that specifically address this subject and have not found one yet , or I have very generic information . To be brutally honest after 3 yrs of being a Rn, I am still overwhelmed at times. If I can begin a shift where everyone is fine and I can finish assessments , vitals signs and charting in a timely matter it would be great. Most days this does not happen.

Preemienurse23 · Oct 11, 2007

I'm in the NICU, and I check my labs before report, and they are usually given to me. I know ICU is a little different than med-surg, (ok a lot) but I would think that your night shift nurses could/would be kind enough to either print or tell you what the labs were during report.

Ms Kylee · Oct 11, 2007

Welcome to my world.... especially when sugars need done by 8:15 and you're getting screamed and at butt ridden starting at 7:15 to get people on carts for test.. never mind I haven't even gotten to the computer to check things... will be so glad when I can go to steady 3-11 after I graduate....

Piki · Oct 11, 2007

We get out of report at 0730. Diabetics patients need finger sticks and coverage. People on Prevacid and Prilosec et al get those. Four patients. VS and initial assessments are supposed to be done by 0800, when the docs show up. Labs are to be checked before 0800 meds.
If I hear another person utter the tired phrase "time management" i'm going to scream.
How is this done?

I feel the same way!! I'm in orientation myself too. I already clock in at 6:30 for my 7-3:30 shift (boss is OK with this) and have to go print up my shift reports/MARS b/c they don't print out an extra copy for those of us on orientation. That in itself eats up a bunch of time, just organizing my paperwork. I have tried a few times to look up labs while I'm there, and getting the VS written (our CNAs do the vitals for the RNs, they start their shift at 6:30 am) -- but it seems the morning crew of nurses want to start listening to report, oh, around 6:45/6:50 - they are an antsy crew, so I always feel like I'm rushing. Evenings seem so much calmer, and I like that excepting maybe the 4 p.m. IVPB antibiotic or the 4:30 blood sugar, most of the meds are passed around 9 p.m. Gives you more time to do your assessments, IMO.

But yeah I had a day not to long ago where 4 out of our 5 daylight patients needed blood sugars and insulin by 7:30 and we typically finish report around 7:30 a.m. I feel like you start the day off before the 8 ball. But I have noticed other nurses sometimes just lump all the morning meds in at the same time (the 7:30/8 and 9 a.m.)

But the bottom line is, you can't be in 5 places at once. You can just do the best you can.

I know if I were to request the UC to print out my labs they'd look at me like I'm crazy -- they already have such a busy job, asking them to print out my labs (esp as a newbie!) will go over like a lead balloon.