If I can only get organized !

moonchild20002000 · Aug 18, 2005

I used a small notebook to make notes of things I had to do.

I would think about what I had to do before my shift and make notes in my notebook.

The more you work the easier it will become. I remember when I was a new graduate it took the better part of a year for me to feel comfortable. You will reach the point where everything just falls into place. Please don't become discouraged,it just takes time.I'll bet that you are doing better than you think.

Welcome to the wonderful world of nursing! I have done this for 33 years and still love it!

Sherri RN · Aug 22, 2005

Congratulations on graduation, starting a career in nursing, and getting to work right away. I went back to med surg to network so I could get the higher paying management jobs. I felt disorganized at first, and what helped me was mapping everything out at the beginning of the shift. It could be as simple as folding a piece of paper a few times so when you unfold it, it has enough boxes for each of your patients. In each box, organize each patient (name, room number, times to go into the room, po meds, IV antibiotics, dressing changes, PCA checks, fingersticks, time to order labs by or the labbie doesn't get the message (check with the lab), likewise for radiology paperwork / orders, check vitals / urine output, etc.) and plan your day. If you or a friendly co worker are computer savvy you could design a form and print out a bunch for your clipboard. Don't print out too many; you'll want to re evaluate your form every few days or weeks for needed revisions. Also, leave an extra box on the form to put things like "check off that I read my email or checked the unit comunication book, check off that I checked all my patients had DVT prophylaxis on their legs pumping air (we call them SCDs), that their teds were on, etc). On my unit, and we called them this in nursing school too, we call it "My Brain." Sounds funny when you lose that piece of paper and you're running around looking for "My Brain" but that's what we call it. Make a point of being on time or 5 minutes early or more, from the start of the shift to the priorities you set, to the charting you do, to the time you are due to go home. Don't dislike yourself for being disorganized. It takes time for any new system "to click." What will happen is you will understand how the unit works as a big picture, and it will make you a better preceptor when it's your time to teach the new nurses. The other nurses would do well to pitch in and help each other take off orders when the ward clerk isn't there and the unit is busy.

wanda06211 · Aug 22, 2005

I graduated in May 05 as well and started working a couple of weeks later. I know exactly how you feel. I work nights on a med/surg unit and I am often still hard at work up to 30 minutes after my shift and still leave every day feeling as though I forgot something or missed something all together. I just feel like I'm missing something some where.

freckled nurse · Aug 23, 2005

I graduated in May 05 as well and started working a couple of weeks later. I know exactly how you feel. I work nights on a med/surg unit and I am often still hard at work up to 30 minutes after my shift and still leave every day feeling as though I forgot something or missed something all together. I just feel like I'm missing something some where.

I REALLY,REALLY understand. I graduated in the middle of July and right now I feel so stupid and inadequate for nursing that there are times I feel like saying, "Screw this!!!" and quit. But then I realize how much I love my patients and its just all the charting that I forget and all the meds that I have to know and all the things that have fled my mind since July that I hate. Last Friday I was leaving work (I work at a hospital in the Med/Onc unit), and as I got on to the elevator, I just started crying. Keep in mind that the last time I cried was probably last year some time and it was the time of the month:-) But I'm going to keep on trucking, no matter what, because I love nursing. You will be fine, I will be fine, all the new nurses out there, WE WILL ALL BE FINE!!! We wouldn't of gotten through nursing school if we weren't capable (at least I hope, for me at least) of doing this. So keep on trucking, you'll make a great nurse!:icon_hug:

Haunted · Aug 23, 2005

I am almost 10 years into this glamour and truly have days like yours! Every now and then I realize I have an IV piggy back sticking out of my scrub pocket that I was supposed to hang and got diverted like some demented nuclear mission only to turn around, run back to the unit and get the stink eye from the evening shift.

Really cuts into Happy Hour but as one wonderful Nurse Manager tells us, sorta like a mantra " we are only one person, we do what we can and are supposed to rely on our brother/sister nurses to carry on after we have long fallen."

But, at the end of the day, as we cruise the rush hour traffic on our journey's end to home and hearth, with our stringy hair, scrub pants cutting into our tender, unfed bellies, we can smile at the setting sun and say " Aw heck, it's nite shifts problem!" It also helps to be strong enough to give the fellow commuter the bird for cutting you off, let's face it, we have a lot of unsung hostility!

By the way, is it me or am I the only nurse on the planet with a 900 cc liter capacity for urine storage when I finally get home? And then, that's the exact point in time when you are sitting in a private spot out of the "chatter zone" that the kids, the dogs, the cats and the next door neighbor seek you out?

And don't you just want to staple gun the nurse mate clogs to the floor of those young, bouncy, fresh faced nurses that have a spring in their step after a 12 hour shift and have the audacity to announce to a withered group of hump backed, grocery coupon collecting, hoping the "secret deoderant" is still working, cartoon footed nurses " I'm OFF TO THE GYM FOR MY WORK OUT WITH MY FITNESS TRAINER!!"

Come on! We love these kids but don't you just want to see a sweat stain SOMEWHERE on them?

RNAnna · Aug 24, 2005

I had to grin at Haunted's post. I'm just off of orientation, but I am an "older new nurse" so I can understand the humor and smile with her. We all go throught the time management crisis. The thing that bothered me soooooo much while in school and on Orientation, was when I asked how to organize things, everyone just said, "well, you have to find your own system in time". What time? Who has time? Until one day, a wise younger than me nurse, and my DON sat down and said "this is what works for me". Then I just started looking at everyone's brain and checking out how they do it. And now, I'm going to pass it along to you.

I have a two sided brain. One side is the report side, and the other is the working side. I take report at the beginning of shift on all of my pts and put all the information in the appropriate places that I've created on my computer. It took a little time for me to just know where all of it was, but now my eye just goes to the right spot when I want to write something or if I want to refer to it. There are places for not only the obvious name, room, dr.,dx, allergies, diet,and such, but some larger blank spots to write in lab values and med changes that occured throughout the day (I work pms).

The second side of the brain is really the most important. It is layed out in a grid pattern. Along the top row is where I put the room and name of the pt. that I am caring for. The left hand collumn is labled with the hous of the shift. one hour for each grid space. This way, I can find any given hour and read across what has to be done with any given pt.

So, I get report. Then I go and check the MAR to see what meds need to be given to what pt and when. I write that down on the grid in the appropriate time slot. PO x 2, IV x 1, things like that. There is an extra unlabled row at the bottom of the grid that I use to write the prns for each pt. Especially the pain meds with how often. "Toradol q 6". All of the other things, enemas, dressing changes, neuro checks, go into the grid as well. things that don't have a time frame, you have some discression as to when to put them down. I had a "enemas til clear" pt recently (yippy) and was able to space out the enemas so that they had time to work and could be spaced out around other things that I needed to do on the floor. You can look at your shift at a glance and see when you have things scheduled. Remember there may be some blank spaces. These spaces you use for charting, dinner, bathroom......

It works for me. I can't say that it will work for anyone else. But if you don't have an idea of how anyone else organizes, then you are lost without a map. Hope this all works out well for you

nursejohio, ASN, RN · Aug 25, 2005

I'm a new nurse too. I started on my floor in the middle of June and have survived my first 2 days off orientation. :roll I started my brains during my last quarter of school and have revised the form several times since joining the real world of being a nurse. It's got 2 parts. The first is a column with a space at the top to stamp the blue plate (saves a little time not having to write the name, age, dr) admitting dx, code status. As I go down the column, it's got a block for neuro, cardiac, resp, GI/GU, skin, IV, dressings, Diet, Activity, labs, new orders, what to pass on in report, accuchecks, and meds. In the meds block I've got 0700-1900, so I can just circle the times for scheduled meds and write in PRNs. The second part has columns I can write in each room #, and the things I have to do. 08,12,16 assessments; 07, 15 tele strips; care plan update, medication reconciliation sheet, admission assessment, I&O, etc.

It seems to be working pretty well. If anyone wants to give it a try I'll be happy to email it to you. PM me if you're interested.

Good luck and keep checking other peoples brains. You'll find something that works well for you

jenrninmi, MSN, RN · Aug 25, 2005

I'm a new nurse too. I started on my floor in the middle of June and have survived my first 2 days off orientation. :roll I started my brains during my last quarter of school and have revised the form several times since joining the real world of being a nurse. It's got 2 parts. The first is a column with a space at the top to stamp the blue plate (saves a little time not having to write the name, age, dr) admitting dx, code status. As I go down the column, it's got a block for neuro, cardiac, resp, GI/GU, skin, IV, dressings, Diet, Activity, labs, new orders, what to pass on in report, accuchecks, and meds. In the meds block I've got 0700-1900, so I can just circle the times for scheduled meds and write in PRNs. The second part has columns I can write in each room #, and the things I have to do. 08,12,16 assessments; 07, 15 tele strips; care plan update, medication reconciliation sheet, admission assessment, I&O, etc.
It seems to be working pretty well. If anyone wants to give it a try I'll be happy to email it to you. [email protected]
Good luck and keep checking other peoples brains. You'll find something that works well for you

Hi there, I tried e-mailing you and it came back with some error. I'll try pm ing you.

USA987, MSN, RN, NP · Aug 25, 2005

And don't you just want to staple gun the nurse mate clogs to the floor of those young, bouncy, fresh faced nurses that have a spring in their step after a 12 hour shift and have the audacity to announce to a withered group of hump backed, grocery coupon collecting, hoping the "secret deoderant" is still working, cartoon footed nurses " I'm OFF TO THE GYM FOR MY WORK OUT WITH MY FITNESS TRAINER!!"

So, so, so, so, so, so TRUE!!!

Another thing to keep in mind is that nursing is SHIFT WORK!!! There are 3 shifts in a day, and therefore it is not your responsibility to get everything done on your shift. Now, I'm no advocating that you be slacker, but you are not superwoman either!!!!

Hang in there! :specs: