It's just not clicking.......

llg, PhD, RN · Jan 21, 2009

Have you made any friends at work? Is there anyone who can help you evaluate your practice and find those areas that you can speed up? That's usually the best way to learn such things. You need someone knowledgable about your workplace and the work processes you need to complete to assess YOUR ways of doing things to help you identify those areas that can be improved.

For example, you might be totally doing things in "single-task" fashion while your speedier colleagues "multi-task" by combining two or more activities in the same time span. You may spend 10 minutes giving the medication and another 5 minutes assessing the patient, while they spend 10 minutes doing both at the same time. You may be "triple-checking" everything because you feel insecure while they just "single-check" or "double-check" them. etc. etc. etc. They may see ways to prevent problems (which saves them time) that you don't see and therefore don't prevent. Tus, you end up spending time dealing with minor complications throughout your shift that the experienced nurses avoid altogether. They may jot down their documentation as they go while you save it up and then have to sit a while and remember it to reconstruct what happened later -- which takes more time, etc. etc. etc.

Find someone who can help you "pick apart" your practice in this way and see if you can shave some time off your shift that way. That type of teaching/mentoring might help save you some time and ease your stress a bit. That ... plus time and experience ... may be all you need to get over this final bump in the road of your transition from student to competent nurse.

It's a common problem that lots of new grads have. I find it particularly common among the more mature new grads who sometimes need a little more time to process information and to feel comfortable in taking action. But just because it is a common problem, doesn't mean it is not a real problem. Plan some concrete learning activities such as the one I suggested to deal with it. Then it will be taken care of and you can move on.

Good luck.

Wise Woman RN · Jan 21, 2009

Perhaps the nurses who are sitting around could give you a hand.

nursemike, ASN, RN · Jan 21, 2009

Practice. The more times you do it, the more efficient you get. Eight months is nothing. (Well, surviving eight months is a worthy accomplishment, but not nearly enough time to become proficient.) My experience was that after my first year, I was still rushing, but rushing to do things that a year before, I didn't even know I was supposed to do. And now, after 3.5 years, I'm still out late, from time to time, but not everyday.

You're right--it's a lot of stress. Thank goodness we have the maturity and life experience to cope. Can you imagine trying to do this work at 25? I'd be curled up in the corner in the fetal position. Of course, at 25, you do have the advantage of being ready to take on the whole world, and God knows there's a lot to be said for stamina.

Hang in there. It gets better. Then it gets worse. Then it gets better. Then you go crazy, and it doesn't bother you so much.

CaLLaCoDe, BSN, RN · Jan 21, 2009

on the subject of efficiency in the work place, i get frustrated with the fact that some just plainly cheat the system. i will list two that make me wince:

i. giving medications too early in the shift. ex: a med at 0800 when it is due at 0900. sure, your meds and assessment are done, but that med you gave overlapped the med before. and don't come to me when your patient has untoward responses to it!!!

ii. charting falsities especially ahead of time and putting it down. charting something that occurred at say l800, when it actually occurred at 1700. i have been guilty of this: i am not entirely innocent of past sins ok. but your fellow coworkers will wonder why your sitting around at 1830 when you charted that you had done something at 1900????

i really dislike it when i am hustling around finishing up my tasks and see people who i know could be doing something either to help me or rounding on their patients. just a personal gripe ok ;-).

ps. to the op, nursing is just plain tricky, especially time management. be kind to yourself at these early stages in your career.

CoffeeRTC, BSN, RN · Jan 21, 2009

Don't give up!!

LLG gave great advice. See if you can have someone go over your care. Be prepared for somethings you might not want to hear tho.

I was always the last person to get done, staying late, charting etc. Finally I turned to another nurse and asked "what am I doing wrong?" Not much to be honest...I was just doing single tasks at a time, trying to be time/ task focused and was inflexible. Granted this was LTC, but I would do meds first and go by the room. Then treatments. Duh...some people were asleep by the time I went to them, took forever to sit them up, give meds, etc. Now...I try to plan to get to them when the CNAs are doing care they are awake, clean and positioned etc....Man...that saves so much time. I chart when I have time ASAP. So much easier than waiting till I 'm complete with everything.

Trust us all.....it will get easier. Just don't take those short cuts that will lead to errors.

lsm332 · Jan 21, 2009

I'm still a student and not graduating until June, but just wanted to remind you not to be afraid to ask for help. I've managed to get pretty good at managing my time after several jobs as a cna/nurse tech, but I've noticed that there are always some students that tend to just take a long time to get their work done at clinicals. It's great to love spending time with your patients and to stay in the room to talk to them and such, but you need to make sure you're getting your work done first. THEN spend as much time in their rooms as you want :)

Good luck! I'm sure it'll get better over time!

marie-francoise · Jan 21, 2009

I think the level of multi-tasking asked of nurses today is unreal.

Check out this Finnish study on multi-tasking:

http://arstechnica.com/news.ars/post/20070327-study-says-leave-the-multitasking-to-your-computer.html

One person can only do so much, especially when one wants to do something well.

Health care is not adapting itself to the fact that nurses are only human.

madwife2002, BSN, RN · Jan 21, 2009

I often wonder to myself why do I finish my work before everybody else, I began to think that I must be missing things as it was impossible to be as busy as some of my fellow collegues are, unless I miss big chunks of my day. then I started realising I priotise my care, I dont double check things that dont need double checking, I have my written work down to a T. Why because I am experienced and that will happen to you in time, 8 months in is very soon so please dont be hard on yourself.

One of my collegues was still reading over his report sheets, chart checking, doing labs when I had finished my head to toe assessments and my pts had all met me and knew who I was. Critical labs are phoned to the floor everything else can wait until I have eyeballed my pts. It is just a matter of what you consider to be more important and the rest will flow

leslie :-D · Jan 21, 2009

It is just a matter of what you consider to be more important and the rest will flow

i think this one statement sums it up well. :up:

my first year i was so far behind my colleagues, even when i got routines/tasks down pat.

then i realized i took up a good chunk of time, conversing w/my pts...

and decided that was priority for me, and continue to do so.

op, you're sounding very thorough.:)

keep it going.

i'm sure you're doing much better than you give yourself credit for.

leslie

Pepper The Cat, BSN, RN · Jan 22, 2009

You may want to check your charting too. Are you chartin way more than you need? If you are computer charting, are you a touch typist, or a hunt and peck type person? I can touch type - even when we first started computer charting, I could chart faster because I knew the keyboard.

Additionally - are you charting more than you need? I work with someone who charts waaaaayyy too much - her progress notes are rambling and long and really don't say much - and take her 1/2 hour to write. I can comunicate the same info in much less time.

And you will improve with time. Experience brings speed.