14 months on job and feel so overwhelmed at times!

[JMoney]

Hi! I've been a staff nurse for about 14 months now. I admit that I have come A LONG way since my first day on the floor - remember having that "deer in the headlights" look frequently.

So, I worked Friday and Saturday and I hit the ground running on Friday. 1 pt needed IV dialuded via PICC line (so each time I had to draw it out of the carpuject into a 10 ml syringe) q 1.5 hours, my other pt was an AKA bedrest pt receiving IV meds q 2 hours, and my last pt a walkie-talkie chest pain pt.

Day 1 I felt super busy but was strumming along. Then day 2 hit. Same first 2 pts, but then in half way through the day, I got discharged pt #3 and replaced that with a high-need chest pain, mentally challenged pt.

Needless to say I was so busy at one pt I just could not even think of what to do next. Luckily, co-workers pitched in to help me. I mean, all 3 pt's needs were equally important.

So, my question is: how am I supposed to get it all done? pass meds, assessments, charting, orders, pass trays, take them to the bathroom, etc., in addition to caring for them? I almost burst into tears yesterday in the afternoon. Sometimes I feel like I neglect them because I have SO much to get done.

I feel I have come so far in my organization skills, but then I get a day like that and I am so frustrated and feel like a failure. Then, I am so busy that I could make a mistake - and that terrifies me! Make a mistake a hurt a patient or get fired. I fear every day of making the "big" mistake and getting fired.

Can anyone please give me some advice? I strive to be the best I can at my job. I love it, yet I don't know how to stay organized and efficient when so much HAS to get done.

Thanks for listening!

[deftonez188]

Take a breath :)

Sometimes, there is a perfect storm of circumstances that challenges your ability. Weather the storm as best you can because this sounds like circumstances in which any normal person in your place would have the same feelings. You're competent, relax

[Double-Helix, BSN, RN]

Your feelings are normal and common. I did my senior partnership on a very busy respiratory med/surg floor where the nurses had to balance five patients with very acute needs. Time management is a learned skill- one that is continually improved for years. It's very common to have days where you feel like there is no way to you can get everything done and feel like your patients have been neglected. Somedays, there isn't anything more you can do. You did the right thing by asking for help when you needed it.

I find that it always helps me to start with a blank sheet or paper, divide it in sections, and write down info about my patients. This include birthday, code status, attending physician, admitting diagnosis, abnormal lab values, and other specifics about the patient. I also include a check list for each patient- shift assessment, IV checks, catheter checks, O2, etc. In another column, I write down the times of their medications for the entire day. This saves me from having to refer to charts of computers frequently- I have all the information in one place. It also helps me prioritize who I need to see first and who I need to check up on.

You'll have days when you are super busy and feel like a bad nurse- but that's not true. As long as your patients stay safe and your orders are complete, it's a good day.

[wooh, BSN, RN]

Years from now, you'll still have days where you're overwhelmed. (Which sounds depressing, but really, I think if you keep in mind, it's not that you're new and still learning, it's that the patient loads are just difficult these days, you'll at least remember that you are competent!)

A couple weeks ago, I had a patient load that was difficult, but would have been fine, by myself. I had a nursing student with me. And I try so hard to let her do as much as possible, that the whole day we were behind. Well there came a point where I was just overwhelmed. Just finally told another nurse, I had to go off the floor for a few minutes and breathe.

That's what I did. Took some deep breaths. Made a plan of attack. Came back, and got back on track.

When things are so bad that you don't have time to take a break, THAT is when you NEED to take one. Take a few minutes to breathe, decompress. Get your brain clear. THEN you'll be able to figure out how to prioritize your current million things to do. It's amazing what just a few minutes to stop and breathe will do for you.

[Lizzie21]

We all feel that way. Some nights when I work I get a heavy load of pt's plus admissions. It is ridiculous. What I do when I get nights like that is I always just take one minute. Yes one minute to breath in the med room. It really clears my head and helps me focus on what the tasks are at hand.

It's important to always ask for help and tell your charge RN that you are feeling overwhelmed. they'll listen. I hope this helps.

[TA123]

All I can say is do your best and leave minor things for next shift. afterall we have 24hrs care. when is that super busy...take a deep breath, pee and just do. as much as you can. Definately ask for help from coworker(s) that you trust. Don't feel like you not a good nurse just because u neglect a pt that want a blanket or cup of water. I rather pay attention to pt c/o chest pain. Trust me as you continue in this nursing field you will develop how to balance/organize yourself. it gets better everyday. Remember nursing is a stressful job.