My performance sucks.

jesskalpn · Dec 4, 2007

As I haven't even started nursing school yet, I don't have any suggestions in regard to time management. I just wanted to say hang in there, I'm sure you'll find your groove.

EmmaG, RN · Dec 4, 2007

Yeah, I can certainly relate. I have experience, but my orientation leaves much to be desired. My preceptors so far have been rather scattered and tend to fly off the handle at the least little thing. I'm more methodical, and I can get my work done when allowed to go at my own pace. As it is, I'm being pulled in a dozen different directions. And God forbid I ask a simple question, like where a certain item is stocked; instead of giving me an answer, they just tell me they'll do it themselves. Very frustrating.

nutella, MSN, RN · Dec 4, 2007

Yeah, I can certainly relate. I have experience, but my orientation leaves much to be desired. My preceptors so far have been rather scattered and tend to fly off the handle at the least little thing. I'm more methodical, and I can get my work done when allowed to go at my own pace. As it is, I'm being pulled in a dozen different directions. And God forbid I ask a simple question, like where a certain item is stocked; instead of giving me an answer, they just tell me they'll do it themselves. Very frustrating.

yeah - that is exactly what happens here. They do stuff for me and now they wonder why I can't do it instead of just giving me 2 patients so I can learn all the things and then move to 3 and 4.

ANnot4me · Dec 4, 2007

This just sounds like floor nursing to me. It'll drive you mad.

DeLana_RN, BSN, RN · Dec 4, 2007

Oh, my, this reminds of the time I spent on a med/tele floor my first year out of school. I had 8 pts on the day shift and believe me, my 9 a.m. meds usually didn't get passed 'till 11:30 -12:00 (except for critical drips, antibiotics, etc. which I prioritized). But how are you supposed to manage all that in addition to admits (including all the paperwork), discharges (paperwork, teaching, phone calls), IV starts, emergencies (it was a cardiac floor after all)?! Needless to say, I didn't stay there too long.

Fortunately, you will have to deal with "only" 4 pts at a time (I certainly understand that this is still a lot). It sounds to me that you got totally inadequate orientation. Yes, they certainly should extend it, but they should do it right (fewer patients, actual teaching by a preceptor).

You worked in ICU before, therefore I'm sure that you know what you're doing; it's just the patient load on the floors that's so difficult. You're no failure, it's the system (poor orientation). Have you talked to your manager about this?

I wish you the best of luck,

DeLana

Shantas · Dec 4, 2007

This is how my days are at my med/surg floor every single day....a chaos....but I have learnt how to organize myself....some days when I feel like a failure I just go to the break room and take time out...I cry:(

I usualy have 5 patients, if I am teaming I have up to 7.

I know many nurses that float from ICU get overwhelmed when they come to our floor. Most of the time our charge nurses try to give them eaiser assignment.

I hope things will get better soon....:)

Shantas · Dec 4, 2007

One more thing:

I hope all the management nurses who are here reading these post will be able understand how truly all the nurses are stressed out, how we all feel and take the messege back to their units and make them better so that their staff will enjoy doing their jobs and be able to keep their sanity :)

wooh, BSN, RN · Dec 4, 2007

M/S nursing is a different ball of wax from the units. It's ALL about prioritization. Not as in "this needs to be done first" but prioritizing what has to be done AT ALL. Get the minimum done, then whatever else you can do that day is gravy. I've had many a day where if my patients got their meds and are alive to hand off to the next shift, well, I did good.

Agnus · Dec 4, 2007

I started my job some weeks ago, it is a med/surg tele floor. Before that I had never worked on reg. floors, ICU & IMC only, well some shifts on regular floors - but really only a few.
I am always in time trouble, have a hard time to pass out all the meds in time, there are times when I need to delay them b/c I just can do only so much.
There were also some struggles with doctors .
Baseline is I feel that after 6 weeks of inconsistent orientation ( several preceptors, inappropriate assignments = too many patients to manage in the beginning or more 'heavy duty cases' then manageable) I am just a mess. I was supposed to go off orientation today but now I will have two more days with somebody to figure out why I just can't get things done in time there.
When I do my first quick round in the morning , there is almost always a situation which requires immediate attention and that it how I get behind in meds right from the start. I just can't ignore compromised oxygenation, blood pressures out of control etc. and just start passing out meds when this is the case . Perhaps I am not the best person when it comes to time management but I try to prioritize best.
I delegate when possible but I was also told that I need to be able to manage 4 patients daytime, 6 - 7 nigh shift. I do admit that I have a problem to pass out meds in time and sometimes I forget one and give it later and I feel like a total failure b/c of this. My assessments are ok, my nursing care is ok, overall communication with doctors is ok but this is the one thing that really sucks.
In addition there is confusion with unlicensed helpers - who is doing what and when and how and I still haven't figured out after 6 weeks.
Often I spend so much time looking for stuff, ordering stuff, running after unlicensed helpers ( also doing their job if there are not enough or they are busy) picking up pieces from the previous shift, trying to figure out which doctor is on service and so on and on.
Perhaps it is b/c I am not used to chaos on regular floors, it is much more organized in units,.
I never feel that I can really give the patients the care I would like to provide.
I could go on and on but will stop now .
Can anybody here relate ? I feel like a total failure.
thanks

You are not a failure. You are a beginner in this environment. It is very different than the units and priorities are a little different here. The level of care is different. How about spending a day with a willing experienced nurse who will show you how she manages her time. Shadow her for a full day and take copious notes.

Generally the pace is very fast. You use a different skill set. Time management is one of the biggest priorities.

Organize your self and develop some personal systems so that you are not doing all that running around and spending a lot of time looking for things.

Plan well ahead so that you did your equipment and supply search well ahead of the time when you will actually need them and then go on to do your other duties. You will find a med serg floor is very task oriented. Sounds bad but for the sake of efficiency this is the way it needs to be.

I have found that a day following someone who is willing to share organizational tips and time management skills with taking notes extreemly helpful.

allnurses Guide · Dec 4, 2007

That's allright, I've been an RN for four years; I'm coming off of a year of psych nursing; before that I was a Med/Surge RN for three years.

And *I'M* having a hard time. The patients on my floor are so unbelievably sick... it's just unreal.

Virgo_RN, BSN, RN · Dec 4, 2007

You just summarized a typical shift for me! Obviously you are not alone! I keep hearing that I'm doing a good job, and things do seem to get a bit easier as time goes by. But I hear it takes at least a year just to start feeling halfway competent, so I still have a way to go. All you can do is the best you know how, and if you feel in over your head, ASK FOR HELP. One bit of advice I got was to find a couple of allies; nurses on your floor whose experience and clinical judgment you respect. Write their phone numbers on your worksheet at the beginning of your shift, and don't hesitate to run things by them if you need to. How I approach it is I'll explain the patient situation and my thinking on what I should do, and ask if that sounds reasonable to them. They will either tell me I'm right on track, or they will suggest an alternate angle to think about. Also, if you have a resource nurse available, use them! Even if it's as simple as checking off orders or starting an IV, use them! That's what they're there for. Don't feel like you have to do it all yourself. Or if there is something you need to do for a patient but you don't feel qualified, you can ask another more experienced nurse to do it and offer to do something for them in exchange. Maybe they have some PO meds that need to be passed, and you can do that while they do something for you.

I started my job some weeks ago, it is a med/surg tele floor. Before that I had never worked on reg. floors, ICU & IMC only, well some shifts on regular floors - but really only a few.
I am always in time trouble, have a hard time to pass out all the meds in time, there are times when I need to delay them b/c I just can do only so much.
There were also some struggles with doctors .
Baseline is I feel that after 6 weeks of inconsistent orientation ( several preceptors, inappropriate assignments = too many patients to manage in the beginning or more 'heavy duty cases' then manageable) I am just a mess. I was supposed to go off orientation today but now I will have two more days with somebody to figure out why I just can't get things done in time there.
When I do my first quick round in the morning , there is almost always a situation which requires immediate attention and that it how I get behind in meds right from the start. I just can't ignore compromised oxygenation, blood pressures out of control etc. and just start passing out meds when this is the case . Perhaps I am not the best person when it comes to time management but I try to prioritize best.
I delegate when possible but I was also told that I need to be able to manage 4 patients daytime, 6 - 7 nigh shift. I do admit that I have a problem to pass out meds in time and sometimes I forget one and give it later and I feel like a total failure b/c of this. My assessments are ok, my nursing care is ok, overall communication with doctors is ok but this is the one thing that really sucks.
In addition there is confusion with unlicensed helpers - who is doing what and when and how and I still haven't figured out after 6 weeks.
Often I spend so much time looking for stuff, ordering stuff, running after unlicensed helpers ( also doing their job if there are not enough or they are busy) picking up pieces from the previous shift, trying to figure out which doctor is on service and so on and on.
Perhaps it is b/c I am not used to chaos on regular floors, it is much more organized in units,.
I never feel that I can really give the patients the care I would like to provide.
I could go on and on but will stop now .
Can anybody here relate ? I feel like a total failure.
thanks