Need help getting organized

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I am a brand new nurse working in a high acuity critical care unit of a large hospital and am due to come off the residency program in 10 days. My preceptor however, thinks I may need a few extra days because I have having trouble getting everything done on time as we often are out late due last minute tasks or charting. I use sticky notes and write down times of of when tasks need to be done, a to do list, etc. but I still have trouble getting everything done and breaks taken. It is just so busy and there is so much to do! We are on 12 our shifts and I didn't even get my first break until 4:00 yesterday! I am not sure what to do, but I know I want to be on my own and I don't want to continue longer in the residency program. Any advice?

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Specializes in Tele, MSN-education grad. 5/10.

I hear you! I'm experiencing the same situation. I did get an extra six shifts to work on "time management". That is bologne, really!! I mean we can't be expected to be fast as the experienced nurses. How is that possible? Even my preceptor and resource nurse told me they didn't feel comfortable in their new role as RN for 9 months and they routinely left late. I've been leaving an hour late almost daily, but I am ensuring everything is done and not leaving things for the next shift.

This is what I have done which has helped me:

*Arrive on the unit 15 min early (can't clock in :no:).

*Get my assignment. Write on each pt paper the important things I don't want to forget. I use the bottom section for new info that happens during my shift. Write down times I call the doc, procedures, etc.

*Get my assessments charted and meds passed before lunch. (I don't usually get a break). I eat around 2 p.m.

*Chart checks 2-3 times a day so I don't miss an order and so I don't have too much at the end of the day.

*After lunch I write down on my sheet the times for the p.m. meds so I can pull them together and give them around the same time.

*Give 3-4 p.m. meds and assess during that time.

Without fail 5-7 p.m. is the craziest part of my day. I will get an admission, someone will need an IV or blood or something!! I will inevitably be late leaving when I have been on time all day...so frustrating.

I have begun writing in a journal after my shift so I know exactly what is happening in case my NM wants to talk about "time management". I believe I manage time quite well despite I leave late. The quality of care I give patients is excellent and I'm not willing to sacrifice care over quickly running out the door. I have heard comments made to me concerning other nurses who do this....believe me the patients can tell who really cares.

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Specializes in Oncology, Med-Surg, Nursery.

I work night shift, so I know it might be a little different for me. Some nights I am done and waiting on the day shift nurse to take report, other mornings I am running around spastic with 100 things left to do and no charting done. It's normal, I think. :)

I by no means have it all figured out. But here are some things I do and more often than not (and depending on my patients) I do have pretty good nights:

As soon as I finish taking report I immediately see what I need to get done and I make lists for each patient. Then I make my initial rounds and do my assessments. After that I start passing my 9PM meds. That takes up the biggest portion of my time, but I try to chart somewhere around 11PM or midnight. After that it is all rounding, occasional medication, and paperwork. I start passing my 7AM meds around 6AM and try to wrap everything up. That is a good night.

If a night comes up where I have to call several doctors or have a patient doing pretty bad, just throw all of that to the wind and I'll get out of there when I get out of there. If it makes you feel any better, there are nurses on my floor who have been there 20+ years that are just as frazzled and pressed for time as I am. I don't really think this part is going to get better. :)

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Specializes in Tele.

Hi Everyone,

I can certainly relate how everyone feels since I felt the same way. I've been on my own for a little over 7 weeks after a 12-week orientation.

What I have found to be helpful is using 1 report sheet per pt and I made up my own checklists - 1 for my shift and 1 for a new addmission. Some of the nurses on my unit have incorporated a mini checklist onto their report sheets but I have mine in my pt notebook (or clipboard) that I carry around.

I'm attaching both in case you might find them helpful. On the report sheet, I tried to set it up so you just need to circle the particular order - med times, diet, etc. In addition, they have been a work in progress as I have update both frequently trying to customized them for my unit.

Let me know if you have any questions about the sheets. :)

Checklists.doc

Generic Report sheet v1.pdf

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