Need tips re: organization

[IngyRN]

I am returning to bedside after a long time. The feeling is AWFUL. I feel like a new grad again. Could anyone please give me tips on getting organized. It seems it takes me forever to do my head to toe assessments ( which is absolutely mandatory prior to giving meds), we get our own VS ( and it seems like the dinamaps never work for me so I waste my time trying with then only to do manuals), my meds are always late. I feel like such an idiot. My preceptor is very patient an dkind but I still cant seem to get all together. Pleae HELP!!

[BinkieRN, BSN, RN]

Every newbie or returning nurse feels the same disorganization frustration, it means you're right on track. Those who don't feel it aren't doing something right (likely forgetting to do most of what they are supposed to be doing or only doing it half way).

Take heart, you'll get better, day by day. When I was first trying to get organized I kept a small notebook in my pocket and jotted down things I needed to remember to do or to chart and it helped me alot.

I also made myself an organizational sheet which I still use to this day and other nurses I work with are using it also.

[IngyRN]

Thanks binkie! Do you mind sharing that organizational chart with me.

[BelleKat, BSN, RN]

I hear ya,it's hard to go back. I worked on a tele floor after working in ICU for so long and it was very hard for me to get organized.

What worked for me was getting a notebook clipboard to keep my papers in order b/c if they weren't in order I didn't know what was going on oh and GUARD IT WITH YOU LIFE.

As for the assessment,I was used to doing the longer head to toe assessment that we had more time for in the ICU I had to pick up the pace and still do it but depending on what the problem was ie respiratory vs neuro. We had to do q4 assessments and I just hit the high points(breath sounds,whatever) for the next two as long as the pt was stable.

With the paperwork I just had to do it how it worked for me,I highlighted certain things and wrote meds to be ordered,pending labs etc in a place where I could look easily and so on.

After you get organized it's just a matter of picking up the pace and seeing how that particular floor works and it will take some time but you'll get it.

Oh and I felt stupid too.:heartbeat

[IngyRN]

BelleKat,

Thanks for the tips. I keep a clipboard as well. the documentations (actually the double documenting & redundancy is unreal!) I guess I just have to get used to how this hospital works. It is expected that our assessment be complete and documented prior to even giving pt a single pill. I can appreciate all measures for timely documtation and decrease in med errors. But if you are running behind, have done vs, assessed your pt ( but not documented) is it truly unsafe an poor nursing practice to give pt their am meds and document? especially when you have only 1 pyxis for 24 pts on a neuro med surg floor. Your feed back is appreciated.

[BelleKat, BSN, RN]

BelleKat,

Thanks for the tips. I keep a clipboard as well. the documentations (actually the double documenting & redundancy is unreal!) I guess I just have to get used to how this hospital works. It is expected that our assessment be complete and documented prior to even giving pt a single pill. I can appreciate all measures for timely documtation and decrease in med errors. But if you are running behind, have done vs, assessed your pt ( but not documented) is it truly unsafe an poor nursing practice to give pt their am meds and document? especially when you have only 1 pyxis for 24 pts on a neuro med surg floor. Your feed back is appreciated.

I was frustrated as well. I know that it's probably not good nursing practice to not have your assessment charted before you give meds but that's how I ended up doing it otherwise my meds were all late. The computer assessment programs were where we could put the time that we did the assessment and I would chart after meds about everything which was kind of handy b/c I usually had to chart about PRN meds needed for pain,hypertension,dr calls and all about the same time so it worked out. I wasn't exactly comforatble with it though you're right.

[BelleKat, BSN, RN]

Yes the charting redundancy is ridiculous and it's mostly b/c the docs don't want to look in the computer for results(some anyway). Some even brag that they don't even have a computer passowrd and won't get one.

:paw::paw::paw::paw: Boo hiss

[medsurgrnco, BSN, RN]

Suggest you read the new thread "New telemetry nurse" to gain tips on organization.

https://allnurses.com/forums/f8/new-telemetry-nurse-328346.html

[AlmostRNDude]

I made a list of duties I needed to get done every hour. IE..., for 7p-7a

1900-Assess & chart assessment

2000-Give meds, chart meds given

2100-Assess wound, Do dressing change

2200-Draw blood, trach care....... & so on. That way if I didn't have time to get things done at the moment, I could easily look down & see what I needed to catch up on + you can anticipate when you may need to give a med & have all of your supplies ready. I did this as a student & was more organized than many of the floor nurses & I was almost always, except for a handful of times, I was able to give report very efficiently & get out of there quickly.

[greenergrass, BSN, RN]

I also recently returned to the bedside after years in management/education & found the tasks difficult to organize for about a month.

The most important keys I discovered for myself:

1. cut yourself a break! (stressing out makes it worse)
   
2. take a breath & think prior to entering a pt's room - what else might I need over the next hour in here?
   
3. ask before leaving the pt's room - is there anything else I can do for you while I'm here? (saves tons of time from callbell-itis!)
   
4. cut yourself a break! (seeing a theme here?)

I know that the more rushing around I did, the less organized I was - causing a lot more trips & frustration...a self perpetuating cycle.

As soon as I just accepted the fact that I was going to mess up & forget stuff & got a sense of humor about it, I was able to start remembering my organizational skills.

It came back quickly, as I'm sure it will for you!

Welcome back!!!!!!

[IngyRN]

Thank you all for your words of support. It makes me feel so much better that I was not the only one experiencing this. I think it is especially frustrating for me because in my previous role as a case maanger, I was very organzed and proficient. I hate feeling like the new kid again! Thanks again everybody. Of course if anybody else has suggestions, please keep them coming!