New to critcal care

commonsense · Oct 22, 2013

Hello all!
First let me start by saying thank you to those whose reply. It is greatly appreciated.
I am in my final year of the BScN program and will be writing my exam in June 2014. I'm currently placed on a CCU, a placement which I requested. I've done very well in my academics and think I have a good grasp of many of the concepts at play in such critical patients. However, my issue is I suppose time management and organization. I'm having trouble finding the time to stop and think about all the underlying issues affecting my patient and how their multiple comorbidities are interacting. It seems there is always a task to be done and it needs to be completed STAT. Does anyone have any suggestions to help me manage my time better? Any ideas that were helpful for you when you were as "green" as I?
Thanks again
Borchefski

When you are "green" as you put it, worry about completing your tasks and taking care of your patients. After you gain more experience you will have the time to stop and think about the whole picture. If you are that concerned with the issue (which is a typical issue among newer nurses), take time to think about everything after you get off work. Better to get the stat tasks done and not have time to connect the whole picture than have the doctor or oncoming nurse show up and tell them, "Sorry, I didn't get the stat antibiotics done or fluids hooked up on your septic patient, but I think I made some progress in connecting the whole picture."

Bringonthenight · Oct 22, 2013

The big picture will come only with time and experience.

chuckz, BSN, RN · Oct 26, 2013

I echo. It takes time. That was the hardest part of nursing for me. The time mgt and prioritizing. It takes a while and will come with time. Just learn more everyday. You will be fine. We all felt like you.

rnangel2011 · Dec 24, 2013

I agree. Finding my routine was something that didn't really click for me for about the first 6 months, with trying to learn a new system, documenting, passing meds, answering call lights, tolieting, ect... What helped me was I was able to take a little bit from the two preceptors I had and incorporated that into my daily routine, but the big picture comes just like it did when you were in nursing school, one day you just say "ooooh, I get it" :) and then off to learn a new task, that's the great part about what we do, it's always new, each patient may have same diagnosis, but each situation is completely different. :)

mh0712, MSN, RN · Dec 24, 2013

When I started in ICU I had a difficult time managing tasks. However, I would organize my day and try to be goal oriented. Get your patients assessed ASAP. Know when they were turned last, urine output, temp, and any immediate needs. Then chart in computer, pull meds by 8 or 815 and then give meds pending no new orders are being written. Then chart once you are finished and then turn. Get your turns and i&o on the same routine. It's hard when you get a new admit, there's a code, or a rapid response. Eventually you will get to where you say "I can survive anything for 12 hours". It takes time and took me a good 6-7 months before I felt halfway competent. Pick the brain of older nurses, good docs, your educator or look up any info. It all helps keep everything straight. Hope this helps.

Ruby Vee, BSN · Dec 24, 2013

I found that I had too much to do during the day to stop and think about things, so I'd carry a little notebook and write down any questions/concerns I had. At the end of the day, when the patients were all tucked in, I'd look things up. These days, of course, you can go home and google them -- you don't have to stay hunched over the reference books in the back of the unit. Don't expect to be able to do it all during your shift. You're going to have to study a bit in your off time as well.