Not enough time for quality care

[NanaT2017]

I usually get to work an hour early so I can write down the important points about my patients. Then it's a dead run most of the day with usually no lunch and sometimes no bathroom break. I want to give quality care to my patients and although there is suppose to be a tech assigned to your patient, you now must go behind them to make sure your patient is bathed; toileted; given food they want and drinks on top of passing meds; giving blood; starting IVs because they now feel the need to take them out themselves; and make sure tubing and IVs are not out of date. On average I have 6-7 patients which doesn't seem like A lot but on a med/surg telemetry floor it's a lot. Doctors calling, diagnostics calling, surgery calling; family members calling and don't forget the lab calling about a critical level. Some days I wanna throw in the badge, but I won't let this defeat me.

[Rose_Queen, BSN, MSN, RN]

Just out of curiosity, how long have you been a nurse? Time management skills will come with more experience. It may just take time.

[RNperdiem, RN]

This sounds like my first job. I barely survived without lunch that year. This is not good for long term nursing survival.

Unfortunately you do not have control over the quality of CNAs hired, and in med-surg they can make or break your day.

When I worked with the best aides, my patients were clean, turned and well fed. On other days I worked with the absentee club where the CNA has mastered the art of long trips to the cafeteria, snack break and smoke breaks.

I ended up switching out of med-surg because I wanted to give my people better care. I haven't missed a meal break in years.

[BonnieSc]

I agree with a previous comment: this sounds like me in my first job. It will come. Concentrate on one task a week and find ways to do it faster or easier (I always joke that I am the laziest nurse on the floor: I don't skimp on care but I WILL find the easiest way to do it). If there is an older/more experienced nurse you admire who seems to have time management down, ask him/her for advice. Just make sure you don't take advice or follow the example of someone who APPEARS to have good time management but is actually just being a shoddy nurse.

Also, after I'd been on the job a couple of years but noticed I was still more likely to miss breaks or leave later than my similarly-experienced co-workers, I started sort of watching them and watching myself to see what the difference was, because I really didn't think I was a slow nurse. The truth was that I was spending too much of my time helping other nurses. I never said no when someone needed an extra hand and I seldom said that I was too busy to take on another patient. In fact, people were usually coming to me first when they needed help because they knew I wouldn't say no (a CNA told me this once, smiling). I scaled back just a bit (I didn't actually mind very much; the management was paying me and didn't complain about me leaving late) but mostly just mentally gave myself a break. I had been a bit worried that I wasn't a good nurse because I always stayed late to finish up. But in my next job I set more boundaries for myself. Working without breaks and with daily overtime isn't sustainable in the long term.

And I would encourage you to STOP coming in an hour early. You are giving your time away to the hospital. It's a transition, but try to get comfortable showing up only five minutes early and trusting the other nurses to give you report on what you need to know immediately. You need to take back those hours for yourself.