Out on Time????

Time management, prioritizing and organization...I am constantly watching the clock and planning my tasks accordingly based on priority. I can't say enough about being organized...without it, I would DROWN! I make lists of what needs to be done for each patient and by when...then I cross it off once complete. It gives me a visual of my tasks and it feels good to watch the list disappear (ha, like it ever does!)...you also have to always keep in mind to expect the unexpected!

...and wouldn't it be nice if the unexpected could just WAIT until you were free???

also develop the attitude that nursing is a 24/7 job and just because you start something does not mean you have to finish it. Someone else can do it.

The other thing to remember is that we are members of a healthcare TEAM ... don't be afraid to ask for help or to offer it!!

It's priorities. Showers first thing in the morning? Get real. The showers are available 24/7. It's the am care that drives me mad. Vitals, meds, and wound care are my priorities. I dont' coddle my patients, if they can walk to the phone or the desk for a newspaper, they usually can stand at a sink to shave and brush their teeth.

Do the assessment charting as you do the assessment. We use the tick method for the routine stuff, so as I monitor the iv site, I'll mark the appropriate info in.

Keep the charting specific. Detail what you did. Unless the patient is totally inappropriate, threatening, or verbally abusive, I don't chart that stuff. Nobody reallly needs to know that the patient's mood is "chatty, friendly, polite" unless there is a request to monitor moods or the unit knows that this is a problem patient.

Encourage the family members camped at the bedside to participate in care. They can fetch ice, sit with the patient or if the patient is steady enough go walk with their family member.

And rememer it isn't carved in stone that everything has to be done by dayshift. Evenings and nights can do showers, ambulate, and all sorts of things that days feel pressured to do.

I agree with the above posts..BE ORGANIZED....every morning I write out all the basics...what does this patient need today, are they off to any tests?, what are the times they are due meds....any wound changes...and I go from there. I do my assessments and teaching (use your incentive spirometer, walk today etc) when I give out am meds and try to document right away. Then I go back for dressing changes etc... By the afternoon, charting is done, most meds are given, and big tasks are done...I check the charts periodically...if there is a new order, I will put it on my list...At 3pm when I pick up a new patient I do all my documentation right away....and then usually by 630 just doing the chart checks and saying my goodbyes to the patients. Now this is on a perfect day :chuckle.....things do pop up constantly at the last minute....however, if you have the main stuff completed already and something comes up...help out, get them settled and pass it on to the next nurse!!

Time management and prioritizing is the key as previously said. I rarely get out 30 min past my signout time. I precept and that is one of the keys I zone in on with new grads. Nursing is 24/7 and I chart out of necsssity. We are required to make two notes a shift and only chart what I do, assessements abnormal findings and chart as I go. I check my charts before I leave per shift and tape my report. This may take out of your time, but as always things happen on shift change and at least I can be out on the floor when all heck breaks loose.

Don't procrastinate on anything. Do everything that is required as early in the shift as possible. Right out of report I go see each pt, assess them, then chart it. I make a list of when meds are due and whatever else needs done--Dr. calls, treatments, etc, and just work down the list. By then I'm usually caught up enough to deal with whatever comes along.

I start med passes early, since it's impossible to actually give every single pt's meds at exactly the minute they are ordered, I don't wait until the scheduled time to start. On charting, just the basics. I don't write a long detailed note on each pt, 99% of them don't need it, the flowsheets are more than adequate. Do what you HAVE to as soon as possible, then start in on the rest. Always keep in mind what you have to do and when, and don't let yourself get distracted by the non-necessities.

Also, let other people earn their money! I do not do other people's jobs for them. Not to say I don't help when needed, but I don't routinely take on my job, the CNA's job, the unit secretary's job, and the job of the nurse down the hall at the same time. I focus on what I am required to do, then I usually have plenty of time after I'm caught up to help others. If it's the CNA's job to pass trays, I don't pass trays--I chart or give meds at that time. If the secretary is supposed to set up consults and follow-up appts, I don't spend all day on the phone doing it myself. I know I can not do everything myself, and I don't try.

And don't waste time. No chatting with coworkers, taking extra breaks, etc. until everything is done. By then, you have time for a nice leisurely lunch break to chat with your friends. But not while it's work time. It's really all about prioritizing.