Please help with Time management techniques

[cornelia]

I really have to take my hats off to the great nurses in the LTC area, how do you do it all? I am a new RN, this is my first month on the job after 5 days of orientation, I am the charge nurse on nights with 3 sometimes 4 CNAs and 40 residents. The night nurse has to pick up orders, do monthly renewals, do meds and treatment sheets, review all the CNA assignments, then chart..chart..chart.

Last night for example 2 residents fell during the night, after I finished the mounds of paperwork required I barely had time to do my 6am med pass!!! The 8 hours are just not enough to get ready for 7am morning rounds. I find myself constantly behind and can't seem to get all my charting and paperwork done. Any advice on how to be more effective? I loved helping people and that's why I became a nurse but after 3 weeks I'm ready to QUIT... Please help. any time management tips that worked for others would be appreciated

[SKM-NURSIEPOOH, BSN, RN]

Originally posted by kids-r-fun

I spent most of the first years in Nursing working in "nursing homes", I am using the tern genericly as my experience ranged from custodial type care to SNF/rehab, to subacute track/vent (the MDs didn't admit until they needed to go to ICU)...the drill is pretty much the same for all. I haven't been on the floor as 'staff' in a "nursing home" in severl years but still pick up an occasional agency shift for the big bucks and my routine still works for me (actually it's my Mom's routine, she's been doing it for 30 years, she oriented me on my first job and was my first Charge Nurse):

It works best on nights---

Get there a couple of minutes early so at time for report you have your census sheet and pen in hand and are ready.

If the previous shift is running behind give them a minute then nicely tell/ask them "can I go ahead and get report so you can finish up?".

Get report, keep it to the facts, write down only what you do not already know or need to pass on to the next shift.

Count narcs.

Make a fast round, just a head check. As you encounter a NAC give them a brief report on their patients, just what they need to know to safely get started.

Get the med and treatment books and go through them, flag all of your meds/tx/blood sugars. If you have the dividers that have colored pullout tabs use them-designate (for your self) a color code system...ie red is blood sugar, blue is 12mn, green is 6am, yellow is weird times. Slide that colored tab back in when you are done with the task.

Get your NAC's together, give them a more detailed report if needed, go over what you need from them and when...if some one has a tx, vs or you need to do an assessment, tell the NAC to let you know when they are rounding on the pt-you can go in together and help each other get done what you need to (also minimizes the number of times the patient gets disturbed. You can also time your assessment for when you are giving a med.

Once the previous shift has cleared out of the nurses station pull out and stack all of the charts you need to chart in. Unless your facility has another policy- chart only to the problem they are on 'alert' for and then by exception. If some one is getting a PRN med and the admin and results are charted on the MAR you do not have to do multiple entries in the notes, you can do one note (Sleeping w/ NAD, c/o's pain relieved with admin of PRN Vicodin. ) Chart as time allows, you can start early in the shift, if there is a change you can make another entry. When you are done with a chart (VS etc) put it away.

I don't know the law in your state, here in WA we are required to give a med within 1 hour before or after the scheduled time. Don't put off doing the meds, start as early as you legally can, that way if something happens midway through a pass you won't get so far behind.

Good Luck, it really does get easier. I would still be doing it if I hadn't discovered Peds!

-nancy

I concur!!!:)