Congrats on completing & reflecting on your first day alone as a new grad RN! And definitely glad you found time during your shift to eat.
I'm a Staff Development Nurse at a skilled nursing/rehab/sub-acute facility & your reflection is refreshing. It's important to think about ways to improve your nursing practice and your team. Healthcare is changing and patients will be transitioned out of hospitals faster. Acuity will continue to increase. Triage & delegation is truly a skill.
Does your facility use electronic records? Time management also includes knowing where to locate & document patient information. Some programs allow you to sort the eMAR based on time or for example, blood sugar checks.
Do you have a person in the staff development role who you can discuss your reflections & provide you with tips?
For the patients who were on the call lights, required pain meds, etc, I have some suggestions or ideas:
- During change of shift or rounds, ask the patient if they need a PRN but let them know you have to finish rounds. This can have two possible results - patient loves when you're working, symptom is managed & they are content the rest of your shift or they will continue to be on the call light. It's important to gauge EACH patient for effectiveness of this method;
- Get to know the patient and use distraction. If there is an area where patients can go so they aren't spending their days in the room hoping for interaction, that would take a lot of weight off of you and the CNAs. I used to even send my patients down to rehab;
- For the agitated patient having hallucinations, do you have a psych service? Patient recovery can be hindered if they are not comfortable or anxious; and
- Take time while you're documenting to review the patient chart, especially the care plan. If others have identified interventions to address things you've assessed, it should be in the care plan.
The other things come with experience. Do a huddle with the CNAs at the start and end of your shift. Let them know if you'll need patients for treatments, labs, or specimens.
Great job! You will be a great nurse and pass on your knowledge & skills to new nurses.