1. Keep in mind that nursing is a 24 hour job and you can't and don't have to do everything.
2. At the start of the shift, sit down and write yourself a skeleton schedule; include when you expect to pass pain meds, do dressing changes, pull catheters etc. Highlight things that are your highest priority.
3. Pee if you need to pee, for goodness sake! Your patient can wait three minutes. Two bladder infections taught me this lesson.
4. Have a roll of paper tape, a couple 2x2s, alcohol wipes, stat locks, IV caps and flushes in your pocket at the beginning of the shift. The first 4 hours are usually the busiest and the last thing you need to be doing is running back and forth to do minor things you notice need to be done during your initial assessment.
5. When you have an older confused patient that keeps trying to get out of bed or pull lines etc., take the time to do a bed bath if you can! Then cover he Pt with a couple of warm blankets and turn on some classical music if your hospital has music therapy. This usually puts the patient to sleep and almost always is more effective than Haldol or Ativan. However, if your patient is pulling lines/taking a swing at you or jumping because of withdrawal, go with the meds, lol!
6. Gain the trust of your patients right away, by doing what you say you will do, and little things like wiping their bedside table down with an antiseptic wiper giving them a warm blanket. If they can see you care and want to make them comfortable, they will generally stay off the call lights. Caution: this can backfire at times so be sure to assess your patients psychosocial needs as well as the physical when you first go in the room.
7. Accept the fact that you are only one person, and it's ok to ask for help. You are not super man/woman.
8. Realize that some shifts you will spend the entire time putting out fires, and you won't be able to do any of the things you want to do. On those days/nights, just let it be what it is and remember the shift WILL end!