I just started a new job in a hospital Transitional Care Unit. It's basically a nursing home in a hospital setting We have 23 beds and get post-op, or post infection patients on their way home or to a nursing home, hips, knees, and people who can't go home yet in order to free up more expensive beds in other areas. There are 3-4 nurses at night and 0-1 aides.
This is my first job as a CNA, or in the nursing field in general. I am working nocs 2 nights a week 7P-7A and will pick up 1-2 more nights a week once I get off orientation until nursing school starts in the fall, it will be my first semester in nursing school.
Getting to the point, My first two nights we had 13 patients, 17 on my third night and 18 on the fourth, nice build up to full load for me to orient with and I am learning my duties pretty well, my only problem is speed. Last shift that I worked the aide who is training me took 10 patients and I had 8, when we did 03:00 vitals she was done and charting by 3:30 It was 04:10 before I got done, granted I had two incontinent patients to change, one of which required a whole bed change, but I still felt I was very slow by comparison.
The night before I was alone, my preceptor was a LPN who had her own duties and was just there in case I needed help. I started at 02:30 and finished at 05:10 with 17 patients. I am supposed to chart my vitals by 05:00 at the latest with a 04:45 time stamp because updated graphs with vitals print at 5:30 and there is no way to redo them after that point, you have to print out your latest vital check seperately which makes updating the charts take twice as long and then the Docs get upset because it takes more work for them to read the graphs since a plot point is missing and on a seperate page. That night the nurses charted half my vitals for me and all my I&Os.
Does anyone have any input for speeding up my vital checks? I can do blood pressure and temps in less than a minute (unless it is a Lying, sitting, standing check), my problem is counting respirations, it often takes me 1-3 additional minutes to get an accurate count, I often feel as though others must be writing down random numbers between 14-20. A few times I have found that I can count respirations during the BP check and do a quick temp scan after, but chatty patients make it difficult and often I feel as though patients are holding their breath during the BP check. Wheezers are a cinch, but shallow and irregular breathers may take me 2-3 minutes and I still feel as though I am guessing. I know a certain degree of speed will come with time, but I feel some tricks of the trade would best help with the particular problem I am having.
Thanks for the assistance.
Oh, by the way during my vital cheks I am responsible to collect I&O sheets, including emptying urinals and foleys and checking water pitcher levels, recording temp., pulse, respirations, and BP, some of which are lying, sitting and standing, and daily weights (which involves clearing the bed of all but one sheet and one pillow).