loshie08

Thanks for the encouragement! My new paper brain is helpful. I'm currently in the middle of two weeks of m/w/f but once these are over I think I will be okay again. My four days in a row after this post were pretty good.... It's odd, it's always either crazy or boring. For the first time on my unit I had only 4 patients for an entire shift! I also talked to some night shift nurses I look up to (and dread giving report to) who reassured me that days have a lot more to deal with than night nurses. It's a gradual, slow process, but I think I'm still making progress. And I think going to an area I am passionate about - like critical care and pediatrics/nicu, I think it will help. Medsurg just isn't all that fulfilling for me, and I think that's okay, as long as I can accept that I am getting much needed experience at the moment. :)

Also, significant others very often never leave and constantly ask for cokes/linens/etc. so I'm thinking it's not just parents of babies that never leave.

I haven't worked in a pediatric setting besides for clinicals so I can't really compare, but I have to say some family members are SO annoying! It seems like Pt's act out way more with family around, and then there's your family who don't understand/bring Meds/foods that aren't allowed/get angry over everything/etc. when I meet good family members who take care of their parents especially I make sure to look them in the eye and thank them. :)

Our CNAs (techs, whatever) do vitals 3xa shift, blood sugars 3x, try to get baths, and mainly assist with toilet trips/changes and "fetching" (I need a coke/sprite/etc). There are some that rock, but some are difficult... Use their personal phones, sit around instead of being proactive about keeping pts clean. Days definitely go smoother with my great techs. We are supposed to bedside round, but few nurses do.... Thanks for the reminder, I'm working the next 4 days so armed with my new brain sheet I may try refocusing on bedside report and doing assessments and meds together. Thanks for the encouragement. I don't want to be caught up catering to my problem patients (the least sick are always the loudest!) all day, to the neglect of my sick pts, so hopefully I'll learn the knack of managing my days better soon.

My name is Ansley - I've known I wanted to be a nurse since I was 10, and I've always known that med-surg would never be my "home" in the field of nursing. (I'd like to go back to school and get a master's at some point, I love the ICU and the NICU. I love having fewer, but higher acuity patients.) I graduated May '14, and started working in September. My preceptorship was a full time, 6 week, night shift position in a PCU in Florida. That was fantastic. Being an ICU step-down we took a max of four patients, and being night shift we sometimes had a tech, often we didn't. By the end of my 6 weeks (320 hours, I think?) I was taking all my patients independently of my preceptor, and she basically acted as a tech for the floor and let me have at it. I felt very comfortable with nursing at that point. Fast forward to the present, I'm working days in a 30bed med-surg unit that has an odd, inexplicable reputation for being the busiest, most difficult floor in my "364-bed regional referral trauma II hospital"(according to google.) I take 5 patients, and we have 3-4 techs on the floor. The unit I trained on was a 17 bed unit just down the hall full of veteran nurses - it's a unit specifically for training new grad nurses, and the load was 4 patients, but because of the unit I was going to, I took 5 patients and was comfortable. When I was sent to my "home unit" things fell apart. I went from a unit with a great work flow to a unit that was pure chaos, and I had to go back to taking 3 patients and build up to 5 again. I was embarrassed and I felt stupid. Even now, over two months of taking 5 patients on my own, I'm really struggling. Some days I run around on my feet from the moment I finish taking report until 1230, 2 'o'clock. We have these little personal phones, which is great, until you're trying to pass meds and you get called every 5 minutes. I know I can't be in two places at once, but when a fall-risk patient - which, almost every single patient is - needs to go to the bathroom and all your techs are busy, what do you do? I recently had a day where I discharged two patients and admitted two, one of which was a chest pain patient. It was one of those days where all the other nurses and techs, including the charge nurses, were just as busy, if not busier, than I was. I had a patient with chest pain who had called for pain meds and I was never told until 2 hours later. I talked with my manager about the day and the lack of safe, quality care, but all they can say is "delegate delegate delegate". I'm not providing quality patient care. I look at my patients and ask myself who needs the most help today. Most times it's an elderly patient or someone who can't speak who needs someone to take the time to say, "you are getting out of bed today, let's go for a walk." Often it's the patients who haven't had a BM since their admission 5 days ago and I need to be proactive about getting a BM in. When I do take the time to look a little deeper and spend more time with a patient than just the required assessments/meds, I end up so busy that I'm ready to cry at the end of the day. My report is lousy. It's never organized and it's pretty much all over the place and here and there. I'm trying to incorporate all the hospital policy specifics like VTE, safety precaution stuff, etc, and there's a specific sheet the unit uses, but I'm going to sit down today and try to work up my own organizational sheet for my work days. I had one that worked very well when I did my preceptorship but the nurses on my unit all give report by the worksheet they use, so it didn't really help. Compared to my previous clinicals/preceptorship experience, the nurses where I work give a really funky, disorganized report. 0_o In the morning, I clock in around 6:40, not being allowed to clock in before 6:38. I used to come a little earlier and start getting some info on my patients before report, but not anymore. I start getting report about 6:50, and am typically done with report by 7:30 unless it's just updates and then I'm generally done much earlier. Things get sticky here. They want us to chart bedside so we get all of our charting done as real time as possible, and spend more time in the pts rooms. (while they're still trying to sleep? :/) If its new pts, then I'll roll through w/ my computer, but I prefer just taking my clipboard and jotting notes and charting later. The computers are huge, difficult to roll around all day, and create a pt/nurse barrier. I think my biggest issue is having not figure out how to work my morning. I want to assess everyone before I give meds, but then after charting all my assessments, its already 845, and then I have to give 8,9,10 ocklock meds, things end up late, and when I'm getting called every 10 minutes to take someone to the bathroom and give a patient PRN meds, plus trying to round with the drs who come in the morning, it can be 11 before I finish my morning tasks. Sometimes I pull all my meds and then assess/give meds, instead of doing all my assessments/then giving meds. I can't decide which one works better. It seems like it all depends on what kind of patients I have. If they're cool and not demanding then I can get it all done, but when I'm getting requests for pain medication every 20 minutes, bathroom calls, and sending patients to and from the floor for tests, I get so discombobulated that I get even further behind. I'm finding it very difficult to stay on track mentally. I feel like I'm working in a mental cloud. Especially after 4pm. What is this? I'm only 24. I should have energy. I've been getting sick a lot more this past 6 months, too. Working with a head cold SUCKS. It makes it so much harder to think. I know 5 patients isn't that many compared to what some nurses handle. I know I'm a bit green, and sometimes it takes time, but in the process of time and all, I'd really like some advice - tips on what I should be looking at trying to change, anything. I want to be a good nurse. I want to be able to get my patients out of the hospital sooner. I want to be on top of my day instead of underneath it. I'm okay with not being perfect, but wow things are rough right now. I feel like if I were left alone and no one called me 6 million times a day, I could be sooooo much more efficient, but that's not a realistic expectation. I'm not planning to stay in med-surg, but I'd like to become a proficient, or even adequate med-surg nurse while I am here. I think Florence Nightingale would be ashamed of me? I know I'm ashamed of myself.