schilm15

Thank you! This makes a lot of sense!! I'll pray this helps. I think I'll try a handful of things such as calling my normal charge nurse and asking her to review my charting to see if I'm charting too much and if I am asking her to refer me to a co-workers charting so I can compare and become more time efficient. I think majority of my time is patient care whether I want it to be or not. Sometimes I know I make myself behind by helping out the aid who is behind but I'm a lot of cases I can help her catch up but she can't help me so I got to be aware of this and keep an eye on it.

During my OB/PEDS clinical, I was in the nursery when a baby was wheeled in by another nurse. As she came in She said to the other nurse, "I have a FLK,". That sounded serious and the nurse I was shadowing seemed as if it was. I quickly rushed over with her to watch them assess the newborn. As I looked at the infant, I noticed it's head seemed larger than the other babies. I asked another standing by nurse what FLK was. She told me it means Funny Looking Kid. Its not meant to be mean but it's when certain features of an infant look different and even though the nurse might not know initially what is different/wrong the features thus prompts the nurse to continue assessment until the reason for an odd characteristic is found. Its sort of like a gut feeling based upon appearence and experience of common features among certain babies with genetic abnormalities. The nurses started doing measurements and were debating on calling a physician in to get a service opinion when the child's father came in. They both looked relieved and signed. There stood a FLP which had a huge head. Like father, like son.

I had a patient who was known to have sundowners and become combative at night. Towards the end of my shift, I went into this patients room to give them their 8 pm meds which included lasix (yes this was varified with MD) and seroquel. The patient took their pills in applesauce r/r swallowing difficulties so I put the two small white pills in the applesauce and gave it to the patient. Then I seen him spit something out. "Was that your pill?!" I frantically asked. "Something was in my mouth," the now-even-more-confused-appearing patient replied. I looked all over the floor searching for the pill to see if I could identify which the patient had spit out. I finally seen the melted unidentifiable pill on the ground. Dang! I showed the pill to the admissions nurse who witnesses the whole thing. Then she said, "Welp, looks like night shift will either have an awful night or a really really good one." I gave report to the oncoming night shift and also gave them my deepest sympathies in case it was the seroquel. As I go to leave I hear the cna yell out for help as she was in the patients room. I ran in to find her in between my patient and his roommate. My patient was yelling that he was going to beat up that man for being in his house. All avenues were tried when I finally told someone to get the charge nurse immediately. A big ordeal later and the unsuccesful attempt of trying to get this man calmed down after taking him to the hallway, I realize I am unneeded and go to leave when the admissions nurse goes, "I guess he got the lasix." The night nurse, charge nurse, and myself could not stop laughing. Lessons learned: Give small look alike pills separate in applesauce if one is much needed Always keep your chin up and look at the bright side, even when you feel like you are in a pitch black cave. Sometimes humor is needed when exhaustion is overpowering.

I'm so glad you said "real nurse". I constantly get asked as a LPN when I'm going to become a "real nurse". I then go on to say that I already am one and ask what they thought the abbreviation LPN stood for-- Licensed practical NURSE. I honestly think some people don't realize the things they say are rude or they just don't care and like its an okay thing since they are just a "blunt and honest" person. I agree, it's very irritating.

I should first start off by saying I am a new nurse. I received my LPN in Aug 2014 but started working as a nurse in April 2015. I have close to 5 months of experience as a nurse working part time (24 hrs per week, 3 PM - 11 PM) at a rehab facility. The patients I typically encounter are weakness r/t a fall or surgeries such as a knee/hip/spine. We are treated as a subacute care hospital so we get the lovely extensive computer charting called ITW to where we chart many different prompts on behavior, even if the patient doesn't have any behavioral problems. Needless to say, it can take me two to three hours to chart correctly if I have the typical 8-10 patients. We chart a lot about patient teaching which seems to take up a lot of charting and time. I am the type of person who likes to do things right and not take short cuts just to get out on time. I do not like laziness. However, I'm having a hard time juggling dressing changes, achs accuchecks, two med passes, and pain meds (mainly pain pills and sleeping/anti-anxiety meds) all while assessing my patient and making sure their needs and questions are met/answered. Our policy on patients who have fallen is for them to be on alarms for the first 3 days they are at our facility then to reevaluate and d/c if indicated. If patients have alarms then of course they can't be on the toilet without staff (cna/nurse) being with them in the bathroom. So a lot of times I will be trying to help the aid toilet if she's stick in a bathroom with such patients or helping her transfer a patient if the other aid on the hall is busy. I firmly believe teamwork means everything. My problem is I'm having a hard time juggling time spent charting between time spent at the bedside. Others have told me to not be detailed in charting but I don't like the idea of cutting corners because it's a very selfish thing. I am the one who monitors the response to medications and therapy and communicates it to the MD/therapists and don't see it fair to the patient to not chart accurately. I am a fairly fast typer (60 wpm) so that isn't the problem. Most times I get about 30 minutes of charting time during my shift and the rest of the charting is after I've given report to the next shift nurse. I get out 2-3 hours after my shift and this not only makes me appear slow and incompetent but makes me (and I'm sure other nurses and the charge nurses) frustrated about the overtime. I feel like I have to choose between good care but sloppy, short charting vs quick care, concerns not getting addressed, responses getting overlooked and patients feeling uncared for but good charting, basic needs met, charge nurse/other nurses happy, and I get out on time. Does anyone have ANY advice or feel the same way. Maybe I just am destined to be an ICU nurse but I just want my patient to be cared for and feel that they are cared for while also having good, accurate charting and leave work when I'm supposed to. I have the feeling a talk will eventually happen if I keep getting out late. A (eat-your-young-kind-of) nurse told me matter of factly that they will eventually make me clock out to chart if I keep staying over late to chart but I didn't even think this was legal in the state of Indiana. Needing advice/opinions desperately! Signed, Newly stressed nurse