Really in need of some time management help. :(

[Pat2012]

I am a brand new RN, this is my first really nursing job, and my first ever full time job. I have got the dinner med pass down pretty good. Assuming there aren't any major crisis, I can get it done within' the time frame... The evening med pass, however, is giving me a terrible time. I am wondering how you would do things for the evening med pass with this situation: 25 patients, 4 insulins, 4-5 treatments, pharmacy comes anywhere between 8:15 and 10, and around 9pm the supervisor comes for report. I am feeling very frustrated and think other nurses must think I'm totally stupid for not getting done at 10pm. On a good day I might get done at 10:30pm, but many times it's 11--- and that's only because I have another nurse with me on the hall. I have tried doing treatments first and last, insulins first and last, people who go to bed early first, breathing treatments first..... I don't know what else to do......

[blinky, ASN, RN]

ask CNA's to get vitals for your pts, go check blood sugars [ or CNA's if they do this],give all meds and insulin as you go, then do all treatments. Then repeat as needed. that's sorta how they do it at my palce. I think it may help. i work 7p=7a so may be different

im also new inLTC adn my first job everas a RN and 18-24 pts, so i feel ya. see my posts.

im a month in..

[CapeCodMermaid, RN]

It sounds as if you're doing wonderfully well for a brand new nurse. You're giving good care and getting out on time. Don't be so hard on yourself. Speed will come with experience.

[jcprn]

I am also a newer nurse in a LTC/rehab unit. I have 24 residents with six insulins, five of them on sliding scales, nebulizer treatments, other treatments, vitals, plus the prns needed as I go. I work 7p - 7a and don't begin med pass until 7:30p, and NEVER get done before midnight - it is SO frustrating! The CNAs do not do vitals or blood sugars at my facility and there are about three residents who take their time and pick out each pill, complaining about each one as they take them! I don't understand how to make it any better - the other nurses are done before 11:00! My speed has improved as I was getting done around 12:30am when I first started, but I really can't get any better than midnight without skimping on care or treatments. I trained with one of the nurses who gets done by 11:00 and I have seen her skip the resident who picks at the pills, or leave the pills at the bedside, she also never told me anything about treatments, so I'm "guessing" that is why she gets it done so early. I feel awful that these residents are getting their meds four hours after they are scheduled, but I don't know how to improve....

[wyogypsy, RN]

We become faster with time, but I have found that the nurses that get done 'too quickly' are skipping treatments, skipping eye drops and nebs, skipping OTCs, not using their MARs, etc. Just do it right and you will get faster as you gain more experience; but a nurse that does it right can't compete for time with the nurses that do it half-assed. I have been a nurse for 20 years and believe me, it is sad the things some nurses skip just to be 'fast' to try and make people think that they are just extremely efficient.

[MountainRN53]

Thank You for sharing all your experiences. I am in the same boat. I have done LTC years ago but I don't recall it ever being as bad as it is today. The multitude of meds, sliding scales, younger behavior patients, those who pick and ask about pills, those who come to your cart and want their pills NOW. The job is not difficult just EXTREMLY time consuming. I know it will get better but this facility recently had a few walk out and I think others aren't real excited to orient or be left with orders.