Some days are good, some are not

[NNNikki]

:uhoh21:Hi everyone,

This is Newbie Nurse Nikki chiming in on the first year nursing. I just wanted to know how many of you other newbies go through this emotional "stuff" at the end of your shift. I bust my butt all NOC shift to make sure all 43 of my residents are taken care of and that all extra documentation that NOC shift is responsible for is done. I only work an 8 hour shift at a time, thank goodness; however, I usually don't even get a break...I know, I know...being a nurse is being without break.

:rolleyes:Anyway, I begin to think I have the night licked and on time when all of a sudden somebody's blood sugar is off, or 3 different people need their prn narcotic for pain, or someone is having difficulty breathing, or a skin tear needs to be documented and assessed....etc, etc...

My schedule then brings me to the point that at the end of the shift, I have no time to record my report. Well, this is where I get the distinct impression that everyone would rather I did audio tape record my report.

Here's why...as I'm trying to go through all 43 residents and which ones had loose stools, which ones had blood glucose readings, which ones had targeted behavior difficulties, who's on antibiotic, which one fell, has increased edema...etc...etc...I get the distinct impression the day shift would rather I give the abridged version of the NOC shift.:uhoh21:

:oHow do I do that? I'm still trying to figure out priorities on passing which information that is relavent or not...ya know? I really begin to feel like I've got a handle on things until half way through the night, something out of the 'norm' happens. I'm still trying to name the resident with the face and know where all the equipment is, and what documentation is most important to complete.

I'm not sure where I'm going with this, but just wanted to air my thoughts and to see if anyone who's in their first months of being a nurse is experiencing any or all of the above said issues?

Thanks for your time!

NNNikki

[AdelaideChic]

(Im not sure what NOC stand for!?!)

When i worked in a residential care facility as the team leader of a 30 bed dementia unit, my handovers where short sharp and shiny.

In order to remember who was having what, i started off by keeping a notepad in my pocket, and just putting the room number and then any issues. Rooms 1-5 where on the first but of paper, 6-10 on the next... and so on. Then when it came to handover and report, i had a quick cheat list of who had prn meds, hyperglycaemia, loose bowels, etc.

As i got more experienced, and knew which pts usually had which issues, i used this less and less, but its a good prompt.

Maybe have a time out period? Say if u finish at 9pm, at 8.15-8.25 you are not to be disturbed unless by emergency/important issues, so that you can do your reporting?

If the same ppl are on a course of antibiotics, then the staff may have been hearing about this for the last week when you tell them, maybe saying "and im sure u no that Mrs X is on anti's for her infected wound" rather than "Mrs X is on Amoxycillin 500mg tds at 0800, 1200, and 1700 for her infection to the left lower leg"... if you can see what im getting at! Similarly, if someone regularly has loose bowels, the staff may not need the finer details, or perhaps are just cringing because they remember last time...

I think a big part of nursing is that you need to work out the best way to be most adaptable, its when you are busy and running behind that ppl that are generally fine on their feet decide to fall and so on.

Dont know if that helps at all, but anyway, besta luck to you!

[AdelaideChic]

Just remember you said match the residents name to face...

If it is a long term facility, which mine was (and predominantly foreign!), the names are often on the inside of the tops and cardigans. Never rely on it for drugs and thigns, but often it is a helpful prompt... especially if you are sure it is either A or B. Just be wary as sometimes clothes get put on wrong ppl by mistake, or 'lent' when the laundry is taking too long...!

[NNNikki]

NOC shift is the night shift; which for me is 10:00pm to 6:15am..graveyard is also a term for it. I appreciate all of the advice you have given me, and I'm working on the organization. I guess it's just a learning curve.

NNNikki