Speaking of... Getting to work early

[jrsmrs]

Reading another thread got me thinking about this...I always get to work at least a half hour before my shift starts. Do I want to or like to work for free? Hell no! But I really don't know how else I would ever get out on the floor in time to get everything done. If I start at 0730, I've got glucs to do before breakfast, probably at least a few 0800 meds to give, etc. never mind getting vitals on 5 pts, doing assessments on all, washes as needed, putting out any fires that spark, etc.How do you adequately prep for your shift if you get there at the beginning of shift and not early? Reading kardexes & shift summaries, checking meds on MARS vs charts, etc takes me minimum half an hour for 5 pts. Usually quite a bit longer if the pt has a thick chart that takes forever to get through (which is many of the pts). There is no way if I spent a half hour-45 mins prepping after start of shift that I would ever get all my stuff done on time and get out for breaks. I hate going in early, in practice and in principle, but just in order to meet expectations and also to avoid the stress of constantly being behind and trying to play catch-up, I do it. If there is some other way, I'd love to hear it. The only nurses I've noticed who don't come in early really don't seem to be double-checking their med orders vs MARS, which is a policy at our hospital q shift. That's the biggest time eater, really.

[Do-over, ASN, RN]

You know, I don't start work early - with the rare exception of ensuring safety if a bed alarm goes off as I walk by to the locker room...

Often, the assignments aren't made until the very last minute anyway, so I wouldn't know who my patients were anyway.

Beyond that, each day I start at the beginning and keep going until the end of the shift.

I don't do chart checks, etc, at teh beginning of my shift - there is no way. I get report, assess, then start morning meds and go from there.

[nurse2033, MSN, RN]

You are to be applauded for your dedication but you are enabling poor management. If you can't get your job done in the time allotted you should bring this to the attention of your boss and work for a solution. Are you being paid for the time? If not, not are not covered under your employers liability because you are not actually working. It is illegal for you to work without being paid. You are putting your license at risk. You are also making the other nurses who do show up on time look like they can't do their work. After all, you get things done... I think you are making a big mistake.

[Altra, BSN, RN]

If I am precepting I arrive 5-10 minutes early to scope out what patients are there and what might be the best assignment for my orientee that day. Otherwise, I arrive exactly on time, ready to work.

[tokmom, BSN, RN]

I arrive 10 min early to get my Vocera, equipment needed for the day. I actually walk out of the breakroom at 0700 and not a minute early (minus a code). I refuse to give management more free time then I already do!

What I don't get done, I pass along.

[Morganalefey]

Do you have aides on your unit? Our aides check sugars, do vitals, and most of the bathing. I start on time, get report, write down the last set of vitals, meds to be given on the shift, and relevant labs. If I need to call a dr for any reason, I do that immediately. If not, I begin assessing and passing meds. I drag a vitals machine w/me if I have b/p or cardiac meds. I ask about toileting when I go in to assess and toilet the pt if needed, then move on to the next one.

I agree, w/the previous poster's. I don't think you should be working off the clock.

[Meriwhen, ASN, BSN, MSN, RN]

I get to work about 20 minutes early but I do not clock in until it's time to clock in. If I'm asked to do something, I tell them (provided it's not a life-or-death situation) that I'm not clocked in yet but I will happily clock in if they authorize the OT.

After saying that, I find that miraculously, a majority of their requests can wait until I clock in :)

I agree with everyone else: you shouldn't be working for free. Management may be unofficially appreciative of the free labor, but should something happen with a patient d/t your actions while off of the clock, they won't hesitate to throw you under the bus.

[SwansonRN]

I don't come in early. Some nurses where I work do to start gathering information on their patients 20 minutes before their shift starts, but I think it's silly when patient assignments can change at any time. Hand off takes anywhere from 30-40 minutes, then I take ~10 minutes looking at orders/labs/meds and organizing my day in my head. I've never felt super rushed to get things done before 0800am. You need some aides to help you!!

[beeker]

I arrive early to review my assignment, and get my info together so if you happen to get a crappy report I am not clueless. There are some people on my floor who seem to know nothing about their patient and getting report from them is a waste of time. I'd rather be ready to go.

[MJB2010]

I get to work early to get my ducks in a row. I do it for the same reason I get up a little earlier before work to sit and have my coffee. I like to be ready to work without a rushed chaotic feeling.

[AnonRNC]

I agree w/PP nurse2033: You are working for free & are making other nurses look bad.

Perhaps you could streamline the essential info you need to start your rounds/medpass...then go back later for the details.

I don't think anyone on my unit does this BUT I concede that NICU is very different from many other environments.

[BostonTerrierLover, BSN, RN]

Lol, I do everything in my power to get to work on time! I work ED, so I know as soon as they catch the first sign of my presence- they are going to scatter like a covey of frightened Quail to the Exits, lol (if their are no patients)- otherwise, I've had report start at the time clock 5 minutes early, with my lunch, drinks, and other junk in tow.

I understand your reasoning, agree with previous posters. Besides, I never knew who my crew would be before report at any facility I worked at on the floors except one, and I didn't want to be there a second longer than required.