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.

[jrsmrs]

Just to be clear, a good 90% of the nurses where I work come in early. The ones who don't are more or less skipping chart checks from what I can tell (although I'm usually too busy to really pay a lot of attention), but i think i can only name maybe 3 nurses that i know of that don't come in til right on time. And I never do patient care before shift, just prep work going over charts, etc. This really is the status quo here, so I'm surprised to hear otherwise. And no, we do not have any aids here. I work in Canada, on a cardiac unit, and I've got 5 pts all to myself during the day. Sometimes a pick-up as well so I end up with 6. We also do get our assignments way ahead. We don't do assignments based on acuity, they are based on room #. Schedules are done a good week in advance so we all know what section we are in ahead of time.

[BostonTerrierLover, BSN, RN]

A week ahead?:)

I'd say this is impossible in 90% of healthcare facilities. But, if coming in 30min-1hr early unpaid, working off the clock despite how many do it, and it is not getting you in trouble-knock yourself out!

I'm sure your employer loves the cheap labor, and they won't even have to take the time to discover a way to fix this problem(I.e. hiring UAP's, getting night shift to do a few baths, etc.). If a problem isn't brought to their attention- I can guarantee that if they see no problems, that the status quo will continue. Your question was do others do this practice- me No Way without Pay:)

[redhead_NURSE98!, ADN, BSN]

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.

Breaks? What are breaks? That's where you're winning on this deal!

I get there about 15 min early just because I want to be on time in the event of traffic etc. But when I'm in charge I hate when people are there early because they just stand at the nurse's station staring at me as I make out the assignment, or placing "McDonald's type orders" for "I don't want Room 13, give me the same people I had five days ago (um this is a hospital, all of those people have been discharged), don't put me on two hallways" etc.

[Guest219794]

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.

I see this one a lot. Got any examples of people who lost licenses from starting work early?

BTW-

Agree 100% with the rest. If this is common practice in your unit, managent knows, and tacitly aproves.

[jrsmrs]

Do you all have overlap of shifts, or....? We don't have any overlap, so even if I only wanted to get report, I'd still have to go in a few mins early or else the previous shift would have to stay late to give me report.For those that don't do chart checks at start of shift, when do you do them?

[jrsmrs]

Also, since there is no overlap of shifts, at 0730 (or whenever my shift starts), it is me and only me who is responsible for those pts. If I don't know anything about them, what if the doo-doo hits the fan? I wouldn't know anything about their dx, code status, hx, nothing. Last night for example, I picked up a pt at 1930 after someone called in sick, and literally as I was printing off his tele strip at 1930, his tele cut out. Went to check on him, he was hunched over the end of his bed, hard to rouse etc. Had I not already done my research on this guy and knew his story, I would have been working in the dark. I wouldn't want to walk into that with no background.

As an aside, the guy went down the shiitter fast. Had to call rapid response, portable tele battery died on the run upstairs to icu. Plugged it in when we got there and he was in vfib. Literally, the guy had been talking to us just seconds before. Bad night

[PediLove2147, BSN, RN]

I get to work at 0700. The assignment is done on the previous shift so I grab my patient list and start looking through their HPI and MAR. Everything is on the computer, no chart checks to do. We start getting report at 0715. We then have safety huddle at 0745. I rarely see a patient before 0800 unless there is a reason for it. We have aids that do blood sugars, vitals, and AM care. We have a few people that get to work early, most people get they're on time or late.

I personally like getting there 15 or so minutes early, I like reading about my patients prior to getting report so I can ask questions but I can't get up early enough so on time it is!

[pixiestudent2]

If you come in 30 minutes early each shift and you get paid 25$/hour. At the end of the year your giving up $1,950...

That wouldn't be ok with me.

[AnonRNC]

Do you all have overlap of shifts, or....? We don't have any overlap, so even if I only wanted to get report, I'd still have to go in a few mins early or else the previous shift would have to stay late to give me report.For those that don't do chart checks at start of shift, when do you do them?

Yes we have overlap. I had no idea that everyone did not! If one works an 8-hour shift with a 1/2-hour unpaid lunch (standard here), then one is at work from 7-1530 or 1500-2330 or 2300-0730. So you see we have a 1/2 hour overlap. No wonder you do what you do!

[OnlybyHisgraceRN, ASN, RN]

I usually get to work early to reveiw the H/P, Progress notes, meds, labs, and etc. I worked in ICU so I wanted to make sure I had as much info. as possible. Sometimes the nurses I've received report from might forget something, and thankfully I would have picked it up to help fill in the blanks. The down side is: people asking for help with lifting and positioning, being there for a code, and having the assignment switched at the last minute.

However, the pros outweighed the cons and I felt that I had a better handle on my patients after I read through there charts before starting my day.

I think it depends on the specialty and the person. As a new grad, I see nothing wrong with arriving early for the first few months until we feel comfortable with a routine.

[chevyv, BSN, RN]

I clock in about 10 mins early. I have never been talked to about this and so I keep on. I will not work off of the clock, no way no how am I working for free! I clock in, do the assignment for the shift, make sure I get rounds done, and get everyone together for report so we are ready to hit the floor. I don't come in and gab to everyone. I say hello to day staff and get moving. I hate all of the chit chat that goes on before work can actually begin.

[wooh, BSN, RN]

Also, since there is no overlap of shifts

Well that's the problem. Report doesn't just magically happen. And management needs to provide time for report. But why should they when they have a bunch of nurses willing to work for free?