Speaking of... Getting to work early

Nurses Professionalism

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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.

I come in early because I do not want to feel harassed. At least when I am early, I feel prepared and still fresh and ready to take on the duties assigned to me.

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Wow, it sounds like things very different where I work! We are not a teeny hospital by any means, and actually a smallish regional center, with lots of pts coming from outlying areas.My floor is not so bad, as we do get more break time than our CBA allows (assuming you can get to them, which the majority of nurses do the majority of the time), however that is not at all true on other floors. I worked a surgical floor for awhile, and the majority there come early, but still only get their union-allotted breaks. If anyone should be complaining, it's them. As it works out for me personally, unless I have an especially heavy pt load, I certainly don't put in more hours on the floor than I'm getting paid for. This is only because the manager allows these longer break times... And because we don't have a clock-in/out system. Unless you call in sick, or put in for OT for missed breaks or staying late, you simply get paid for the shift you're scheduled for.

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I don't work for free. I'm happy to stay late or come in early, but if I do so I am clocked in. I don't think refusing to donate time to management makes me a bad or thoughtless nurse. I also fill out the exception form if I do not have the opportunity to take my lunch break. I refuse to support any expectation that nurses volunteer their time to their employer.

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Specializes in Pediatrics (neuro).

I get to work 15 or 20 minutes early so I can review my orders and recent lab work, and plan my day. When I take report (1:1 handover) I can actually ask relevant questions about the patients. The moment I take report, that patient is my responsibility - I don't want to be just reviewing my orders then if my patient calls out. But that is our unit culture, it's just the way it is. We don't have personal support workers to help us with our care.

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wellll, I am going to call this what i see it. Martyr/enabler, behavior much too common in nursing.

I get to work 30 minutes before my shift starts. If I can get my report, check my patients then check my MARS I'm doing good. The nurses that get there at 7pm (which is shift start) are way behind waiting for a computer to use to check their MAR and to complete their computer work. The doctors show up starting at 730pm, so good luck then. We do not get paid, and they will not pay us for this. I don't care, this 30 minutes does a world of difference for the quality of my day. What annoys me to no end is the nurses that come to me during the shift to ask me for help, "are you busy? can you do me a favor? I do not get to work early to free up my time for starting ivs on their patients, taking their calls and their transfer and admission. These nurse also run out the second their shift is complete. Giving a crappy report and leaving a sloppy mess for the next nurse is not on their mind. I usually get out about 730pm (our shift ends at 715PM). I would get out on time if the next shift was a courteous as me. I think the nurse that started this post cares about the quality of care she gives her patients. When you get a chunk of your work out the way, you can spend more time with your patients and carefully review the chart. I think my 30 minute sacrifice helps more than just me.
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There is a nurse that's comes in at 555am every single shift.... We start report at 715am.... And she straight GRILLS you during the entire thing, like she hasn't looked up every patient in painful detail and collected all of their AM meds in perfectly labeled and organized baggies.. Tad OCD if you ask me

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I just did My Preceptorship in Medsurg ( I graduate Thursday ) Yayy! and she had your same work pattern. started early and we were done by 9am!!! all the time! This drove me NUTS! Poor Time Management is an issue. I was able to pick it up right away, and I not even a Nurse yet! I do not wanna spend 14 hours every shift , no, no. no!

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Specializes in Acute Care, Rehab, Palliative.

I get in about 15 minutes early. Then I have time to use the washroom, pour my coffee and have a look at the assignment.We don't have shifts that overlap.Report takes about 15 minutes and we get on the floor around 7:45-0800.Report is done by whoever was charge for the shift, everyone else leaves.We have a report sheet that everyone writes on and the charge reads it plus adds her own stuff.

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Specializes in Emergency, Telemetry, Transplant.

I plan to get to work approx 10-15 minutes before my shift. That way, if there is a minor incident along the way, for example, a traffic light is out, I will still be on time. Plus, that way, I don't feel like I have to speed to get to work. I never clock in before the timed start of my shift, and I never work before I am clocked it.

How does management justify no overlap in the shifts in light of a safe transfer of pt care? If I walk in to room 5, find the pt confused with slurred speech--is this their baseline or are they having an acute CVA?

Besides with the obvious problems described in the OP's situation (i.e. doing a large amount of work 'off the clock'), I also see this as a major obstacle to safe patient care.

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Specializes in Emergency, Telemetry, Transplant.
There is a nurse that's comes in at 555am every single shift.... We start report at 715am.... And she straight GRILLS you during the entire thing, like she hasn't looked up every patient in painful detail and collected all of their AM meds in perfectly labeled and organized baggies.. Tad OCD if you ask me

I had to handoff to a nurse like this once. Maybe she wasn't in quite as early as 0555, but she had thoroughly researched each patient before report. Such as "did anyone address this low potassium they had 4 days ago on admission?" (you have to imagine it with a severely condescending tone of voice. Me: "uh, I'm not sure, what was it?" Her: "3.1" Me (trying not to roll me eyes): "He has chronic renal insufficiency, so I imagine the doctor is quite apprehensive about an aggressive replacement of the K." Her: "Well someone should have called him to find out." What I wanted to say but didn't: "well, now you have a project for the day. I'd like you to take this attitude with the doctor to see where it gets you."

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Specializes in Emergency Room, Trauma ICU.

I'm chronically early, but I'm that way for everything. I get to work about 15 mins early every day, longer if I'm worried about the snowy weather, BUT I don't start working till it's time. I like to get organized, get a drink, pee, whatever before going onto the floor. I'm in the ED so looking up information on my pts is not going to happen. When I was in the ICU I HATED giving report to this one nurse cause she always wandered in, eating a breakfast sandwhich, would stop to get her coffee. Peeved me like nothing else, especially when she responds with stuff like "don't be a lazy night shift nurse". But I digress, I'm all for showing up early, but not for working off the clock. I've gone out to the floor early cause we had two arrests going on and wouldn't do that to my coworkers.

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Specializes in Ambulatory care.

sigh there's not enough time in a work day ... as new nurse i know im' slow so I gotta get the time from somewhere, ... so starting monday i'm going to go in 40 mins early and start work at the 30 min mark because I can't think of any other way to get the work done, not lose license, not cut corners. I won't be doing any patient care before my shift, and will only sign out the med keys at the start of my shift time no earlier. Procedure book says X steps, but I don't have time to do it to that level ... Maybe everyone else cuts corners and thier superior turns a blind eye i dunno. Whose job is it to restock nurses's rooms anyways? PCA or nurses? Anyways rant over I gonna take my time with meds, procedures and if anything i cna't be fired for being slow and using lunch hour to do more work but can be fired lose license if i screw up.

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