Need help with prioritizing

Clovery · Feb 25, 2014

Basically it's go go go until you're done. I have the same issues. Days when I'm forced to take a lunch I clock out half an hour late.

My advice is to try to coordinate with your CNA. If it's a patient that requires 2 people to turn, then arrange a time when you will go perform incontinence care and do the wounds at the same time. To get my meds done quicker I pull them all at the same time (we use a pyxis) and deliver them to the room, so I can just go in a line and give them quickly. (We're not supposed to do this, but I label them all and it saves time going back and forth from the med room). If possible find a good hiding place to chart. Don't worry too much about giving daily meds on time. Your patients will live if they get their multivitamins and Zoloft at 11 am instead of 9. Do all the time critical meds like IV abx and insulins first. If you have a patient who takes pills one at a time in applesauce, save them for last.

I hear you about family members and PT/OT taking up time. If someone's family shows up and mom is sitting in a mess, they don't care that 3 other patients need meds NOW. I wish I had time to change the patients as soon as they are incontinent but I just don't, and neither do the aids. Everyone works very hard. I find that if I just drop off the supplies like a linen change in the room and say "I'll be right back" then it buys me a little time to go pass another person's meds and come back. Be wary of the Q2 IV dilaudid patients. These are the ones who will go right to your manager and get you in trouble. Find the time to give them their pain meds promptly and they will rave about you.

Finally, hang in there. I feel like they expect us to do the impossible. Everyone works their butt off and that is the most they can expect from us. Some meds don't really matter if they are late. Like if someone is on a tube feed and they need one unit per sliding scale insulin, it's not really critical that you get it done in that half hour window. Save the biggest time commitments for last. If your 400 lb. patient pooped all over their sacral wound vac and the whole thing needs to be changed out, realize that's going to take you at least half an hour so get everything else done before you go in there. I also find it helpful to chart at least 2 assessments first thing in the morning, before anyone but nursing is on the floor to distract you. Finally if you overhear your co-workers chatting, realize they have time to help you and ask for it.

MissRN7 · Feb 26, 2014

Thank you Clovery, I appreciate your advise. Its true they expect you to do the impossible.

Road2CNO · Mar 28, 2014

Try and rely on others if possible. I have been a nurse for 4 years and this occasionally still happens to me. We have a charge nurse at our facility that will typically have no patients or only 1 so they are usually available to assist other staff. Also, sometimes the assignments are not "even" in that someone may have 5 "easy" patients and another person will have 5 "difficult" patients. Ask those that seem caught up if they have time to do a wound dressing or pass some meds. Most of the time they are willing. Nursing is a team effort even though you have your own assignments. A facility should feel like a team and it will work.