The infamous time management post

[Iwander]

For those of you who don't have too tired eyes, and who can manage some wordiness, here is my time management vent for the day:

Well, I've been reading some of the time management threads on here and realizing I'm in the same boat as others. I've been a new grad at this particular job for 5 months now. I work on a busy med-surg floor and on bad days like today, sometimes I wonder will I make it. Do I need to switch to a less fast-paced floor, but no matter where I go, I will always have the time management, prioritization, and think on my feet challenges. Today one of the experienced nurses, who is completely on my side, said that I spend too much time planning out my day when I need to just go do it. After going to allnurses for help, I thought I was making an improvement by writing down the meds for the day and trying to plan my day. Turns out I need to be like Nike and "Just do it". . Silliness aside though, I've realized that I am a slow to medium-speed processor. When I have 5 things to do at once, I can't go rush into action easily after mentally prioriitzing. I have to write down a plan (which takes awhile), try to go do each task, and recheck the computer, all the while not even timing myself to see how long it takes. By the time I write something down, it's too late and there goes the time. I realized today I must just go and do it. But my brain doesn't work that way.

In counseling recently we discussed that I might have some minor adult ADD going on, where I can't divide up tasks into their respective times and see the big picture. I have anxiety already which fogs up my brain and slows me down, but I also might have some ADD slowing down the process as well. I tried to stop today and deep breathe to handle my anxiety, but my brain fog had already come over me, I was already beet red (which lasts for hours on me unfortunately), and I was already getting slower and "more stupid". I also lose what little common sense I have when this occurs. I find it hard to just connect 1 2 and 3, if that makes sense. I then start losing my supplies and papers, and realize oh that's right, I was supposed to be organized today. Well thanks for listening to my rant. I hope I can benefit tomorrow from "Just doing it".

I do struggle with the 5 things thrown at you at once scenario. Our unit has a quick turnover rate, which means, I can have a scenario similar to this: I'm passing the morning meds. 30 minutes into my shift, I have 2 discharge orders written at the same time. Meanwhile that afternoon (after those rooms are clean and empty), I have 3 post-surgical admits within an hour, and 2 of those come within 5 minutes of each other. They both have a time-sensitive antibiotic due. These scenarios have happened to me before, and instead of getting those post-op tasks and assessments done within say, an hour, it takes me 2-3 hours. I'm still slow at getting the new patient settled. Then there goes any charting time I have and I don't get off work until 9 p.m. When you get those 2 new patients thrown at you, how can you breathe and do just one at a time? You can't wait 30 minutes to go see that second patient. Just wondering how some of ya'll handle those multiple new patients. Because it's pretty common on my unit.

[Nola009]

Sounds busy. I struggle with ADD (I think) and anxiety as well. Will be starting a new med surg position soon. As new nurses, there's a lot for us to learn and it's been my experience so far that so much comes in time and with practice. So, hang in there!.

[Farawyn]

It sounds like you do need to go faster. Know that this WILL come with time, on some level. If you truly do have ADD I'm glad you are getting help.

2 or 3 admits at once? Ask for help, see if vitals an be done by another RN or a nursing assistant. Alert your NM if he/she's not at a meeting. If not, vital them all, poke your head in, introduce yourself, eyeball them and give them the call bell. Tell them you will be back. Tell the unit secretary you got 2 admits at the same time and go to the sicker one first. Remember that 4pm meds can be given with some leeway, they don't have to all be given AT 4. Pain meds trump a lot of other meds. You WILL be able to do this. You will find YOUR method as time goes on. And some nurses are just slower than others. That's okay. As long as your patients are safe.

[Iwander]

Thanks! And the other day, there were 3 nurses and we each got 4 new patients. Not at once. But in that instance I don't really have the resources to ask them for help much as they are running around busy also. Thanks for your post!

[Iwander]

Thanks for the encouragement!

[icuRNmaggie, BSN, RN]

to iwander,

That is a ridiculous and unsafe situation. No one should get three post ops in one hour. That is a crummy thing to do to a new nurse. I suggest that you switch to nightshift for the next seven months and then transfer out of there. My two cents.