time managament ..sniff~

blondnursey · Jul 22, 2009

wasnt there anybody you could have asked for help??

or do you (like myself in the early years) suffer from supernurse syndrome? lol....

i used to always try to do everything myself & then when i boo hoo later somebody always says you should have asked me , i would have helped you....

so now i ask & am always willing to help others.... :nurse:

locolorenzo22, BSN, RN · Jul 22, 2009

Always ask....always say to someone sitting there charting..."hey I need to do this procedure...could you do it for me?"

I often walk into work at 5pm with 5-6 patients and maybe another 1-2 admits coming for me to do. I look at the computer, get my 6pm meds...and depending if my admit is there or not, I'll go see patients...quick 5 minute head to toe assessment, doing anything with IV's foleys drains answer questions, give meds done...if the admit is there, I'll go see them, check meds, answer questions, check in...then go back after seeing everyone else and ask them admit questions and do the head to toe....it depends...you can be quick some days and slow the others...I've gone in at 5pm, and been done charting by 2030, or not even started by 0000....

ask if someone you trust has any suggestions and keep your chin up!

erin01 · Jul 22, 2009

does it get better...i have heard people say oh i go in do this this and that and am done by such and such time,and it sounds amazing! but i just cant seem to get there myself. I did ask someone to take my patient down to cat scan at the end of the day.

so that was good. I guess i should be looking for help. Does this mean i am not doiing well as a nurse?

rachelgeorgina · Jul 22, 2009

Im not sure that I can answer your question but I relate... I'm currently work as an NA in a long term hospital facility for children with exceptionally severe disabilities. Each nurse/assistant is allocated a pod of 4-6 kids for the shift. I've only just started and so far, I'm slow going. I'm always last to leave! It's taking me time to figure out what to do when and what goes in which order (e.g. put as many kids as possible in their PJs BEFORE dinner etc)

I guess I just wanted to let you know that you aren't alone!

onetiredmomma · Jul 22, 2009

Time management is hard to teach. Ask your preceptor for suggestions on how to "do it better" when she says "you should have...". No it does not mean you aren't doing well as a nurse! It means you are still trying to find your niche. What type unit are you moving to? And as mentioned above, don't be afraid to ask for help, delegate or pass on something to your relief. Also, do not find yourself in pt rooms after you give report. Go somewhere away from the busyness of the unit to do your charting. If someone asks you to do something just smile and say I'm just finishing up my paper work and I will be glad to get you the current shift nurse to do that. Good luck and don't lose hope!

vivacious1healer · Jul 22, 2009

As a new RN, ask your preceptor which things you can delegate to a CNA or even the charge nurse. Don't try to do EVERYTHING by yourself, it becomes too overwhelming, and you end up missing your breaks or leaving work late, and frankly burnt out. I have also learned the hard way that if you expect that you should be able to do everything for all your patients, then it will soon be expected!

After receiving report, review with your preceptor the priorities based on each patient needs, medication times, tests that require them to leave the floor, etc...

PS. you are a new grad, please don't be so hard on yourself! Ask the preceptor to review those skills that you do well, as well as those you need to work on to give you a better perspective.

morte, LPN, LVN · Jul 22, 2009

if i read the OP correctly, your preceptor said when she had "them" (the same assignment?) she was there until 830 and it only took you a 1/2 hour longer??? dont see an issue here, lol

NurseKatie08, MSN · Jul 22, 2009

It does get better...I'm a new grad (year with my license, almost a year practicing) and I'm in subacute rehab. I always have the same four semi-private rooms on my team, so I can max out at 8 patients. Sometimes it is very overwhelming, because on top of needing to do a ton for your patients, dealing with admissions, calls from MDs/NPs, new orders, labs etc. I end up baraged with a million questions from family members (I work 3-11, and most family members seem to come in to visit pts on my time after they get out of work) and sometimes I just can't get to their requests fast enough for them of course. You only do what you can do. Nursing is a 24 hour job, and there is no shame in having to pass something on...the prioritizing/time management does come easier after a while.

Some examples that might be of help...

Just yesterday, right as I came on shift, one of the CNAs came to me stating that one of my patients was asking for tylenol. It was 3pm, and she had meds due at 4pm (we have the hour window). I decided if I was going to go in there to assess her pain/give her tylenol etc, I sure was going to do her assessment & give her the 4pm meds while I was in there. Seems like a small thing, but it can free up a few minutes for you later.

Last Friday, in the midst of me dealing with one of my patients who was having increasing GI symptoms and trying to get on the phone with his doc, plus helping one of the other nurses whose pt took a fall and needed to go out to the ER, daughter of one of my very stable patients approaches me looking for a remote for mom's TV. I politely but firmly told her that I was dealing with an emergent situation just then and would get to that when I could.

Good luck with your time management OP, it really does get easier!

j621d · Jul 22, 2009

if i read the OP correctly, your preceptor said when she had "them" (the same assignment?) she was there until 830 and it only took you a 1/2 hour longer??? dont see an issue here, lol

The problem I see is the preceptor may not be the best in time management. The preceptor should have been helping you to stay on track by guiding you. With two nurses (you and preceptor) you should have been able to get out on time (barring any unforseen problems). Time management does take time to learn, and the preceptor should have been there to guide you.

meadow85 · Jul 22, 2009

Its just one of those days! You will get better at time management w/experience. It used to take me well over an hour to complete a admission, but now I can finish them in half an hour. I stayed late the other day because I was administering chemo, two blood transfusions and mentoring a student?! I went home late as well ... but I kinda figured that half way through the shift. I stayed late to make sure all my documentation was accurate and complete. Documentation is important and if you need to stay that extra amount to document you should. It will be well worth it in the long run if something were to come up. Good luck!

guest64485 · Jul 22, 2009

You are new, stop beating yourself up. 9:00 is nothing especially this early in your career. Think of how many things take up time now, that won't later on? Looking up meds, figuring out protocols, figuring out the computer system, figuring out who your resource people are, figuring out the best way to do things, figuring out tips and tricks, etc. For example, with our Pyxis system, sometimes a drawer won't open, but if you give it a good smack it will, and this will prevent you from having to waste time calling pharmacy for the med or walking over to another nurses station to obtain it.

I had a day when I was there for 17, yes 17 hours. I had no tech and I had 3 of my patients who were very, very ill and I stayed late to stabilize them/hanging blood/rapid response forms, and ship one off to a higher level of care (the patient should have been transferred 2 hours into my shift but wasn't; the charge nurse was fighting it all night, and it was a big mess, the other floor's doctors were coming down to see her and write their orders. The charge nurse had a full patient load herself and couldn't help me much either.). At the end, I then sat down with my patient that I ignored all night who was about to go home and had 0 teaching about her colostomy; hadn't even looked at it, she was so anxious. I stayed with her a good half hour at 11am and showed her everything she needed to know about it. So I guess I could have passed it on to the already overwhelmed day nurse who got my patient load and had it be a 16 1/2 hr day but I needed to ensure that this lady got a bit of care that day since I ignored her all night and it looked like day shift was going to have to ignore her too, so I stayed. I felt it was important to help her.

It was a horrible day, but, the one who was seeing his dead relatives beckoning to him lived, the one who was transferred out to a higher level of care was not doing well but was still alive, and the other was stabilized. Look at your day that way, not that you failed, but that people got care because you were there, and you didn't take short cuts, but gave quality care to them.

People happen to code at 6:59 and what are you going to do, stop compressions, say it is your shift change and not stay? Working in medicine you will not always be able to go home on time, sometimes it will be a very late night and your family needs to realize that. Sure, no one is perfect and we can always improve on our time management skills, but be realistic about it too - healthcare are has many unpredictable variables; we don't know if someone will code or our pleasant man will turn violent, and turn something simple into an hour ordeal right at shift change. This isn't a stack of predictable paperwork and while we can pass along some things, we shouldn't pass along everything. Besides of which too, they oftentimes knowingly understaff. Look at the other people on the floor, who will be a good barometer of what it is like when you'll be on your own. As long as you do the best you can and continue to look for ways to improve, that's all you can humanly do. I've been a nurse almost 3 years and still have 9:00 days or later even. Very experienced nurses on my floor also on occasion are there till 9 as well, though less than me of course because they have that much greater of a knowledge base to work from. If you are feeling overwhelmed, ask for help from another nurse or from your charge(who hopefully doesn't have a full load)