TIME MANAGEMENT HELP

First off - breathe.  This feeling goes away eventually - or so they say.  I'm going on a year and feel the same way.  Some things that have helped me....

Take 5 minutes to understand each of your patients basic hx when you start shift. Make a list of your to do for that patient with time boxes and checkoffs - ie labs, meds, imaging, bath - etc.  As new orders come in, then you only have to add to the list. I have seen this done in 2 ways: by having a sheet per patient or by drawing blocks on your paper for each hour and putting each thing in the hour block. I choose the paper per person because I'm in the ER and my patients always change and if someone is discharged I can just burn bin that paper.  My main boxes are: diet/NPO, Meds, Labs, consults and I really only do that for admitted patients (which we have way more often than we should).  I put a pt sticker in the upper left with their room number and then lay everything out on my paper the same way for each patient.  Diet and Code status goes under the sticker, consults in upper right, meds and labs take up the bottom right half of the page.  Hx goes under the diet.  Makes it easy for me to give report also.

Learn to cluster your care.  Keep in mind I have NO idea how to be a med-surg nurse but - when I have admitted patients - I go into their room, do a quick assessment on pain which allows me to see if they need pain meds, can swallow, figure out if they need new linens, etc... Then tell them I'll be back in a few minutes - go get all the things and come back and do all the things.  

As far as charting goes, my goal for this month is to learn to use Siri more for notes - not patient names or anything, but I really suck at writing times down (I look at my watch, think I'll remember them and never do).  My plan is to have Siri take down times for me - IE - 0242 - IV R AC.  0300 to CT 0422 EMS arrived and 0430 EMS departed. That way when I go back to chart that serious pt that we had to send to the specialty hospital I at least have the right times to do so.

Most of our time is wasted in 2 ways - sucking at knowing the system and running trying to find things.  Time will fix both of these things.  It always amazes me when I watch a seasoned nurse flip around though things. They know where everything is instead of having to look around for it - this saves a tremendous amount of time.  Also - they know where everything is - so they don't have to search for crap.  If you are in med-surg and have to do the same thing for all of your patients - when you are getting supplies - get a set for each patient so you only have to "go get" the things once. It sounds simple in theory - but it isn't when you are trying to execute it.

Give yourself grace.  You are learning and it's hard. Also - keep in mind just because the other nurses are sitting around chatting, it doesn't mean that their patients are taken care of - it means their patients aren't complaining and that's a big difference. Ironically, the only thing that makes time management better - is time itself.  You've got this!

The above was perfectly written. You will learn with time, you are still getting your feet wet. You can do this! 

Have a small sheet for each patient on the important notes from the prior shift, task items, MAR, labs and area of focus. What has to be done on your shift, what do you wish to accomplish; when things go sideways, you at least have your must do's, your important information to pass on to the physician/family/PT etc. 

Delegate! Don't be afraid to ask for help. Use your techs, not abuse, but let them help you. Ask your fellow nurses, many will be happy to assist you as you work your way to being efficient. It takes time, allow yourself at least a year before you start to feel like you have control.