Published May 9, 2014
sdupnik
8 Posts
So I just started back in the hospital on telemetry after taking a 2 yr hiatus to do home health. I am happy to be back in the hospital but I am really having trouble managing my time and staying organized. I work day shift and the typical nurse patient ratio is 1:5. I am having trouble with time management especially with having to give meda, talk to doctors, pts going/coming back from tests/cath lab etc. I have made myself a schedule that I really try to follow. Some days I do ok with it and other times I really struggle. I only have 3 weeks of orientation left and I want to prove to everyone that I can do this. I know my stuff most of the time, and learn lots of new info every day, but sometimes I overthink things and that probably contributed to my poor time management. I was hoping someone has some suggestions and helpful tips for me to successfully complete orientation. Thanks in advance!
delphine22
306 Posts
-- Find a good "brain" that you like and works for you. By this I mean a pre-formatted report sheet or SBAR that has all the info you need for your pt at a glance. Sneak a peek at your coworkers' brains and ask for a copy if you like theirs. You need everything in one place: labs, meds, sugars, vitals, etc., for when you call the doc. Or make your own, but be organized. This also helps you in report because when you see blank spots you can say, "You forgot to tell me what the pt's IV site is."
-- When you worked home health, you had all the supplies with you when you went to your pt's home. You didn't run back and forth to pick up meds, dressing change materials, etc. Do the same on the floor. Never walk into your pt's room empty handed; if you know you have a drsg change due later, bring those supplies in when you pass meds, as well as the fresh IV tubing if you have to change it, etc.
-- Hourly rounding is a fairly new concept that most returning nurses aren't as fluent with. Some places have the nurse alternate with the CNA; they take the even hours and you take the odds. But if you walk into your pt's room and make sure they don't have pain, don't need to potty, have everything they need and all their questions answered, then you are helping them on YOUR time and your terms, not waiting for them to hit the call bell, when you're in the middle of something else, and have to drop what you're doing to see what they need. It's being proactive, and though it seems like a chore it will save you time in the end (and raise satisfaction scores!).
-- Bedside report is another thing. If your facility isn't forcing you at gunpoint to do it (haha) then you should still do it. At the beginning of the shift the pt needs to know who you are, what the plan is for today, when any meds are due and what tests are going on. That way, if there are any issues ("I have an eye drop I take at home, can the doctor order it for me?") you know it at the beginning so you're not calling the doc a million times for stuff. This is doubly important on night shift; I ask my pts the moment I meet them if they take anything for sleep; no one wants to call the doc at 2300 bc the pt just said to me, "Oh by the way, I need Ambien, I don't have it ordered and I freak out without it."
-- Use the time your pts are gone to get caught up on your charting, or do the time-consuming dressing change. Conversely, if you know your pt's going somewhere, make sure their charting is done first; you never know if they might not end up coming back to your unit. Get with your charge or call the receiving dept if you're not sure who's going where when.
-- Take a breath. You still have three weeks left of orientation and no one gets this all down pat the first few months. Give yourself some grace, give good pt care, ask for help if you need it. You can do this! :-)
Thank you so much for all the suggestions. I'm thinking maybe the biggest problem I'm running into right now is being able to stay on task in the am and have all 8-10 am meds passed by 0930 (hopefully). I think if I can do this and stay organized the rest of my day will go smoothly (hopefully)! Lol.
My preceptor gave me the report sheet she uses and brought me to the realization that I was even writing report on it in a disorganized manner (leave it to me to screw up a pre made report sheet). Lol! Also, one of the night shift charge nurses gave me the one she uses which seems helpful. I hope that if I can build up my confidence and stop overthinking things I should be able to successfully complete orientation.
I would love to hear other nurses suggestions too!