Im sure this is difficult to have a solid answer for but Im hopeful someone might help me a little...
Im just about done with my 3mos orientation as a new RN on a IMC/Tele floor...I have a 5 patient assignment of varying degree acuity including truamatic head injuries and fx's to LoL's with pneumonia....Im having trouble getting meds passed on time, chart checks, orders put in, people turned, IV's started, flushed, assessments complete, charting done, etc etc....seriously, how the hell does everone else do it?? Im running my a** off and dont sit down except to chart and the experience nurses are all sitting at the station with time on their hands...Im getting a "talkin to" by my manager last night after my 2nd 12 this week and very little sleep in between saying, "youre not progressing as fast as we'd like since youre nearing the end of orientation"....Me ":eek:...really?" my preceptor has only had me seeing 5 for the last 5 shifts and Im getting almost every task done barring being a little late on some meds or staying after report to complete charting....other than walking even faster or rushing thru meds and not ever talking to my patients to listen to their needs as a nurse, I dont know how else to be better....
So, how do y'all experience RN's get all this done and do it safely???? help please...
While your paragraph one is unfortunately true regarding being able to give your patients a FEW MINUTES of undivided attention, it is the reason I am looking to leave bedside nursing in the future. It is a sad state when you are stressed for time to the point where actively listening to your patient is all but impossible. I define active listening as giving your undivided attention to a patient and not multitasking when the patient is talking. I find this appears to be uncaring and disrespectful to the patient. If the patient starts to go off on a tangent then of course you have to move on to your next task. It really does not feel very good when you are trying to talk to someone and they are checking IV sites, foley catheters, looking up meds on the computer, etc. I am not being critical of anyone because unfortunately this is the reality of hospital nursing. Even though I know management is going to come down on me I stop and listen to my patients for a few minutes. Does this put me behind? Of course it does. It is disheartening to me that as nurses we are not able to fully be in the moment with our patients because of time constrictions. If nurses cannot give 5 minutes to a patient to talk with them and truly listen to them the system is broken.
I realilze you weren't criticizing or blaming me ... and I'm not trying to argue with you in this response. I'm just trying to further the conversation.
Patients CAN feel cared for even while the nurse multi-tasks. It just takes expertise on the part of the nurse -- and not everyone can provide that level of care early in their careers. And of course ... even the best nurses have their limits as to how much they can do well at one time. Unfortunately for new grads, many of them are at the opposite end of the spectrum -- such novices that they must give intense focus to every action they take and that slows them down excessively. Even a good hospital with decent staffing needs the nurses to work at a reasonable pace and sometimes new grads struggle with that.
Yes ... in some places, the system is broken and nurses are expected to carry too heavy a load. But the problems are not ALWAYS due to unrealistic expectations or poor staffing. It's not always the hospital's fault. Sometimes, the problem lies with the new grad who is not learning at the pace typical for a new grad. I've seen new grads standing at the med cart -- rechecking and rechecking their meds -- and then checking them again -- taking forever to summon the courage to actually give that med. I've seen new grads go in and out of a patient's room repeatedly to get supplies and do little tasks because they "didn't think of it the first time." Sometimes, the best we can do is give the new grad tips on how to pick up her pace by learning the practical "tricks of the trade."
I think the OP has gotten some good tips in this thread and some insight into how she might succeed in her current job. I hope she can integrate some of these tips into her practice and wish her success in her current hospital job.
Again, thanks to everyone for replying....I truly appreciate the insight...
On a side note, sistasouls addition was one of the parts I struggles with...while I realize Im that new grad that is still
making 5 trips instead of one to draw blood out of a PICC because I forgot one more flush, and then the new caps, then the......but Im getting better at it...however, I feel like Im not "nursing" anyone....Im merely running my ass off for 12hrs just "doing things TO them" not necessarily for them or even being there WITH them....that is a struggle and I will likely get over it but may be the reason floor nursing is not my cup tea after a few years....dunno...
and just for the record to the last poster, llg, the OP is in fact male ....jus sayin.....no harm, just being a wise guy...
thanks again y'all...hope those that are working right now are having a great night....and those that work in a few hours, have a safe day!
One of the schools that does clinicals where I used to work does not allow students to group timed meds together. If I have a pt that needs pain med at 0755 I will also grab the 8's and 9's while I am in there (unless the pt is writhing in pain and I need to hurry). These students are taught to get the pain med, then go gt the 08 meds then go back for 09....starts a new nurse off right away with learning poor management skills. To the OP: ask for specifics about where your "progress is lacking". I agree with the above about keeping the chit chat with coworkers to a minimum during your busiest times (begining of shift esp).
....jus sayin...
..no harm, just being a wise guy...
llg, PhD, RN
13,469 Posts
I realilze you weren't criticizing or blaming me ... and I'm not trying to argue with you in this response. I'm just trying to further the conversation.
Patients CAN feel cared for even while the nurse multi-tasks. It just takes expertise on the part of the nurse -- and not everyone can provide that level of care early in their careers. And of course ... even the best nurses have their limits as to how much they can do well at one time. Unfortunately for new grads, many of them are at the opposite end of the spectrum -- such novices that they must give intense focus to every action they take and that slows them down excessively. Even a good hospital with decent staffing needs the nurses to work at a reasonable pace and sometimes new grads struggle with that.
Yes ... in some places, the system is broken and nurses are expected to carry too heavy a load. But the problems are not ALWAYS due to unrealistic expectations or poor staffing. It's not always the hospital's fault. Sometimes, the problem lies with the new grad who is not learning at the pace typical for a new grad. I've seen new grads standing at the med cart -- rechecking and rechecking their meds -- and then checking them again -- taking forever to summon the courage to actually give that med. I've seen new grads go in and out of a patient's room repeatedly to get supplies and do little tasks because they "didn't think of it the first time." Sometimes, the best we can do is give the new grad tips on how to pick up her pace by learning the practical "tricks of the trade."
I think the OP has gotten some good tips in this thread and some insight into how she might succeed in her current job. I hope she can integrate some of these tips into her practice and wish her success in her current hospital job.