Time management

First, congrats on landing your first nursing position!

You are being proactive on trying to develop a routine, which will help in the long run.

One of the most important aspects when accepting a pt assignment is report-make sure you list system wise (ie neuro, cardiac, respiratory, GI/GU, skin musculoskeletal ) to give a picture of your patient; also learn that safety checks are important, so initial rounding is key; you can also cluster you care in your first round by assessing, VS and making sure there are needs that can be met.

Most important that can help organize your time is having a brain sheet.

Look for a brain sheet here on AN:

https://allnurses.com/gsearch.php?cx=partner-pub-9350112648257122%3Avaz70l-mgo9&cof=FORID%3A10&ie=UTF-8&q=Brain+sheet

Brain sheets help a nurse organize what needs to be done; pertinent information, as well as provide pertinent information.

You will be well armed to have one.

Best wishes.

Oh this is my favourite type of thread! How I organise my day.

When I worked on the floor this is how my shift would go.

DAY SHIFT 7-7pm.

1. I always liked to come in to work 10 minutes before I started (many people don't agree with this but it helped me so much). In this time I would check my assignment, read charts, check orders, check labs, check telemetry monitors. This allowed me to develop a small picture on my patients before I even received report.

2. Does your unit do bed side report? During report I would assess the environment at the same time.

Eg: Patient As fluid bag is nearly empty, I'll know to bring a fresh bag in before I do my head to toe assessment. Saves an extra trip back and forward. I would finish my brain for the shift: when meds/dressings etc are due.

3. After report I would assess patients generally based on acuity. Head to toe. Make sure you check your IV lines! Administer their medications and provide assistance with setting up for break fast. Hint: If I had diabetics who needed a finger stick and insulin with breakfast, I would assess them first as breakfast trays often came between 7.15 and 7.30.

4. After assessments and meds are complete I like to get started with patients' hygiene cares. My floor was total care so nurses did all showers/sponge baths/ make beds etc. Your facility would probably use CNA/techs.?

5. After everyone's hygiene cares were complete I would probably take a break myself. Look after yourself! Your patients wouldn't appreciate you collapsing on them!

6.Dressing changes, more medications, answering call lights, admissions, discharges, rapid responses, codes, falls, time consuming patients and relatives! All this things and more are what will slow you down. Ah the joys of the floor! It's because of these constant interruptions that I would (when safe and legal) cluster care.

Eg: my patient A needs a picc dressing change. hospital policy says I have to change the bag and line with the dressing and the patient has an antibiotic due at 10. So I'll do the dressing and antibiotic at 10 to save multiple trips back and forward.

7.hourly round. Trust me, you might think it's annoying and tedious but this will decrease your call lights/complaints and increase patient satisfaction. But more importantly, you will always be in the loop with your patients and their needs. Trust meeee this will be your greatest tool on the floor.

8. Chart as you go. Seems impossible at times but trust me!

This is a messy response I'm sorry! Post shift myself and tired.

thanks guys that helps so much!!!!

Hi ko,

I try to get in 20 minutes early for noc shift so I can fill out as much of my brain sheet r/t diagnosis/surgery/wound, orders/treatments, labs (abnormals and upcoming) assist status, age, IV or SL, DM, tele, O2, diet or NPO, doctor, date of arrival, VS (q8?q4?). This helps me focus on what questions I will have during bedside report. During report, I will note things I can see--IV location, what's running (and what's left in the bag), A&O, O2 setting, etc., eg. RFA NS75 1/4, X3, 2L. I ask about prn meds given and times. After report, I take a quick run through what time meds/IV's are due and decide which order to see patients. I try and do full assessments at med pass time, if at all possible, so they don't have to be woken later. Well, that's the plan, anyway :)

how early do you get to work to look all this stuff up before hand. our job wont allow us to be more than 7 min early and 7 min late. Can i do all that in 7 min? or get there earlier and just dont clock in until i can without getting in trouble?

I always got to work 10-15min early. Wow 7 minutes! What a bizarre number. The OCD nurse in me demands they round it to 5 or 10mins! Haha

right?! its so odd how they figure these numbers out but oh well 7 min grace is what i have to work with lol. i will definitely consider coming in early and then get report that way i don't have to spend so much time after report looking at their charts and go straight to assessments and meds. Thanks!

We don't have a punch clock, or I'm sure there would be limits. It doesn't take very long for each one with a good sheet and circling the stuff--I could probably do 5-6 in 10 minutes if I wanted to :)

well technically, you're not supposed to be working OFF the clock... if you're in early, you're already "LATE". with that being said, there are seasoned nurses on my staff that arrive 30 minutes early, and some leave 30-60 minutes late. we're understaffed, the patient acuity is high, and have NO CNA. 25% of our nurses are per/day nurses who started at our location ONLY to bail after obtaining that golden year of hospital experience. they tell me, if you make it here, you can work ANY hospital... sometimes, you just are not going to finish on time.

The 7 minute thing is for time clocks that round to the nearest 15 minutes. If you clock in 7 minutes or less, you'll get your correct hours. If you clock in 8 min early or late, you'll get an extra 15 min on your day.