This thread is intended for all nurses out there, but more specifically for new nurses or nurses who have just changed a specialty area and could use any helpful tips/wisdom/stress management techniques!
I guess this thread was misleading as all of you thought I was sharing tips/wisdom that I had. I guess I do have a few tips :). We can do it!
Here are some of my tips:
1). Things are never as bad as you think they may be. For instance, you're anxious about your shift, but it really in all actuality will go well since you're prepared, and know you have resources if you need them. And, if you have one bad shift, that does not mean you're a bad nurse. Go back the next day, and it will go much better. Just keep showing up.
2). Rewards: treat yourselves like Pavlov's dogs. When you get home, celebrate your good night (or day or decent night you had considering the obstacles you faced) by eating your favorite treat. Now, it doesn't have to be a hershey bar every day because this could become very unhealthy lol; maybe make sure you have your favorite yogurt stocked or something.
I'm not praising materialism or anything lol, but there is something to be said for: hey, after x many shifts, I am going to buy those pair of shoes I wanted. Or after this week, I am going ice skating with the girls, which brings me to number 3:
3). Have something to look forward to :).
4). Know that as time goes on, your anxiety will decrease, and you will look forward to going to work. Okay, maybe not always look forward to it, but you will reach a point where you are confident that you can handle most anything that comes along (because you have handled most things by that point; trust me, I have been there before, and it does happen).
5). A good shift is more likely to happen if you are well-rested, and organized prior to work. Have everything ready ahead of time so you're not rushing to get to work on time. This just makes you stressed before you even start your shift.
6). Also, be confident in what you do know. We know more than we give ourselves credit for, and think of how far you have progressed in a short time.
1. Keep in mind that nursing is a 24 hour job and you can't and don't have to do everything.
2. At the start of the shift, sit down and write yourself a skeleton schedule; include when you expect to pass pain meds, do dressing changes, pull catheters etc. Highlight things that are your highest priority.
3. Pee if you need to pee, for goodness sake! Your patient can wait three minutes. Two bladder infections taught me this lesson.
4. Have a roll of paper tape, a couple 2x2s, alcohol wipes, stat locks, IV caps and flushes in your pocket at the beginning of the shift. The first 4 hours are usually the busiest and the last thing you need to be doing is running back and forth to do minor things you notice need to be done during your initial assessment.
5. When you have an older confused patient that keeps trying to get out of bed or pull lines etc., take the time to do a bed bath if you can! Then cover he Pt with a couple of warm blankets and turn on some classical music if your hospital has music therapy. This usually puts the patient to sleep and almost always is more effective than Haldol or Ativan. However, if your patient is pulling lines/taking a swing at you or jumping because of withdrawal, go with the meds, lol!
6. Gain the trust of your patients right away, by doing what you say you will do, and little things like wiping their bedside table down with an antiseptic wiper giving them a warm blanket. If they can see you care and want to make them comfortable, they will generally stay off the call lights. Caution: this can backfire at times so be sure to assess your patients psychosocial needs as well as the physical when you first go in the room.
7. Accept the fact that you are only one person, and it's ok to ask for help. You are not super man/woman.
8. Realize that some shifts you will spend the entire time putting out fires, and you won't be able to do any of the things you want to do. On those days/nights, just let it be what it is and remember the shift WILL end!
I'm scared of the 300-500 pound patients, 200 pounds is about average it seems. It's such a delight to get a little old skinny lady, light as a feather, safe on your back.
What's up with taking the two messiest patients, that doesn't make sense? No doubt they are obese and incontinent, unless your plan is to put tubes in them and fix it that way. lol I don't understand why a foley is so bad, they have silver antimicrobial ones these days and if it were me I'd rather have a foley than wet the bed! Just sayin.
We do have a nurse where I work that would come in early and change the assignment to avoid the heavy patients (complex dressing changes, etc). This went on for a long time till finally the supervisor put an end to it. We have another nurse that comes in "late" and then has a meltdown and demands certain patients because she had them before, etc and her coworkers have already gotten report, but they just give in and change the assignment or even float out of turn rather than deal with her drama!
My feeling is, hey if your going to be changing the assignment, at least have the courtesy to come in early! I think it is reasonable to say, please don't give me this patient I've taken care of him and I just need a break! WE are human after all! I think that is the proper way to go about it rather than just sneakily changin assignments!
Good posts! I think maybe she meant the messiest patients as in most critical? So, they're more likely to be sedated, and not thrashing about in the bed? lol. Maybe that's not what she meant, but that's how I took it.
You're comment about the worst shifts making the best stories made me smile. I've had two in the past two months that I've earned some good-natured teasing over.
1. I was in my very first code in our ICU. We were giving RBCs left and right and someone handed me a bag that we just checked. She didn't tell me they weren't clamped. I splattered blood everywhere. Before I realized what I was doing, I turned slightly toward my right and squirted blood all over one of our trauma docs. I wanted to cry. She was cool about it though. Now everytime she sees me she teases that I owe her a shoe shine . Some of the nurses thanked me squirting her (hehe).
2. I made what I thought was a huge mistake that ended up working out for the best in the end even though I didn't realize it until later. I was really upset about it that night and on my way out one of the experienced nurses made a comment about it and I thought she was serious. When I realized that she was joking (and that it's something that happens kind of frequently on our unit) I was fine but it has earned me a nickname of sorts.
So thanks for reminding me that there's always something to be taken away from a shift, good or bad. :heartbeat
- Start everything early on ur shift. Do IV meds first: they take up the most time, ie: mixing, checking & setting up the pump.
- Use a good cheat sheet to get yourself organised.
- Don't let people/patients/families etc manipulate ur time. Learn how to say no or how to handle people.
- Get to work a bit earlier 4 handover & to get ur pt load.
- Learn to prioritise your work.
- Time management & people management will be your 2 biggest hurdles to overcome.
- If u make an error, say something. Don't try 2 cover it up. Report med errors immediately - the outcome won't be as bad as you think. Covering up med errors especially looks worse than not reporting it.
- People will always be annoying, impatient & demanding. Learn how to handle them quickly, talk to a psych nurse if unsure how to do this.
- Always start writing your notes EARLY. The earlier the better. If you forget something after u have written ur notes, you can always add it in later.
-Always call the doc for anything necessary even if it is 3am, and yes...they will be grumpy so expect it. Just have all your facts in front of you & apologise for disturbing them & remain professional. Use a walkabout phone next 2 the patient's bedside so if u 4get anything the doc wants to know, you can access it right away @ the pt's bedside.
- Old patients will take up A LOT of ur time. They can be petulant & very demanding. They love to talk about anything: the weather, their grandchildren, their pets. Do not let them take away ur time - you can be talking whilst doing ur work. Learn good work & people habits, and if you need to get away from a particularly chatty person, just cut them off and say: I will be back Mr/Mrs later on as I have to go see my other patients now. Do not stand & hope for a break in the conversation, cos it won't come - time will fly away from you otherwise.
Use down time (make a little if you have to) to keep yourself hydrated, toileted, fed and so on. There are few things more annoying than worrying about wetting your pants while doing a jaw thrust, for example.
Have fun. Chat and joke around with your colleagues and patients while your hands are busy with tasks that don't require much thought.
Be flexible and roll with the punches. Few things ever go as planned.
Always bring a tasty, nutritious lunch. It's something to look forward to, and gives you energy to get through the day. I usually make a batch of salad (something with protein, like a quinoa or chickpea salad), and then i have enough to last me 3-4 days.
Also, wear quality, comfortable scrubs. It always makes me feel better about my day.
I LOVE this thread! Your suggestions have been noted.
Personally, I noticed that if I TRY to complain less (muttering to myself, gossiping with other staff, venting my frustrations every chance I get), I tend not to get wound up in negativity and my shift seems like it went a lot better in retrospect
. Some of the nurses thanked me squirting her (hehe).
Ruby Vee, BSN
17 Articles; 14,051 Posts
take your breaks. cpr can't wait for your lunch break, obviously, but most else can.
laugh when you can.
the worse shift in the world makes a very good story some day.