Tips for a new nurse

[car2614]

I would welcome tips on time managment and chart documentation. I got a new job 11p-7a and any words of wisdom are welcomed:idea:

[YEGRN]

Hi Car2514 ... I'm thinking that the best tip I can give you is to get your charting done whenever you have a free moment so that you don't fall behind. I see that you're working permanent nights (I'm a night owl myself), and this is actually a good thing for a new nurse because the pace tends to be a little slower, although often your patient load will be higher than days. Also, don't be afraid to ask for help or delegate ... remember to pee and take your breaks! Also, you'll find that with a bit of time and experience you'll develop a "groove" and things will begin falling into place for you. All the best to you!

[NBMom1225]

I have a tip that may save you some time: make a list of all of the phone extensions you use the most (like lab, pharmacy, dietary, etc) and print them on a badge-size paper that you can laminate and attach to your badge...it saves me from having to run to the phone number list at the front desk every time you need to make a call. Eventually you'll probably have the extensions memorized, but it's handy when you're first starting out at a facility :)

[roser13, ASN, RN]

Also make a cheat sheet with lab values specific to the facility and therapeutic drugs levels (digoxin, lithium, etc.). I carried a clip board with my careplans/assignements, etc., and the bottom page was always the Essential Info page.

[stressednurse70]

To help with time management I use a 3x5 index card with pt rooms across the top and time down the side. I then mark the times for pt's meds and if they need a DSG change, blood to be administered, watch for a lab at a certain time (such as APTT for heparin gtt pt.)

The other suggestions are all great too! Good luck!

[himilayaneyes]

One of my tips would be to not double chart...chart by exception as well. Don't check the GI system is WNL and then write bowel sounds x 4 quad,abd soft non-tender...if GI is WNL then all those things are expected. Double charting waste time. Also chart whenever you have a chance...you'll find that charting takes a lot of your time...but eventually you'll fly through it.

[Zookeeper3]

see your sickest patient first, always the most time consuming, but these folks turn on a penny, not a dime and you need a full head to toe assessment of any patient that worries you or the previous nurse.

don't ignore and put off the difficult families until last. If all your patients status are fairly equal, hit the hard ones with the troublesome family first, take your time, put them at ease, gain trust, yes piddle primp and do all the 'small" things you would do on next rounds like mouth care turning,, pain assessment, offer to have the aid tend to them.

It's human nature to avoid these folks and teach them you'll be there when you're good and ready. I promise you, it you can hit the high maintenence family first and appease them, your shift will run smooth. Knock it off your list and be done.

those in pain come either first or next, don't wait until 2am to call the doc that your patient has unrelieved pain, nausea or vomiting, call immediately and fix it, it will save you hours of time down the road. Call early.

Trust you aides, if one says "so and so is acting funny"... consider that an emergency where everything stops and you head to toe assess"so and so". your aides are your lifeline.

Never discount a confused patient for having airway/respiratory issues or metabolic issues. The level of consciousness change, is always your first clue,,, it's respiratory or metabolic and they will code on you if you sedate and restrain them rather than find the issue that is causing it.

That's plenty, I could go on for hours, but this is more than enough food for thought.

[felineRN]

To everyone who has posted thus far, this is excellent advice! I'm getting some 3x5s as we speak!

[Tina, RN]

Right after I take report on my patients, I take a few minutes to make myself a checklist. I divide a blank sheet of paper up, so that all patients are all listed on the front, separated by a horizontal line. On the right side of my paper, I'll make a list of times each patient is getting meds, dressing changes, labs to check, calls to make, etc. Anything important that I don't want to forget. Then, as each is completed, I check it off. I guess it's sort of like the index card idea, but sized bigger. My handwriting is pretty big, I'd never fit everything on a card.

In addition to the above advice, I'd like to add: Invest in excellent shoes, don't take the cheap-o way out! I know it's not a time management thing, but it's extremely important. :)

Best wishes!

[car2614]

Thanks so much would love to hear your "hours of advice"..... Thanks again :)