Why are some RNs rarely busy, while others are always busy

[DesiDani]

Is the RN who is not busy all the time a better nurse, more organized, and efficient? Or is the busy RN the better nurse? I've seen RNs who are never busy, but others nurses say they are horrible nurses.

[Littleblackdog, ADN, BSN, RN]

On 4/12/2020 at 9:24 AM, meanmaryjean said:

I used to work with a nurse who spent the FIRST hour of her shift having breakfast, a second cup of coffee and schmoozing with her co-workers - and the LAST hour of her shift begging for help because she was so hopelessly behind.

LOL, yep, have seen a few of those! Used to work with a CNA who, as soon as she clocked in and got her assignment, would go to the cafeteria and return with a huge breakfast, would take plenty of time eating it in the breakroom, forget vitals and patients who needed feeding! Same at lunch, lot of breaks, working with her was exhausting.

[PrevHealthNurse]

On 4/12/2020 at 7:02 PM, CommunityRNBSN said:

While I am suspicious of people sitting around... I am FAR MORE suspicious of people who constantly talk about how swamped they are! There are one or two nurses at my current job who go on and on and on about how many phone calls they need to make (we are outpatient), how many documents are piling up... I always have a great desire to say “Well maybe you need to stop talking about it, and go tackle some of your tasks!”

So true -- but I think it's a copying strategy that lots of people use and obviously one that triggers you! But good on you for your self control!!

[SansNom]

I think a lot of nurses waste a ton of time charting unnecessarily. Most charting software is designed for us to chart by exception only. Take Cerner, for example. If you click on on the hyperlink to WNL it clearly defines the parameters that you are charting by clicking "within normal limits". So if you chart "WNL" in pulmonary, there is no need to also go through clicking "clear breath sounds" on every lung field, because "WNL" already states that. Everytime I chart I see nurses have charted "WNL" and then they'll go and chart all the normal things too, it's time consuming and unnecessarily repetitive. This adds up to a lot of wasted time over the course of charting for 5-6 patients.

If the the patient has bowel sounds and is pooping and nothing abnormal is happening, just click "WNL" and keep going. If they're having diarrhea then click "WNL except" and only chart the abnormalities. Just seeing something charted to feel better is a waste of time.

The same is true in Epic too.

[Hoosier_RN, MSN]

18 minutes ago, SansNom said:

I think a lot of nurses waste a ton of time charting unnecessarily. Most charting software is designed for us to chart by exception only. Take Cerner, for example. If you click on on the hyperlink to WNL it clearly defines the parameters that you are charting by clicking "within normal limits". So if you chart "WNL" in pulmonary, there is no need to also go through clicking "clear breath sounds" on every lung field, because "WNL" already states that. Everytime I chart I see nurses have charted "WNL" and then they'll go and chart all the normal things too, it's time consuming and unnecessarily repetitive. This adds up to a lot of wasted time over the course of charting for 5-6 patients.

If the the patient has bowel sounds and is pooping and nothing abnormal is happening, just click "WNL" and keep going. If they're having diarrhea then click "WNL except" and only chart the abnormalities. Just seeing something charted to feel better is a waste of time.

The same is true in Epic too.

If the program is set up for the particular facility that way. Each entity purchases the software to be setup how the purchaser wishes, although most go the exception only route

[turtlesRcool]

3 hours ago, Hoosier_RN said:

If the program is set up for the particular facility that way. Each entity purchases the software to be setup how the purchaser wishes, although most go the exception only route

Exactly! We use Cerner, and I freaking hate it. My understanding is we got a pretty basic package, and WNL does not exist in our version. I waste so much time double clicking a million little boxes on that spreadsheet. It's the most ridiculous time-waster.

[LibraNurse27, BSN, RN]

On 4/18/2020 at 6:21 AM, SansNom said:

There's a large degree of individual personality to consider here. I work with some nurses that just seem to NEED to feel stressed to accomplish anything. It's like it helps them focus, and if they don't have a stressful situation, they'll pretty much just create it or imagine it. You could give them an assignment of friendly walkie-talkies with no meds and they'd find something to stress out about. "Oh no, the doctor ordered a CT at 11! It's 8 o'clock and I have to chart a dressing change! Why do I always get the worst assignment?!?!" These nurses often like everyone to know about it too, and they usually have the misperception that if you don't appear as stressed as they are then you are either being lazy or must have a much easier assignment. Also, I've found that these nurses will often reject help when you offer it, as though they want to maintain their stress level (although I doubt that's the conscious intention).

Others just don't wear their stress on their sleeve, like myself. If you see me stressed then you know there's really a lot going on. I do feel like I've done the job long enough to be very efficient and good at what I do, but more so I just don't get overwhelmed very easily.

Nurses that are always behind and always stressed aren't actually given harder assignments, nor are they worse nurses, they just wear their stress differently.

hahaha oh nooo this is me sometimes! I don't mean to do it but I just vent my stress out loud while running around getting everything done on time and refusing help. And as you said it's 0800 and the doc puts in a bunch of orders but they're like 1000 meds, 1100 labs, 1300 CT. But I see it all at once and I'm saying (loudly) OMG they just ordered so much stuff at once!? But I always get it all done, don't ask for help unless I'm drowning, and all pts and docs happy. Only downside is my coworkers laughing and rolling their eyes at my drama! The trick is to multitask: don't stop to freak out; do it while you're working!