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Advice to Nurses — Get
Organized
Dodi Iannaco, RN, MSN
Nancy*, a new RN on the
medical/surgical unit, listens to report at the start of
her first shift after orientation. Her eyes widen as she
learns the details of the six patients she has been
assigned. One patient has an IV heparin infusion, another
needs a blood transfusion today, and a third patient has
a tracheostomy that will need suctioning and care.
Although the three other patients seem less complicated
— one has IV fluids and two are expected to be
discharged today — Nancy emerges from the report
room with panic in her eyes.
“How can I handle it
all?” she wonders. Lisa*, an experienced staff
nurse, senses Nancy’s tension and intervenes. She
sits down with Nancy and encourages her to relax. After
several years as a med/surg nurse, Lisa has become
organized and efficient. She helps Nancy through the day
with the following organizational tips —
- Use a
systematic report sheet. You will save
time by organizing all your patients’ data.
Some facilities have computer printouts with all
the pertinent patient information for each shift.
If your facility does not have this type of
system, you need to create a report sheet with
sections for demographic data, diagnoses, diet,
activity status, IVs, cardiovascular info,
respiratory info, genitourinary info, and testing
(such as glucose levels or scheduled
diagnostics). Also, leave room to write your
assessment and any new orders.
- Know your
resources, and don’t be afraid to ask for
help. During orientation, most new
nurses are paired with one or two preceptors.
Preceptors typically enjoy working with new
nurses and are friendly and knowledgeable. They
welcome — and expect to answer —
requests for help and advice. Also, keep an eye
out for nurses who are skilled in a certain area,
so you can ask them for help when you need it.
For example, a nurse with good IV insertion
skills would be the person to ask to help you
with difficult IV starts.
- Develop
time-management skills. Build your
schedule around tasks that must be done at a
certain time, and set deadlines for your other
responsibilities. For example, a day shift nurse
might design a schedule something like this: 7 AM
— get report; 8 AM — assess patients
and begin medications; 9 AM — complete
nurses’ notes; 10 AM — check lab
results, etc.
- Delegate to
ancillary staff. If you have licensed
practical nurses or nursing assistants on your
unit, don’t be shy about assigning them
tasks. You can start by asking for help and
completing tasks together. For example, you could
say, “Mrs. Jones needs to be ambulated but
is very weak; can you help me do that?”
Teamwork pays off.
- Always ask
for help the first time you do a procedure. Maybe
your unit has a charge nurse or clinical care
manager who can help with procedures. If not,
review the policy and procedure manual before
doing something you have never done, like
inserting a nasogastric tube. Then find a nurse
who can guide and assist you during the
procedure.
Above all, don’t be
discouraged if you don’t know everything about
med/surg nursing in the first six months on the job.
Med/surg is a specialty in which nurses can take care of
a variety of illnesses. Being organized and making use of
the resources available to new nurses will help —
but it takes time. Be patient with yourself, and good
luck!
*Names have
been changed.
Editor’s
Note: For more career advice, watch for
CareerFitness® columns by Dear
Donna in Nursing Spectrum or go to: www.nursingspectrum.com and ask Dear Donna!
Donna Cardillo, RN, MA, a well-known career guru, is
Nursing Spectrum’s Dear Donna and author of Your
First Year as a Nurse: Making the Transition from Total
Novice to Successful Professional.
Dodi
Iannaco, RN, MSN, has been a staff nurse at Virtua West
Jersey Hospital, Voorhees, NJ, for six years.
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