11.23.2008

the grind

Now that my coworkers have figured out that I'll volunteer for every and any open shift there is, I'm putting tons of hours in. Now, in addition to a couple of days a week acting as supervisor, I'll be running one of the two sides of the facility (one is predominantly long-term care, the other predominantly rehab) a couple days a week. I've shadowed on both sides, following the LPNs as they do their treatments and pass out meds. Now, I've done one day on my own on each side, and I'll probably do more of this next week (I'm working all the way through thanksgiving!).

I got compliments from our director about an admission I ran and an incident report I wrote up. Yay!

One of the pool nurses (who is actually an MSN!) asked me an interesting question. "Which side do you think is more difficult?" she asked. She always takes the long-term care side, which is generally thought by most of the nurses to be the easier side, since there are usually less dressing changes and more chronic patients.

At this point I was nearing the end of a shift on the rehab side, which is thought to be more difficult because there are more treatments and frequent requests for as-needed pain medications.

I told her I thought the long-term care side was more difficult to complete on time, because I'm more apt to spend more time at the bedside on that side, leaving less time for my tasks. This answer seemed to suprise her somewhat, until I mentioned that of that time at the bedside, I spent most of -that- reorienting confused people.

I qualified that by saying that I've really only done one day on my own on each side, and I'm still learning how to organize myself. BOTH of those days had me walking out of the building 45 minutes after the end of my shift, with a verbal report to the oncoming shift being the last thing I do before I leave. There's a voice recorder to record report, but by the end of the night I've left so much paperwork to do I never get out on time.

The paperwork, whether you're supervising or one of the floor nurses, is staggering.

I say this mostly because if I were to bring along on my two carts (meds and treatments) all of the 3-ring binders I need to chart in, they would be sliding off each other and falling off the carts. There are simply too many of them. There's a huge binder for medication kardexes, another one for treatment kardexes, a controlled substance disposition log, a binder containing the nurses notes and assessment flowsheets for everyone on the side for the last three days, and then my 3-page printout for my notes that I write for myself throughout the day (most of which also has to be documented elsewhere in the other binders).

It's true what they say, I spend more of my time wrangling these binders and writing things down in them than I do actually caring for patients. I actually get more time at the bedside as a supervisor than as a floor nurse!

So, I'm getting quicker at it as I continue to fold in organizational tips from the floor nurses, It'll probably take a while to settle in on the scheme that works well for me. I have a feeling that the optimal scheme for me would involve..you know..one of those computer thingies.

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