Reports, charting, administering drugs, assessments, tidying up, more charting, and more reports—and no meaningful interaction with the patient.

Suzanna’s first year was a nightmare.

Suzanna, a new nurse on a pediatric ward, didn’t like having to live by the laundry list of to-dos. She was most fulfilled spending time with patients, making sure both their emotional and physical needs were met.

The bottom line: You can’t be a nurse minus the tasks.  That’s why Suzanna’s first year was so shocking.

A 12-hour shift would often slip by without having engaged with one patient. Fearful of not getting her job done right (and of the sneering remarks of a few seasoned nurses that inevitably would follow), Suzanna’s mantra was “Am I getting my tasks done?”

The mental cataloguing buzzed in her head even after her shift.  She wondered what she forgot to report to the incoming nurse, if she administered the right medication to Patient D, and if she confused Patient C’s charts with Patient A’s.

“It all drove me crazy,” says Suzanne, “because that’s not why I went into nursing. I wanted to spend time with the sick children on the floor.”

Small Changes

Well into her first year, Suzanna had an “Aha” moment: “I couldn’t continue running around for 12 hours and not know much about the needs of my patients. I realized I needed to make a change: I needed to disengage a bit from the tasks and find small amounts of time with the patients – and enjoy that time.”

But how do you realistically do that?

Dr. Cece Grindel, RealityRN advisory board member and veteran nurse, shares the practical ways new nurses can make sure the patients don’t come secondary to the tasks.

1.   Prioritize your patients. Ask yourself who has the greatest need during your day. You will find that some patients (and their families) need you more, because they are having a difficult time dealing with the illness and its repercussions, are depressed, need education about some aspect of care or treatment, or are afraid of upcoming treatments or diagnostics.  Pick out one or two patients each day that need special care, and focus on them.

2.   Plan time. There are times throughout the day that are more conducive to therapeutic conversation. For example, early mornings are flooded with activities (am care, mealtime, diagnostic testing, etc.), making them a bad time to drop in.  By mid to late afternoon most testing is done, and patients are more settled and relaxed—this is a good time to talk with your patients. If you are on the 7am-7pm shift, take advantage of the patients’ waking hours. Often in the evening--after visitors have left--patients are more reflective and will share their needs with you.

3.   Delegate. Rethink how you delegate to your team members, particularly your unlicensed nursing staff.  If a patient needs your listening ear, discuss this need with your assistants. Together determine how the workload could be altered so you can have some time to talk with the patient(s).

4.   Talk while at task. Use some of the time you are doing tasks to encourage the patient to share his/her concerns with you. For example, while hanging an IV, ask the patient about his concerns for his upcoming surgery. When doing a dressing change, initiate a discussion about the patient's diagnosis with pancreatic cancer.  Or while distributing medication, ask about his/her family, passions, or hobbies.
Yes, tasks will always vie for your attention; but you never should sacrifice the patient. After all, they are why you come to work every day. While not as measurable as hanging an IV, changing a dressing, or distributing meds, meeting your patients’ emotional needs is essential to your work—and often the most satisfying.

Related: Balance, Caregivers, Caring, Charting, Communication, Delegation, Expectations, New Nurse, New Nurse Tips, Patient Advocate, Patients, Prioritizing, Teamwork