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Tips for a hot mess shift

Tips for a hot mess shift

We’ve all had those shifts that seem to be out of our control. The constant of juggling tasks, discharges, admissions, codes, conflicts, you name it!

It’s easy to become overwhelmed at the reactive nature of everything.

This is regrettably normal, even for the most experienced nurse or midwife. Some shifts are just unpredictable, and that is okay.

When faced with a wild time, please remember to be gentle with yourself.  Take a breath, remind yourself you only have two hands and you can’t be in two places at once.

Often re-prioritisation, communication and delegation will be your best friends.

Here are some techniques that might be helpful when the shift hits the fan…

Optimise your shift planner – plan, review, prioritise, repeat – on wild shifts your planner may be out the window quickly. It can be easy to run from spotfire to spotfire, become consumed by the chaos and lose track of the plan – we’ve all been there! 😊

Start with a solid plan at the beginning of your shift, then review as you go. This will help you re-prioritise as things change and assist you to delegate any tasks to ensure the essentials are completed.

Escalate early – if you’re swamped and feeling overwhelmed, seek assistance from your ANUM/in-charge/educator who can help with reprioritisation and delegation. If you’re worried about your patient load, escalate this at the beginning of the shift so there’s more opportunities for help.

‘Phone a friend’ – review your planner and look out for tasks you may need help with. Communicate as soon as you can with your ANUM/in-charge/educator and plan a time to complete tasks together so they can also organise their time and you get the support you need.

Do the big jobs early and prioritise urgent tasks – if you have a high priority task or a complex procedure to do, try and get them done as early as possible whilst you are fresh and still have time to troubleshoot.

Prioritise your notes – documentation is essential to protect your practice. It’s also a task you cannot handover to a colleague for obvious reasons.

  • Try completing ‘on-time’ notes for complex patients or procedures.
  • Put notes down as a task on your planner as a reminder.
  • Attempt to complete at least two patient notes prior to your main break to reduce staying back after your shift to finish all patient notes.

You can always add notes on at the end of shift with updates.

Cluster tasks – when heading to the bedside, check first to see if you can complete any other tasks at the same time.

  • Can you complete obs?
  • Update fluid balance charts?
  • Any upcoming medications?
  • Education or assessments?

If your patient is under contact precautions give them a call prior (if appropriate) to see if they need anything that you can arrange before donning PPE.

Try and squeeze in your breaks – often your tea break will be the last thing on your mind when hit with a wild shift. But you are just as important as everything else. You will be able to focus and be more efficient if you’ve been able to have a break, eat and drink and take a breath.

Drink water and listen to your bladder – please go to the loo! Stay hydrated. Don’t put yourself last. Don’t put off a break, your health matters.

That’s all well and good but what if I am so overwhelmed to the point of screaming or crying?

Many of us have had many teary moments in storerooms, pan rooms, quiet cupboards – you’re not alone.  There are lots of little tactics to help you find a moment of clarity when you are pushed to your limits and are at a loss of what to do next. Here are a couple to try:

  1. Breathe – take a moment to inhale for four seconds, pause. Exhale for 4 seconds, next inhale for 4 seconds – hold your breath for 2 seconds – then exhale for 4 seconds. Repeat.
  2. Wash your hands – seems silly but if you are having a moment find the closest wash station and wash your hands. Let the cool water run over your wrists. If you can, try the breathing technique from above at the same time and just take a minute for yourself.
  3. Active listening – just pausing and taking in all the sounds happening at the time where you are. It’s one of the quickest ways to bring your focus into the present moment and collect your thoughts.

These little tricks above are quick and simple ways to help bring your focus back, ground yourself, and give yourself time to shake out  and re-prioritise.

Have boundaries once you leave for the day. Allow yourself the trip home to analyse your day. Or 10 mins to debrief with your housemate (respecting privacy and confidentiality as you always do) and then try to switch off from work and enjoy your time off.

Do something to relax when you get home go for a walk, exercise, socialise, meditate, journal, put some disco on, call your Mum, hug your Dog – whatever helps you relax, unwind, disconnect from work and reconnect to yourself and your people.

Please remember nursing and midwifery is a 24-hour job and its okay to hand things over that are not time critical or urgent.

Some days will be a hot mess no matter what you do, but hopefully these tips will help you navigate them a little easier.

You got this mate. Hang in there, and if you need extra support please reach out for help.