How do I deal with an overwhelming assignment?

Deep breathing might seem like a waste of time when you have a post-op wheeling down the hall, one patient waiting for discharge and an ER nurse on hold, ready to give you report on your new admission—not to mention your other patients who, hopefully, are holding their own. (Please let them be holding their own!)

But unless you get control of your thoughts, you’re going to spin your way through your shift without ever really knowing what to do next. You’ll lurch from one crisis to another, and then go home with your head still spinning, wondering if you truly did everything that needed to be done.

So find a quiet place and begin prioritizing. Make a list, if you’re a list person. What things absolutely, positively must be done? What has to be done now and what can wait until later?

Then think about available resources. Who can help you? Do you have a CNA assigned to you? Delegate, delegate, delegate! Is there another nurse you can ask for help? Ask! In fact, even if you think the answer is “There’s no one who can help me,” ask anyway. You may be surprised to find a colleague who is more than willing, for instance, to do some post-op vitals for you while you take report from the ER.

If you still feel overwhelmed, tell your charge nurse. Staying quiet helps no one—not you, not your patients and not the healthcare team. Express your concerns in a constructive manner, though. Flying off the handle and loudly complaining, “This is ridiculous! What do I look like, an octopus?” is probably not going to net you any additional help. (Laughter, by the way, can also help you cope with an impossible assignment.) You’d have better luck asking for help with specific tasks.

One final point: If you truly believe that your assignment is excessive and potentially endangering, it’s your responsibility to let someone know. Start with your immediate supervisor and work your way up the chain of command until someone listens.