Thursday, November 06, 2014

Gratitude Challenge Day 6 -- Details

My job is all about the details. The details on how my patient looks, what his/her history is, what meds are being given, what the home meds are, when thing need to be given, what everything sounds like etc....You have to be seriously organized.

And I am not naturally organized.
I love how my nurse friends have made some great organizational 'brains' to help them get through their days/nights. I end up spending too much time trying to plug in what I need to in the slots provided in the various 'brains' out there. I'm more of a let's be free kind of person. (wheeee, picture me in scrubs singing and twirling -- never mind, don't picture that). I also have to have everything on one page to make sure I don't miss anything through the night. I'm not good at continuously flipping through individual sheets for each patient to see if something is due for that patient.  So this is how I organize my night.

 At our hospital we get our assignment sheet and individual information sheets for each patient. I just used blank sheets for my demonstration here -- because you know, HIPPA, they frown on us sharing personal patient information.  So my top page is our assignment sheet, and the bottom sheets are the individual patient information sheets, all folded so if I leave my 'brain' anywhere personal information isn't in plain view. I put the room numbers on each folded patient sheet and if there's something really important to know about a patient I'll add that too - i.e., DNR, or NPO, or a PICC line.
The top sheet is where I put everything I need to do for the night. I organize it out by times. In my job there are some time sensitve action items, and I find this helps me stay on target. Mostly it's when my patients' meds are due. I also give myself a note in case the meds are not in the Pyxis and they are in the patients' med bins, or if it's an IV antibiotic (then I'm queued into making sure I have lines etc to hang it). I'm on a neuro joint spine surgery floor so we need to do neuro checks every four hours. For our safety no falls protocol we also need to check on their toileting needs every four hours and check for pain every four hours if they're on a PCA (NO ONE EVER GETS TO SLEEP IN THE HOSPITAL). Our 730 am meds are kind of a gray area between night and day shift, technically they're a day shift medication, but I try and give them if I can, so I put them on my list (I'm nice that way). I also put down when my patients can get their PRN pain and nausea meds. Because it's a surgical floor with a lot of people with chronic pain people, those PRN pain meds are really important. Like REALLY important.
So on each individual page I put down what I get and what to give in report. What I need to tell the CNA about the patient in my report to them, the patient's assessment, their fluids, their diet, what arm bands they have and if I need to add a band (i.e., if they don't have their fall band, or missing an allergy band) pain, times I do things since I'll be charting later.

And there you go. The detailed way and unorganized person, organizes her day. Because in my job, those details are important.

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