Cardiac Tele floor: I get assignment and look up labs before start of shift. Take report at bedside on 4 pts then get the 1st set of VS and do my assessments, flush IV's, check IVF, gtt's and chart VS, IV & risk assessments using a WOW at bedside, usually finish around 8am. Cover insulin and then start AM meds, pulling from pyxis and med cart. Finish between 9:30-10 and go eat my breakfast-coffee. I chart Assessments, Education and Care plans
after breakfast and chart interventions t/o shift as performed. The rest of the day is highly variable, pt's going off floor for procedures, pacers, CXR, Echo, US, Cath lab, Stress tests, HD. Start IV's (they always go bad when you have a new bag of PRBC's...) Rounding with MD's, updating family at bedside, fetching "stuff" because the CNA is busy in isolation room. Dressing changes, making sure pt get's up to chair for meals and CNA ambulates them. CNA's do baths and most daily care. I may have a CABG with CT's, confused, restraints, multiple Isolation... MRSA, C-diff, shingles, scabies..., Total care turn q2hr, NGT with tube feeding, pain management and multiple IVPB's, Meds t/o the day, 1-2 units PRBC's, Mag & K scales, Accuchecks with Novolog coverage, discharges and new admits or transfers in. Our most common gtts are Amiodarone, Cardizem, Dopamine, Dobutamine, Integrillin, Heparin& Lasix. We only do Insulin gtt's on new CABG patients. I've started the shift (more than once) with patient BP 70's/40's which is usually a RATT call unless the pt is AOx4, asymptomatic, with Cardizem or Amiodarone gtt infusing, Stop gtt, call to MD to inform and get new orders. I usually get lunch around 1430, charge nurse holds my pager and that is my 30 mins to sit.