Brain Sheet

[porkey2]

Happy New Year allnurses! I will be starting my new job in a 23 hour observation unit and was wondering if anyone had a good brain sheet or any type of organizational tips I could use to help me with the whole process. I'm very excited and nervous of course. Any help would be greatly appreciated. Should I just use a regularly med surg brain sheet?

Thanks in advance.

[Altra, BSN, RN]

Esme, I have to say ... in my experience in multiple EDs -- where I am often guiding emergency, medicine and other specialty residents through the admission decision process ... if a patient was requiring hourly labs they would by definition be considered inappropriate for an obs / CDU admit. Obs/CDU patients in my experience are fairly low acuity - those requiring some hours to rule out a condition or get a non-life threatening symptom under control. If a ACS r/o patient goes to the obs unit, but then develops rhythm changes/worsening symptoms/an upward trend in cardiac enzymes ... they become a full admission and are transferred to tele or ICU. And I have not ever seen cardiac enzymes checked hourly.

I absolutely agree with you that the similarity between the ED and a CDU/obs unit is the turnover and the constant coming/going from various diagnostics. I'm noticing an incremental increase in the number of posts related to obs units here in the ED forum because of that similarity.

I don't mean to unnecessarily belabor a point ... but IMHO "hourly labs" are generally not part of an obs unit environment.

[emerjensee]

Altra -

From my understanding of Esme's post, she was referring to the point of between the 6-8 patients on a CDU floor, you are likely to be running labs every hour. Not for each patient per-say, but between the bunch of them

-emerjensee