How do you all like to start your shifts? - page 3

I'm trying to get into a fairly efficient groove while starting my shifts. My shifts start at 1900, but the majority of my patients don't have meds due until 2100. At or institution, we can give meds one hour before and after the... Read More

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    Depends who I am working after. If I am working after someone who left a mess, I spend the first hour or so answering call lights for pain meds, beeping ivs, and bathroom and checking off all the orders that got left behind. If I work after someone who has their stuff together, I start off by doing my assessments, then do my med pass. I feel like before you leave at the end of your shift, you should make a last round to make sure no one needs pain med or has an empty iv bag. Just common courtesy. But we all have crazy days or that busy shift where you get slammed and can't get to it. But there is a difference between leaving a mess once in a while and those who do it every single time. On my floor we do bedside report, so I have already had a look at everyone and said hello.
    Last edit by MJB2010 on Jan 17, '13
    Soon2BNurse3, joanna73, gonzo1, and 1 other like this.

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    I work both days and night shifts in the ICU. For days my ideal routine after report, peak in on my patients, check/caliper their strips, then look through their orders, meds, ins and outs that I didn't catch during report. Ideally I can actually see my first patient at 0800, do my assessment first thing, check that they have the right safety equipment, check the monitor alarms, weigh pt, zero a line, check cvp, temp, vitals blah blah. Hopefully I can have all of this documented, but by 0830 latest I leave to see my less acute patient, do the same thing. I rarely pass any meds before 9am unless it's super important. At nights it's about the same, but usually less hectic and I make a "shopping list" and "shop" for each patient. We do our baths and change lines/cannisters/supplies at night which is just tasky and time consuming so I find that if I bring everything in the room at the beginning of the shift its easiest.
    MJB2010 likes this.
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    I work day shift. My first priority after getting report is to get blood sugars and insulins done as well as any tx or assessments that are that are best done before people get out of bed for the day (I work in LTC and have a mix of long term and short-term rehab pts). Once everyone is to breakfast, I take some time at the desk to look at everyone's chart and make my plan for the rest of the day.
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    I work ICU days with shift starting at 0630. Get bedside report and take that time to do a visual assessment, ABCs and safety check as well as turn my patient while I have the extra set of hands. We look at labs and go over the previous shifts orders and do a delirium assessment. After report I head to toe assess my most critical patient, check CVP, dressings, oral care, and talk to RT about the POC. Same thing with patient #2. IDEALLY I have both assessments charted by 0800. Then I go back and do meds, accu checks and pass trays if my patients are eating. Typically, docs round from 8-10 so if I have my assessments done and charted early, I can round and be completely in touch with what's going on with my patients.
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    Quote from j_tay1981
    I'm trying to get into a fairly efficient groove while starting my shifts. My shifts start at 1900, but the majority of my patients don't have meds due until 2100. At or institution, we can give meds one hour before and after the time they are due.As a float nurse, the nurse managers seem to believe that I like to start my shift every night with an admission and they seem to believe that I love ending my shift the same way. Go figure....My first assessment is done around 2000.I'm trying to be as efficient as I can. I was waiting until 2000, (an hour into my shift) to do both meds and initial assessments for each patient. That way, I could wrap PRN pain meds they may need into their scheduled meds when I ask about pain during assessment. Sort of a 'one stop shop' method, I suppose. The problem here is that this seems to take awhile.Some nurses, upon arrival to the floor, see each patient briefly and ask if they need anything OR do their assessment then and return around 2100 to give meds. To me, this seems like it would be slower since patients would likely ask for pain meds (or any other PRN) at this time, thus creating a situation where the RN would need to return to give scheduled meds.I know it is about the patient and not about me, but I'm just trying to build a certain amount of efficiency into my shift.How do you all like to begin your shifts?
    As a float nurse, the nurse managers seem to think I like starting my shift with an admission every night and for some reason, they feel the same way about my ending the shift. Go figure......
    amarilla and nightnurse28 like this.
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    I really feel strongly that you can tell a lot about someone by how they treat the float or traveler. Some charges dump on them while others are fair. It is a good show of character.
    StarryEyed, RN, prinsessa, amarilla, and 4 others like this.
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    MJB2010 likes this.
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    I work both days and nights but mostly days. I get in at 0700 and get report, we have something called "safety huddle" so I usually don't get in to see my patients until 0800. I do meds and assessments at the same time. I do all my charting after unless I have an early discharge. I've the chart as you go and I found myself getting too behind. It definitely works for some though.
  9. 0
    IN LTC I round on my pts right after report and narcotic count. I want to know they were all breathing when I took over the shift. Then I review the MAR for the shift highlighting any unusual times for meds or any treatments/dressing changes. I give report to the LNA's on my side (of which there are never enough) and what my expectations are. And then all bets are off! I try to have things wrapped up at the beginning of the last hour so I can make an easy transition for the next shift. Sometimes it works, sometimes not so much!
  10. 0
    I'm a case management nurse. I work 9-5, M-F and I'm salaried so don't punch a clock. I roll in around 9am. Get settled at my desk. Turn on the radio. Make a pot of tea. Boot up computer and open email. Check for urgent referrals first, take care of those then start my task list I set up the night before.

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