How do you all like to start your shifts? - page 4

by 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... Read More


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    First I visit my patients and assess/chart in the room. If they need any prn meds, I get them before moving on to the next pt.
    I start my 2100 meds around 2030. I save the diabetics for last or after the accuchecks have resulted, in case I need to give insulin with the meds.
    Then I do any dressing changes/treatments.
    Make sure they're tucked in and comfy.
    I'm usually finished by 2130.
    albsRN likes this.
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    It really all depends on the night. If I get there, and have a crashing and burning patient, then obviously, I assess them first, and pick up wherever the previous nurse left off. Get them stable, however long that takes, and then spend maybe 5 minutes quickly assessing my other patient and administering their meds at the same time. Then, on a night like that, I chart my assessments whenever I have the time, which may be at 2300, 0100, or 0700 lol if the patient is unstable all night long, and I still have my other patient to care for, etc. It's pretty atypical that I have to stay over my shift, but on nights when someone is very unstable or I get an admission at 0500, then I will be staying late to chart.

    Typically, I get there, receive report from the offgoing nurse, do my chart checks to ensure everything has been done; if not, then I call the lab to see if labs have been drawn or whatnot; assess both of my patients, and if it's close enough to 2000 and 2100 to administer those meds, then I assess and administer meds at the same time, draw serial labs if applicable, blood sugars, etc. If it's still only 1915, then I assess that patient, and assess the other patient, turn/reposition, chart on both for a little while, and then administer meds. Then, the families come back around that time.

    Really just depends on the night, and what's going on in the unit. If one of my team members has a more difficult or unstable patient, then I help them for a little while prior to going into my patient's room. You'll find a good routine in time.
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    I used to have 1030 meds, at that job I would do all the assessments and dressing changed or whatever I could fit in the one between 730 and 930. I would have everyone documented on and assessed well before 930 and usually ate breakfast and drank some coffee. The at 930 I would start meds...that's if I didn't have discharges and admissions or blood or someone getting cathed etc.

    At my current jobs the am and pm meds are 830 so I can assess/give meds/dressings/etc in one fell swoop right after bedside report. 830 made me anxious at first but I quickly realized it was more efficient.

    I'm all about getting **** done fast
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    If I get an admission at shift change, that delays things a bit. As long as they are stable, I allow them to get settled, eat something, get orders straight, then reformulate. I don't tend to stray too far off schedule though.
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    5 cigarettes in my car before I go in and a redbull.
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    Coffee and a good gossip before report starts.
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    Coffee! Coffee! Coffee! Try and wake up...more coffee! All trainees know not to ask me crazy questions til after 1000!

    Okay, seriously...get report and chart review while I drink coffee. Do turns and look at patient with off going nurse. Review meds, labs, and tests, print tele strips & post in chart. Get organized and plan day based on report and review of chart. Start assessments, check IV's, gtts, tele monitor, meds, hygiene, activity, and meals with first patient. Repeat with the others. I try to do assessments and first meds by 0900 and get charted up by 1000. I get interrupted by doctors, lab, radiology, surgery, the patient, families, therapies, miscellaneous phone calls, etc...so I regroup and reassess what to do next. That's assuming my patient doesn't crash! Repeat throughout the shift...remember to eat and pee too!


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