You will always feel like your are forgetting something.
When I started in acute care I had a check-list of things that I needed to complete for each patient. Assessments, VS, I+O, charting. If someone needed to have their foley removed I wrote it down. Dressing changed? Wrote that down.
Crossing things off my list really helped me manage my time, and I wasn't constantly second-guessing if I had done something or not done something.
After a while the list got burned into the back of my eyeballs and while I still write down non-routine things, every item on that list is mentally crossed off by the end of the shift. And if it's something like a qday dressing change that I didn't get to -- well that is why we have nurses working 24 hours a day. Once in a while you'll have days where there just isn't enough time to get that one extra thing completed before the next shift comes on.
It takes a while, probably a bit longer than 8 months, but once you have the routine things streamlined you will find time to spend with your patients. An assessment is a really great time to talk with your patient, find out about them, plan their day. I usually spend at least 15-20 minutes with each patient during their first assessment (my patient load is 3 - 4).
And of course my organization recommends hourly rounding. You may already be doing this, but you will find that hourly rounding really decreases the use of call lights and bed-wetting emergencies. When you check on the patient ask them "Do you need to use the bathroom? Do you have pain? Are you hungry or thirsty? Is there anything else I can get for you while I'm here? I'll be back in approximately one hour".
I agree with the above poster that the ICU can be more stressful than floor nursing. While I don't steadily work in the ICU, I sometimes float there. Of course I take some of the less critical patients but I get to see everything that goes on. They have more codes than any other unit which can be stressful and of course dealing with the family can be tricky at times.
Mar 22, '11 by R*Star*RNYou will always feel like your are forgetting something.
