Quote from wintergreen
I have recently started precepting and increase my patient load each shift. With each increase, obviously it gets a little harder to stay organized, Any hints or ticks of the trade that come with experience?
Find out who is the most organized nurse in your unit. Get her/him to share with you thier system.
You need to deveop a system a routine that if interupted will not thow you. You will have your routine interupted and you need to be systematic so that you can easily pick up where you left off.
I get report. I look in on patients. I check charts. I check the meds and times to give them. I assess. and give meds. I do what ever else must be done now then I chart as soon as possible.
Remember check the sickest pts, first.
Remember pts, going for surgery and procedures need to be given priority. If you have CNAs or tech let them do thier job. If they do vitals etc. you should be taking advantage of that to do other things. Don't be afraid to give direction to those persons.
Conscioulsly think about a routine. Write it down if necessary. Thow out what doesn't work for you.
Try to do things in order. Write your self notes to remind you of things.
Understand you will have unexpected events that will throw every thing off.
Take your breaks. You will accomplish more than if you try to work though them.
Do a mini assessment every time you look at a patient. You might not get to do a full leasurly assessment on every patient, and checking some general things and essestial things when you first lay eyes and every time after will keep you from missing something and keep you from HAVING to do a lenghty assessment on every one.
Mini assement. general apearance. color , breathing pattern, symetry, pupils, edema, pulse. Often from that you can write up a good assessment summary and be right on. It only takes a few seconds and you do it as you greet patient and introduce self. basically how do they look, how do they respond, Look in thier eyes, (pupils, sclera, tracking etc) Facial color tells a lot. Touch them. Tells skin temp., turgor, moisture, muscle tone.
Are they breathing normal. If not what is different. acessory use, posture, noisy breaths, coughing. Can you palpate peidal pulses.
Get in the habit of observing every person close on first meeting for these. About all you can not do on the street is check pedial pulses. But in most cases you wont have to with the person on the street because you can tell by general apearance that the pedial pulses are just fine.
I try to do full assessments on everyone first thing but it doesn't always happen. The sicker usually need a fuller assessment but you have more oportunity to assess them because you are by necesity having to do more for them and so you are assessing them as you work with them.