Quote from dadfirst
The first hour of your day sets the tone for the rest of the shift. Getting report, vitals, assessment, and meds passed by 10am is the benchmark that I use. Some days I get it some days I don't.
Good luck to you!!
Totally agree! The first thing I do is get my papers together. We each get a patient summary printout in the AM (0640-0645), which I "tab" by cutting or folding away parts of the margin so I have a tab for each patient. I then print out a scheduled med report for my patients, and write the med admin times at the bottom. It really doesn't take as long as it sounds...I'm often done before the NOC RN is ready to give me report. So then, at a glance to my clipboard, I can easily see what times my meds are due and flip to the appopriate patient's 24-hour summary (where I write notes during report). So helpful throughout the day! I also add a blank sheet of paper over those sheets to jot down my "to-do list" that I make during report and cover confidential info.
If report goes smoothly (done by 0700!), I check for abnormal labs prior to assessing my patients, so that I can include that information in my talk with the patient re: our plan for the day.
If report runs long (still not done by 7:20), I go see each patient, doing physical assessment and passing any 0700 meds that weren't given (iron, metformin usually).
During my assessments, I try to tell the patient our plan for the day...and if things are up in the air, I tell them that. I feel they need to know if we're waiting for labs, tests, or simply an MD to round. Usually, the more info I give my patients at that time, the easier my day goes because they know what to expect. I'm generally ready to chart at least one assessment before my am med pass starts (815-830).
After my morning med pass (sometimes during, if able), I chart, chart, chart...as much as I can. Then, as my patient's are cleaned up, I do my dressing changes (sometimes done during the am med pass, if able). Then, chart, chart, chart...
My goal is to get as much scheduled stuff complete early on so that any surgical admissions or unexpected direct admits can go more smoothly. I'm also the charge RN, so I really want to make myself available to the other RNs (and we have a LOT of new nurses) and review their patient's labs. So, the more I get done early, the better
But, a previous poster was right...you'll get a system that works for you! Mine has changed quite a bit since I started two years ago...