So, what's your minimum "good shift" standard?
3I'm a pretty new RN, had to float to another unit for nightshift last night (our census was low on the home turf). So, after reporting off, finishing up, know that everyone was breathing and that a nurse had spot checked them before I left, I had the following thought.
It was a good shift if at the end, in this order, things happen this way:
- I charted quantity and quality sufficient to keep my rear end out of a lawsuit and to accurately document the patient' s progress through the night. Yes, in that priority.
- Everyone is breathing (maybe that should be concurrent w/ number one......), pain controlled, early meds done, toileted, and consents done for any procedures, diet orders in, and ideally has fresh fluids hung. OK, I try really hard to think about where the bag is in its lifecycle, but I don't always get that one done. Strike that.
- I get to give report and be finished with that no later than my official end time. Thanks, 'cause today's day staff is one awesome group, they get in and on it on time! I'm serious.
- I have less than 2.7% "Oh crap, did I remember to do X ?" per patient, increased in inverse proportion for later admits during the shift. I loved that 0300 admit today, just not the fact that that admit put me at max pt load on a floor I usually don't work on. Argh. Still, per #1 & #2 above, I did ok.
- I spend no more than 7 minutes finishing up charting so that I don't hit the dreaded 8 minute over that rolls to the 15+ mark for incremental overtime....bah!
- I remember to get my lunch leftovers out of the fridge, especially my lunch bag.
- I remember to put my badge and keys in my bag, and not leave them out somewhere necessitating a call to locate or a return trip to the unit. Or an incident form (bah! again) and extra forms for replacements. Haven't had that happen, hope not to, but it does cross my mind.
- I don't have any pesky meds in my pockets, like insulin, or, oh, narcotics that should have been wasted. That just destroys the whole good shift vibe right there when that happens. Do not pass go, do not collect $200. On previous shift I left with a Lantus Solostar in my pocket. Gosh, that made the trip home a little longer that day....
- My car has minimal frost on the windows.
That's it. What crosses your mind to make you say, "hey, good shift...." as you swipe out and walk away?
5Feb 5, '12 by Ruby Veei'll bite:
my patient is alive at 7:35.
i haven't had to work with dr. imaflamingdonkeybutt . . . or dr. iknoweverythingsowhydon'tyoujustshutupanddomyway.
i've remembered my to get my wallet from my locker, my lunch bag from the refrigerator and the same number of garments i came in with. (coat, sweater, scarf, gloves, etc.)
charting is done, report is given and meds are signed off. even those 6:00 meds that i often give but forget to sign off.
i've signed off my virtual desktop, gmail account, allnurses.com and anything else i ought not to have signed into on a public computer in the first place.
i've remembered which parking garage i parked my car in, on which floor, and i've actually exited the hospital from the correct end to get to the correct parking garage.
i've remembered to touch base with dh if he's actually at work or call him if he isn't. (he often walks me out to the car, which is helpful because he almost always remembers which day of the week it is . . . saturdays and sundays and night shifts i can park in the closest garage.)
4Feb 5, '12 by Sun0408Well besides the obvious.. A minimum good shift to me depends on who's on the schedule. Some of us work better together than others.. The rest falls into place if the right members are on no matter what happens on the unit. I work trauma ICU so its always something, but knowing I am with x,y and z tonight can make or break a shift..
Now, please don't get this wrong.. We all work well as a team and solo but things just fall into place better and the over all vibe is better when we click and not fight/butt heads all shift.
2Feb 5, '12 by tokmom, BSNWhen I arrive an hour after the 0600 shift and I'm not greeted at the stairs or breakroom door by the day shift complaining about their assignment, or refusing to take a pt that they might not even get. I can arrive quietly and get my lunch in the fridge, say hello and get to my locker.
A good day is doing education on a new CHF or diabetic and they get it. That I had the time to sit and do a good quality education without being called on vocera.
Having my favorite team on. I like all my co workers, but some I like better. We work more as as team.
We have the right bed for the right pt. The pt doesn't have to wait for the bed and ED doesn't have to get their panties in a twist keeping a pt until a bed is cleaned.
When my favorite hospitalists are on duty and supervisor. I know things will flow well.
Oh! I get a lunch break. Uninterrupted and in the cafeteria.
2Feb 5, '12 by locolorenzo22when the patient who was really scared about a test/procedure slept well and I was able to answer their questions.
The incontinent patient just got cleaned up at 0430 before next shift got in.
dr. Idon'twanttobeadoctorsoiwon'tgiveyouordersthathelp anything was any of my patients' doctors.
and I got home quick so I can get to bed and do it all over again.
3You know, yup. I like when the previous shift thinks about getting the time suckers out of the way for you when you're starting (like "poop on aisle seven" overhead page) so that you don't have the whole beginning of your start to shift derailed. I like to think that I get some of those suckers out of the way for the team I'll hand off the group to, too. And I like when my bestest resource RN is on and my rockstar CNA (PCA), too.
Oh, and home on time without a whirlwind of shoulda, coulda, woulda making sleep problematic, yup. Like that, too.
And love when I can do diabetic ed, and they are actually interested. Love that!
And sometimes I love knowing that I will have 4 days off, and the PITA in room X has about a 2% chance of still being there. ahhhhh.