Tips for a good shift!

[Good Morning, Gil]

Okay, allnurses,

This thread is intended for all nurses out there, but more specifically for new nurses or nurses who have just changed a specialty area and could use any helpful tips/wisdom/stress management techniques!

I guess this thread was misleading as all of you thought I was sharing tips/wisdom that I had. I guess I do have a few tips :). We can do it!

Here are some of my tips:

1). Things are never as bad as you think they may be. For instance, you're anxious about your shift, but it really in all actuality will go well since you're prepared, and know you have resources if you need them. And, if you have one bad shift, that does not mean you're a bad nurse. Go back the next day, and it will go much better. Just keep showing up.

2). Rewards: treat yourselves like Pavlov's dogs. When you get home, celebrate your good night (or day or decent night you had considering the obstacles you faced) by eating your favorite treat. Now, it doesn't have to be a hershey bar every day because this could become very unhealthy lol; maybe make sure you have your favorite yogurt stocked or something.

I'm not praising materialism or anything lol, but there is something to be said for: hey, after x many shifts, I am going to buy those pair of shoes I wanted. Or after this week, I am going ice skating with the girls, which brings me to number 3:

3). Have something to look forward to :).

4). Know that as time goes on, your anxiety will decrease, and you will look forward to going to work. Okay, maybe not always look forward to it, but you will reach a point where you are confident that you can handle most anything that comes along (because you have handled most things by that point; trust me, I have been there before, and it does happen).

5). A good shift is more likely to happen if you are well-rested, and organized prior to work. Have everything ready ahead of time so you're not rushing to get to work on time. This just makes you stressed before you even start your shift.

6). Also, be confident in what you do know. We know more than we give ourselves credit for, and think of how far you have progressed in a short time.

Keep the tips/wisdom rolling!

[LobotRN, BSN, RN]

Hey latina2brn....

Well, it seems kind of silly, but here goes:

* ID Badge/Card Key

* PCA and Cart Keys

* Stethoscope

* Penlight w/ Pupil guage

* Watch

* Hemostat x2

* Scissors

* Calculator

* Ipod (for med info)

* Clipboard

* Day Sheets x10 (aka brain sheet)

* Blank Paper x 5

* Dry Erase Marker

* Hilighter

* Four Color ball point pen

* Blue Ball Point pen

* Sharpie

* Water Bottle

* Chapstick/Lotion

* Lunch

* Snacks

I just know that if I use this to pack the bag, then I'm not worrying as I'm driving, "Crap! Is my ID badge with me?" I hate doing the manual clocking in and accessing the med rooms is a real pain using the "temp badge method" where I work.

On the last two, I leave the little card on top of my bag at the doorway to remind myself to get my lunch and snacks out of the fridge/freezer just before I go.

Oh, and on my brain sheet, I finally found one that is working better for me. It has a pic of a human body, front and back, but fairly large. I use symbols to mark the "what's up" with a pt. For example, I write "20G D5LR 75/hr" with an arrow to the left forearm for site and fluids, circle the left knee for knee arthroplasty (or stab sites on the belly for lap chole, other wounds that need documentation., etc), draw eye glasses on the head and "X's" on the ears for vision and hard of hearing, a "T" on the chest for tele monitor (and the rhythm if weird)....etc etc.....I just like this one, because other sheets I've tried are form based, and then I sometimes can't visualize exactly which pt I'm talking about based on a bunch of words on a form. Making the picture works better for my mind.....

[LatinaRN978]

LobotRN,

Wow! Great input! Thank you so much for the reply! =) Good stuff, especially the brain sheet!

[LobotRN, BSN, RN]

Here's the brain sheet for those who asked.

The "OBS, LDA,Wound, etc." correspond to the order in which our initial assessments and risk assessments show up in our EMR. I check the box to indicate that I've already physically done that part of the assessment w/ the pt, then I cross it out when I've put it into the EMR. The blank spots are for "specials" like when we get overflow pts and I have to do q2 neuro checks on a r/o TIA pt.

The MED portion, I just circle when meds are due, and cross out as I complete. I also use red ink if it is IV Abx or IV Push, those take me a little longer and I'm clued in that I might need a secondary set or syringe for the pump, and I see it more clearly.

The PAIN column is so I can keep track of pre/post intervention, and we have a standard to chart pain Q2. I circle if the pt is on accu-cheks for blood glucose (FS AC/HS), and write down the values as I get them. I'm still thinking of a way to put in lab values that will be fast. I've seen the "stick" diagrams, like the "X" w/ Hg/Hct top to bottom and WBC/Platelets right to left. I sometimes need those,sometimes they're in normal limits. Maybe I'll put a space in just to write in the wack-a-doo values and manually create the "X" or other stick diagram as needed.

So far this has also made giving a better report easier. I've tried to keep a little list of what I am asked consistently in report so I can get that on the form and just have the info at the ready.

Anybody else have good tricks for brain sheets that helped you "get your can in gear" as a new grad?

DAY SHEET 2 doc.doc

[9livesRN, BSN, RN]

Expect the best, be ready for the worse! Be patient, take it easy, and think! Just think! Be kind, resourceful to others ( the pay it forward kind of way) Rest, exercise, live, eat, pray, love!Have fun,Chill it out! Be a watch dog, be observative, think your day through after report before you leave, when you clock out, shake it off, go be your self, let the relax mode kick in!

[9livesRN, BSN, RN]

Hi, Ortho Nurse here as well, I get to work at 630 am, get my assignments, READ PROGRESS NOTES! Check read all the orders from day one (at this point I don't write anything)I take on report, with the patient's chat in hand right on my COW, get my report, verify IV, PCA, dressing site, drains, telemetry, LOC, pain, pulses, wake up the patient just to say hello, and make sure they are ok, update the board with my phone number, then name and nurse tech info. It sounds like a whole lot, but it doesn't take more then 5 min/patientThen I will write my day planner, one page per pt, with a sum of the H&P, hx, allergy, all active orders, meds and times, and plan of the day....Then I cover my blood sugars, if needed, get some breakfast, pee, and it will be 8 am, which it's time to assess all pts, head to toe with in room live charting, cover their pain and take vitals, At 9 am I will draw 10am meds for everybody, one at the time, and place at the pt specific bin, then I have spare time to investigate the chart, help ambulate patients, take report on a new pt, or complete a morning discharge,10 am, I pass meds, ambulate, make beds, give baths, change beds ( I try not to use my tech to spare them some work!)Then I just monitor, ambulate, cover pain, assess, reassess, change dressings, deal with doctors,e eat lunch, pee as much and as many times as I need, take 5 whenever! Admit, discharge throughout the day, at 6 pm I say good bey, wrap up charting, offer help to other nurses, at 7 pm I give report, rethink things and off I go!

[my_purpose]

Here's the brain sheet for those who asked.

The "OBS, LDA,Wound, etc." correspond to the order in which our initial assessments and risk assessments show up in our EMR. I check the box to indicate that I've already physically done that part of the assessment w/ the pt, then I cross it out when I've put it into the EMR. The blank spots are for "specials" like when we get overflow pts and I have to do q2 neuro checks on a r/o TIA pt.

The MED portion, I just circle when meds are due, and cross out as I complete. I also use red ink if it is IV Abx or IV Push, those take me a little longer and I'm clued in that I might need a secondary set or syringe for the pump, and I see it more clearly.

The PAIN column is so I can keep track of pre/post intervention, and we have a standard to chart pain Q2. I circle if the pt is on accu-cheks for blood glucose (FS AC/HS), and write down the values as I get them. I'm still thinking of a way to put in lab values that will be fast. I've seen the "stick" diagrams, like the "X" w/ Hg/Hct top to bottom and WBC/Platelets right to left. I sometimes need those,sometimes they're in normal limits. Maybe I'll put a space in just to write in the wack-a-doo values and manually create the "X" or other stick diagram as needed.

So far this has also made giving a better report easier. I've tried to keep a little list of what I am asked consistently in report so I can get that on the form and just have the info at the ready.

Anybody else have good tricks for brain sheets that helped you "get your can in gear" as a new grad?

LobotRN, I don't know who you are but your comments to this post are amazing and just what this New Grad RN needed!!! KUDOS.