How do you organize your day?

  1. 0
    New grad here. Just received a job offer for my first job! (YAY!)
    I am now a charge nurse at a rehab/long term care facility.

    I'm working evenings (2-10:30) and there will be one other nurse on the floor with me. They average 50 patients (63 beds total).

    The nurses are responsible for passing meds and doing treatments.

    They still do paper charting still.

    I know I will eventually get my own routine and everyone is different but I'd love to hear some tips on how you stay organized and prioritize your care, when do you write your notes etc.
    Oh and are you responsible for writing nurses notes on ALL of your pts everyday or just if something is out of the norm?


    Thanks!!
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  3. 6 Comments so far...

  4. 1
    I just can't imagine having to be a charge nurse as a new grad... When I started in LTC/SNF I was the only nurse on my floor but was not the charge, their was 3 other floors and a more experienced RN as charge.

    With time you will develop a routine. Get to know your patients and staff to start with. Review your facilities policies and procedures.

    Good luck to you!
    Ginnym1981 likes this.
  5. 1
    Quote from Ginnym1981
    New grad here. Just received a job offer for my first job! (YAY!)
    I am now a charge nurse at a rehab/long term care facility.

    I'm working evenings (2-10:30) and there will be one other nurse on the floor with me. They average 50 patients (63 beds total).

    The nurses are responsible for passing meds and doing treatments.

    They still do paper charting still.

    I know I will eventually get my own routine and everyone is different but I'd love to hear some tips on how you stay organized and prioritize your care, when do you write your notes etc.
    Oh and are you responsible for writing nurses notes on ALL of your pts everyday or just if something is out of the norm?

    Thanks!!
    I am also a new grad Charge RN. I am still orienting, but I have been watching my preceptors. They get it done early if possible and cluster care. Dressing changes after showers, etc.
    Ginnym1981 likes this.
  6. 1
    Quote from Ginnym1981
    New grad here. Just received a job offer for my first job! (YAY!)
    I am now a charge nurse at a rehab/long term care facility.

    I'm working evenings (2-10:30) and there will be one other nurse on the floor with me. They average 50 patients (63 beds total).

    The nurses are responsible for passing meds and doing treatments.

    They still do paper charting still.

    I know I will eventually get my own routine and everyone is different but I'd love to hear some tips on how you stay organized and prioritize your care, when do you write your notes etc.
    Oh and are you responsible for writing nurses notes on ALL of your pts everyday or just if something is out of the norm?


    Thanks!!
    I write everything down and check it off as I go,I developed a work sheet for my own use years ago. I document by exception -except for med a residents, they must be documented on Q shift (at least) I also keep a small note book with frequently used and any new policies and procedures written down for quick reference. I always assess any unstable residents (people who are on shift report) and flush any feeding tubes at the start of the shift and get a nurse's note in early on those folks. Make sure you know who is on Coumadin,has a sx disorder,is IDDM,is a full code. Most units have lists behind the desk with this info.If not,make one for yourself.
    Gather your supplies,stock your med cart prior to your med pass.I also look over the treatments I'll need to do and sometimes carry some of that with me (especially the skin creams)so the cna's can call me during care and they don't have to wait (it's an infection control issue,we are not supposed to carry that stuff in our med carts and I'm NOT telling you to do it ) but I would NEVER get done if I didn't carry some skin prep,skin protectant and such in my pockets or in a drawer in the med cart (just make sure you remove it before the end of the shift)
    If you have skin checks,weights,behavior documentation to do make sure you lay the notebooks on your desk so you don't forget them (write it down-check it off)
    Carry some fiber bars,bags of nuts,yogurt-things you can eat fast. It will take you a few shifts to learn the residents likes and dislikes,the routine of the shift and get through the med pass.Don't expect to fly through it initially.Take your time,it does not matter if it takes you 3 hours-accuracy is more important then time.Don't let yourself feel rushed or overwhelmed.
    Don't be surprised if the demented residents give you trouble with their meds,you aren't a familiar face.Don't be surprised if the A/O residents give you trouble with their meds--they need to learn to trust you and they may question every pill.
    It DOES get easier.
    Ginnym1981 likes this.
  7. 0
    I get report, then go and ck on pts with G tubes/IV's/unstable, stock cart, write out list of vitals/showers/weights for CNA's to get (preferably in the first hour of shift), highlite pts who need BS, start med pass. After the med pass start charting, only on the patients that are short term/ABT/neuro's/ status change. By then I start my second med pass, when that is done, start tx's- by then they are in bed and it is easier to do, I work 3-11. That's it in a nutshell, provided that there aren't a lot of interruptions from the long term dementia patients needing to be redirected or the occasional fall or even a trip to the hospital for respitory distress.
  8. 0
    These are really good advice. I am a new RN grad with no experience except school. I just accepted a job offer for a part time position at a LTC facility 2:30pm-11:00pm. I will be responsible for 30 residents and 3 STNAs... There are no charge nurses, the RNs are response for their own unit. I think once we get our routine going, everything will be fine. Just remember to ask for help if needed and never take short cuts during med pass!
  9. 0
    I try to get there as early as my facility will allow which is 5 minutes til (I work 7am-330p). That way I can get report first and be on my way. We work the same hall for 2 weeks then switch. The first day I write my treatments on a list so I can check it off. Then I take that home and type up a sheet without pt. identifiers, just in the order that I get them done on the floor and save it in my computer. Each day on that floor, I can print it off and carry it to work, then I just write the pt. name beside each section. (my sheet will say something like "eucerin, ted hose, bp", next section will say "Ensure x2, Nystatin" etc.)I also have a separate paper that I always carry in my cart about what goes on the MD notification list and what goes on the 24 hour report and when to call the doc answering service on the weekend.


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