Can you describe your 12hr 7a-7p shift?what goes on and tips Can you describe your 12hr 7a-7p shift?what goes on and tips | allnurses

Can you describe your 12hr 7a-7p shift?what goes on and tips

  1. 0 hi, ill be starting in august in a med/surg floor, can you describe what goes on,
    what you usually do once you punch in, and describe your daily tasks, and
    time management, and organization skills until you leave at 7pm? I have about 10mos of experience under my belt, i am currently
    working at a sub-acute unit/rehab floor at one of the long term care facilities
    in nj. also, do you think my experience working there will somehow be helpful?
    thank you very much!! any tips, suggestions and advice will be greatly appreciated.
  2. 23 Comments so far...

  3. Visit  Been there,done that profile page
    4
    I don't mean to scare you , but....

    Hopefully you will receive a quick and thorough report. Ask questions after each patient to clarify any thoughts/questions you might have.
    Eyeball your peeps , look at your vital signs and labs and start the AM med pass... ASAP.
    Unless you have the luxury of a 1:4 ratio... FORGET a head to toe assessment. Concentrate on the system(s) that is the reason for admission. While briefly assessing the rest.
    For here on out.. time management and organization are OUT THE WINDOW. You will be running around, putting out the biggest fires.
    Don't forget to smile the entire time. It's now a job requirement.
    Keep up with your meds and IV's at all costs.Delegate to your assistant . If you get flack in any way, start writing them up.

    Good luck, let us know how it goes.

    Please fellow posters... don't even go there with MY advice.. this is how I have successfully made it for 30 years, and considered an excellent nurse.
    on eagles wings, mitral, anotherone, and 1 other like this.
  4. Visit  tokmom profile page
    0
    Can you give us an idea on ratio, whom is on your team? LPN, CNA?

    What I have done that works for me:

    Get my cheat sheet ready with my pt's names

    Obtain report from Nocs.
    As I'm getting my report, I'm mentally going through my pt's acuity and making a mental list on whom I'm going to see first and second, etc..
    Some nurses see the sickest first, others the easiest. See what works for you.

    Once of report, check your med times and labs if back.

    Go round on your pts and do your assessments. Put out fires as needed.

    Pass meds within the next hour prior. Remember, you have an hour before and after.

    Always put in the back of your mind that you could get an admit at any time. I think 'working' ahead in your mind helps you become organized and stay that way.

    Yes, your prev job can and will help you in your new position.

    Congrats and welcome to Med/Surg. I hope you find it as interesting as many of us long time med/surg nurses do.
  5. Visit  lvloverRN profile page
    0
    thank you so much for your time and response..appreciate it!
  6. Visit  lvloverRN profile page
    0
    thank you tokmom for your time and reponse.... and for your encouragement. God bless.
  7. Visit  suziqiluv profile page
    2
    why in the world would a person check their sickest patients LAST?
  8. Visit  suziqiluv profile page
    1
    why would you want to check your sickest pt last? you need to see them FIRST
    liveyourlife747 likes this.
  9. Visit  lvloverRN profile page
    3
    prolly bec you know you'll get stuck with them for a while and might not get a chance to see how the others are doing / baseline upon coming to your shift..im not sure but i guess it depends how sick they are, are they in distress or not, that's the question.
    anotherone, Hay, RN, and tokmom like this.
  10. Visit  Susie2310 profile page
    0
    Quote from lvloverRN
    prolly bec you know you'll get stuck with them for a while and might not get a chance to see how the others are doing / baseline upon coming to your shift..im not sure but i guess it depends how sick they are, are they in distress or not, that's the question.
    When my husband was admitted to a med/surg unit with acute renal failure and sepsis, I certainly hoped he was high on his nurse's (and doctor's) prioritization of patients to see. I would have been very unhappy if I had thought his nurse had given him a lower priority because he was very sick. He needed fluid boluses and antibiotics, and he needed them quickly. People die from septic shock and renal failure. The point I'm making, and that I think the above poster is making, is that acutely ill patients need prompt care and should be a nurse's first priority. The nurse needs to prioritize on the basis of the patient's needs: Who is the sickest, most unstable patient right now, what is going on with them, and what medications/IV fluids or other care does the patient need now to prevent further deterioration.
  11. Visit  tokmom profile page
    2
    Quote from lvloverRN
    prolly bec you know you'll get stuck with them for a while and might not get a chance to see how the others are doing / baseline upon coming to your shift..im not sure but i guess it depends how sick they are, are they in distress or not, that's the question.
    I don't mean pts that are ready to code or even an RRT. I mean those with a zillion tubes, higher acuity, max assist etc..Some nurses see the lesser acuity first to get them out of the way so they can spend time with the higher acuity.
    PediLove2147 and anotherone like this.
  12. Visit  tokmom profile page
    1
    Quote from Susie2310
    When my husband was admitted to a med/surg unit with acute renal failure and sepsis, I certainly hoped he was high on his nurse's (and doctor's) prioritization of patients to see. I would have been very unhappy if I had thought his nurse had given him a lower priority because he was very sick. He needed fluid boluses and antibiotics, and he needed them quickly. People die from septic shock and renal failure. The point I'm making, and that I think the above poster is making, is that acutely ill patients need prompt care and should be a nurse's first priority. The nurse needs to prioritize on the basis of the patient's needs: Who is the sickest, most unstable patient right now, what is going on with them, and what medications/IV fluids or other care does the patient need now to prevent further deterioration.
    Yes, I'm well educated on sepsis. I educate nurses on the protocol. I'm not talking about a severly sick person. (see my post above) I would like to think a nurse would use critical thinking in such a situation and see your husband first, and get him to an ICU where aggressive fluid resus can be done with ABX, pressure lines, etc..
    I'm talking STABLE, but higher acuity...sheesh
    anotherone likes this.
  13. Visit  tokmom profile page
    3
    Quote from suziqiluv
    why would you want to check your sickest pt last? you need to see them FIRST
    OMG people, read the post above!

    I'm NOT talking about ignoring the circling the drain pt that and seeing a simple post op etc..
    Geez!
    I'm not going to repeat myself.

    For the OP. I have done it both ways and it depends on my acuity/load, what I do first. And for the record with over 20 yrs of nursing and certified in Med/Surg, I have never coded any of my pts or been surprised by a down turn. I must be doing something right.

    The only times I have almost ran to a room to see a pt is when some dumb nurse tells me in report the pt's KCL is 7.5 and she could not figure out why the pt is 'sleepy'. Or the nurse who told me a pt's tele was showing something that looked liked gravestones. Now those situations I can tell everyone that I did of course, see those pts first. I also called an RRT and took care of that pt before seeing the lesser acuities.

    This is why you have to use your brain in report to weed through the fluff they give you and prioritized who to see first. If all your pt's appear super stable, go see the lesser acuity if granny is going to take a bulk of your time.
    Last edit by tokmom on Jul 13, '12
  14. Visit  gcupid profile page
    5
    Quote from suziqiluv
    why would you want to check your sickest pt last? you need to see them FIRST
    Each pt assignment is different. You must utilize both time management as well as prioritization. Ideally in a world somewhere over the rainbow where the skies are blue and the things that you dare to dream...blah, blah, you would see the sickest first. But I only have a few years of experience in med-surg, so here is my rationale for seeing the sickest patient last at times......Tell me EXPERTS if you agree:

    Everyone needs everything done ASAP in the hospital setting but its only one nurse to however many patients and in order to avoid sinking and not get pulled in so many directions, unless its critical it can wait. Time management is priority over prioritizing based upon acuity unless it's life or death.

    The patients that are walkie talkie and can swallow pills whole...Im going to hurry up & throw them da*! pills down their throat to get them out of the way bc you never know whats going to happen next. You can take your time with the sickest and not be worried about what all you have to do for the others bc its taking you so long.......Reducing anxiety..

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