Advice for taking 2 patients

[nurseinthemaking24, BSN, RN]

Hi guys

I have been struggling to take on two patients. Even if one is stable and the other is critical, I really struggle to do this. Does it just take more time? What can I do to improve my time management skills? I'm working on clustering my care but don't know what else I can possibly do to implement changes or things to enhance and better my time management while still maintaining patient safety and doing my 3x checks. I'm assuming I will improve overtime but I am just not sure :/

[vintagemother, BSN, CNA, LVN, RN]

I try to get that 1st head to toe (or at least the assessment of the main problems) assessment done first.

For me, it helps to stop after I get report, to map out my day (based on the pts plan for the day- imaging trips, labs, meds, etc) I use 1 brain per Pt and 1 brain with meds / labs for each pt, in a column for each Pt)

 I enter the room ready to do physical assessment, glucose checks and will likely also do a turn, oral care, temp check, etc. then I might chart and then go to the other pts room to do the same. 

I’ve also tried to get faster with my daily cares- I’m still not fast, but when I go in the room, for anything, I do a turn, give meds, educate, do safety checks, do oral/ peri care. As long as it’s within the hour of it being due, I try to do it. 

And chart, chart, chart! We can copy our own assessments for the most part, so I try my hardest to have all the charting up to date and done within the 1st 4-5 hrs, then I can copy and paste my own assessments including any changes easily for the rest of my shift. 
 

I assume our charting is standard (I’ve heard it’s overkill) we do head to toe Q4H, daily cares (incl oral care and reposition Q2H). Gtt rates and VS Q1H, etc

 

 

[vintagemother, BSN, CNA, LVN, RN]

Do you feel you need to be faster with charting or with cares? I’ve worked on charting fast, but as I said, it still takes me what I feel is a long time to clean a pt, reposition them, educate them, give oral care, etc. so I try to be fast when I can - I can give g tube meds or any meds pretty fast, I can reposition a pt without cleaning them really quick. But other things (like cleaning a vented pts BM up or educating family) take me awhile cause I want to be safe and kind to the pt.

[Nurse Alexa, MSN, RN]

The fact that it's so apparent how much you care about taking two patients and performing well - shows how great of a nurse you are and will be.

Keys to perfecting two patient assignments:

1. Cluster care - grab meds, bath supplies (everything needed for daily duties in the morning so it's all together)

2. Document consistently - throughout the day go back to your documentation every 2 hrs atleast so it doesn't creep up on you 

3. Be proactive - if you know your patients going for a test, think ahead and call and schedule. Planning your day accordingly will make the biggest difference 

 

you'll be great ❤️