Any hints for organization?

Tephra · Jun 16, 2004

Did you have some sort of daily task checksheet you worked off in school? If that was helpful to you, you can modify that to help guide your work. If not, maybe you can make up a form that includes typical tasks/assessments needed for your shift and work off that. Only problem is, papers tend to get lost LOL. (After time, the routine becomes imprinted into your brain and you won't need the checksheet but it does seem to help the new grads.)

Many hospitals work off a computer-printed Kardex/MAR (mine does) -- I have a place on it that I make notes of things that will need doing during the shift (dsg changes, labs to be drawn, docs to call, questions/advisories for the next shift, etc.). I cross them off as I get to them.

KaroSnowQueen, RN · Jun 16, 2004

I take report on my cardex by making the following notations and filling them in as report progresses:

*A&O:, Heart:, Lungs:, O2:, IV:, IVF:, PPP:, Ed (edema):, BS (bowels sounds, last BM, abd soft/firm/whatever):, F/C (or voids):, Accu (accuchecks ac/hs, q4h, whatever):, Skin (includes dressings, rashes, etc):.

*I write notes out to the side re: reason for admission, recent findings, etc.

*I then have a paper worksheet which I made on Works Spreadsheet, that has boxes for each pt with name, room #, dr, dx (diagnosis), diet, all of the above categories I used in report, procedures, consents, labs, dressings, call out to dr, chart check, meds, etc. I fill this out after report, and use it as the top sheet of my clipboard all day long. There is an empty space at the bottom of each column and I write in new orders in red, and cross out changed info, such as IV restarts, IVF heplocked, dsg now OTA, etc.

I have been a nurse 20 years and have made out my little "cheat sheet" every day. This helps immensely.

*It also helps to have your own little "shorthand code" when you are taking report. Sometimes I give report to people who write EVERYTHING out long, even "oxygen" for O2!! and I wonder how they ever get anything done!!!

*Also look thru my MARs right after report, write under each pt's name when their meds are due (9,12,1,2,5,6, whatever) and sign my name on each freakin' sheet of the MARs.

*Then I get on the computer and look up each pt's labs. If they're ok, or within a point or two of normal, I just make a mental note of it. If something or everything is off kilter, I print a copy and put it on on my clipboard next to that pt's Kardex, and if it's really weird, then I go immediately and put out a call to the MD,^^ (AND always chart in the nurse's notes or wherever, that you have noted the abnormal lab and that you called the doc and talked to "X" & put down their name of whom you talked to at the office/service, and that you are awaiting return call. Then chart when he called back and what he said, or if he didn't and you called again. This is personal pet peeve of mine but has got me out of some jams when the doc says, "Nobody called me about XYZ")^^.

*Also, doesn't hurt if your Kardex lists all the consulting MDs to write out by their name what their specialty is, if you can find it out. I hate to get an order from dr to "do X if ok with Cardiology" and have to wade through a list of six or eight consultings to figure out which one is which. Of course once you've worked in a place a while you will know off the top of your head who is who, and just have to look up the occasional odd name.

*Basically, it's taking 15 minutes to make a detailed list and follow through with it.

Hope this helps!!!

Underbedmonster · Feb 13, 2005

KaroSnowQueen, your post was a great help for me. I'm in the first half of my senior year as a nursing student, and we're increasing our patient loads. I'm trying very hard to get organized, since my instructor is adept at removing one's rear before you ever realize she's there. I've been scouring the web for nurses' routines, and you're the first one I've found who actually listed what you do! Most just say, "you'll get your own routine with time." Tell that to my missing rear, heheh. Thanks again!

starcandy · Feb 14, 2005

I have been working for 8 mths and I still have not become organized. I devised another new plan to start tomorrow. If I am working with a CNA I will make sure that they pass water at the beginning of the shift. I hate when I pass meds and there is no water at the bedside. I will make sure everyone that is on telemetry monitioring that it is on. After report I will attempt to do my all of my assessments. Most days this strategy does not work because it depends whats going on and countless interruptions. I will create new spaces on my kardex for assessments completed and telemetry strips read. I am juggling two or three things in my mind at any given time and I am afraid I am going to forget something important. Last week a pt had a stat med to be given I noted the order and forgot to send it pharmacy and completely forgot about it. I do not care how backed I am I will go over the MAR before I leave. I will put pt med times on my report sheet. No harm came to the patient but working and trying to juggle so many tasks is difficult. Some days it is so difficult to stay organized. I know how my day is going to go when I am called over the intercom at least five times before I have recieved report. I do not know if I ever will become organized and this makes me feel really inadequate also. Some nurses seem to be really good at organization and others do not. I wonder what the successful nurses do differently but I realize everyone routine is individualized but how to be successfully organized in nursing is a 60 million dollar question.