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Brain Sheet

Emergency   (24,282 Views 27 Comments)
by porkey2 porkey2 (Member) Member

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Happy New Year allnurses! I will be starting my new job in a 23 hour observation unit and was wondering if anyone had a good brain sheet or any type of organizational tips I could use to help me with the whole process. Im very excited and nervous of course. Any help would be greatly appreciated. Should I just use a regularly med surg brain sheet?

Thanks in advance.

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3 Articles; 2,815 Posts; 30,415 Profile Views

I don't know of any ED nurses who use brain sheets. I designed my own brain sheet when I was a floor nurse. I'm not sure how useful a typical med-surg brain sheet would be for an obs unit. I'd just design my own.

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3,408 Posts; 29,292 Profile Views

I usually just job myself notes and cross out as I do things. Patient turnover is so great that a standard brain sheet would be more of a hindrance than a help.

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emtb2rn has 21 years experience as a BSN, RN, EMT-B and specializes in Emergency.

2,599 Posts; 28,788 Profile Views

Only times I write notes are for holds & psych stories.

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141 Posts; 4,475 Profile Views

Thanks guys, your comments are very helpful, as I was wondering how a brain sheet would be helpful on this type of unit. Any other tips would be greatly appreciated as well. Anyone know what the a day is like on the unit. I will be on midnights, thanks again!

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mmutk has 11 years experience as a BSN, RN, EMT-I and specializes in Emergency Dept, ICU.

482 Posts; 8,332 Profile Views

See attatched for a copy of my report sheet I use in the ICU... I'm not sure if this is what you were asking for when you referred to your "brain sheet"?

MYFLOWSHEET.docx

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NurseOnAMotorcycle has 10 years experience as a ASN, RN and specializes in Med-Surg, Emergency, CEN.

1 Article; 1,065 Posts; 23,971 Profile Views

In the E.D. brain sheets can slow you down. Usually if you do keep notes, it's like this:

(Room) 2- VS, IV, BP up.

3- Labs, urine

4- Recheck temp, meds due

In other words, if I'm going to use a brain sheet, it's more to remind me of what that patient needs at that time. 99% of what I do is computerized and easy to get to from anywhere in the E.D. so no detailed sheet is needed.

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141 Posts; 4,475 Profile Views

Cool, thanks, this helps a lot.

In the E.D. brain sheets can slow you down. Usually if you do keep notes, it's like this:

(Room) 2- VS, IV, BP up.

3- Labs, urine

4- Recheck temp, meds due

In other words, if I'm going to use a brain sheet, it's more to remind me of what that patient needs at that time. 99% of what I do is computerized and easy to get to from anywhere in the E.D. so no detailed sheet is needed.

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The closest thing to a brain sheet I used in the ED was the back of the medic slip, where I would take notes of the EMT's report, add my own observations, and then transcribe it to the chart in an organized format.

In an observation unit, I'm guessing you'll need to include much of the same basic information that you would use on a medical floor, only tailored for the obs unit. Basically on an obs unit, you're doing a lot of ruling out and waiting for conditions to declare themselves, so you're watching vital signs trends, labs, diagnostics, etc. so the physician can determine if the patient needs hospitalization or is safe to return home.

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mmutk has 11 years experience as a BSN, RN, EMT-I and specializes in Emergency Dept, ICU.

482 Posts; 8,332 Profile Views

I suppose the sheet she is looking for is for the "observation unit" she will be working in. I don't see how this is ER related, I also don't use sheets in the ER.

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My ER has an OBS and I've worked nights there randomly. Depending on what you use your's as, because ours is for mainly CP OBS, URI holds and admit holds, will change what will be useful to you. As our OBS deals a lot more with orders as well as computerized systems, you could try what I do and basically just put a little cheat sheet on the front of each chart saying what that person will need at 1900, 0000, 0600 etc. For example, pt 1 may need 6 hr troponin level, EKG, and to place stress test consult with cardiology, then pt 2 may need to be seen by resp for abg's on RA with VS at 20:00 etc. Our ED floats/rotates nurses to OBS so I'm usually ED, but I can tell you be ready for a switch and a lot more paperwork and orders checking.

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