Brain Sheet

LalaJJB said:

Am I the only one out there that has no idea what a brain sheet is? I'm assuming it's some kind of organizational thing, but I've never heard that term before. Can someone be so kind to explain it to me?

It is an organizational tool for keeping information on your patient together. It may include any variety of things depending on the unit and what is needed.

It can include data from report, assessment data, VS, accuchecks, etc.

They are usually a typed form and you fill in data throughout the day. Some enjoy a typed form, others just use a piece of paper and scribble. If you use the search box in the upper right, just type "brain sheet" and you will find a wealth of them. Esme12 has a number of them that she often provides.

LalaJJB said:

Am I the only one out there that has no idea what a brain sheet is? I'm assuming it's some kind of organizational thing, but I've never heard that term before. Can someone be so kind to explain it to me?

Maybe "report sheet" is a term you are more familiar with?

I have one that I used in the ED all the time...it's stored on my work computer, so I'll send it to ya when I get back in on Saturday

I just started in er (minor care to begin, then hopefully advancing to the main er in a year or so) after working a rehab type setting. I loved my brain sheets but quickly learned the way I used to do it won't work in this setting. I started using a blank piece of printer paper folded into fourths (fits perfectly in my pocket) and whenever I go into a pt room, enter X-rays labs whatever, I document the time on the left side, pts room number and initials and any info I want to remember for charting. Once I chart it I cross it out with a yello highlighter. Just an idea :)

I used a brainsheet on the floor, but I had a fairly stable group of patients (6 on average with a turnover of half of them qday) and the reason why I used it was for report. Since I discharge so many patients without transferring them to another nurse a sheet like that would be kind of pointless and a waste of time.

There is a nursing iPhone and iPad app to make it easier for nurses life and it ibased on the brain sheet. You can also keep track of completed tasks are completed and shift information too. App is called myShift and check it out in Apple app store.

I use plain 8 x 11 paper. I write as follows

Name Chief Complaint

Allergies

Abnormal labs IV location

I underline tasks that have been done and "circle" tasks that need to be completed.

Esme12 said:

I see that you are working a CDU...a clinical decision unit. There are CDU's that are adjacent to the ED in many ED's I have worked. You will need to be highly organized......for there will be almost hourly labs for cardiac rule out etc......You will need brain sheets.....organization is key!

Hourly labs on a rule out ACS patient? Maybe I'm misunderstanding you. Even most of my ICU patients don't need labs hourly. ?

Our obs patients admitted to r/o ACS get 2 additional sets of cardiac enzymes drawn q4 or q8 ... and a stress and/or echo done in the meantime ... and discharged.

When I float to the ER, I use paper towels, scrap pieces of paper....even alcohol swabs (writing on the outside package) if I don't have anything to write on. I just write notes. I have brain sheets when I'm on my own floor (or ICU or wherever they decide to send me) but I find in the ER it can kind of slow you down...probably because you usually only have these patients for a few hours vs. a whole 12-hour shift. Jotting down quick notes on what needs to be done seems to be more efficient, in my opinion.

Esme, I have to say ... in my experience in multiple EDs -- where I am often guiding emergency, medicine and other specialty residents through the admission decision process ... if a patient was requiring hourly labs they would by definition be considered inappropriate for an obs / CDU admit. Obs/CDU patients in my experience are fairly low acuity - those requiring some hours to rule out a condition or get a non-life threatening symptom under control. If a ACS r/o patient goes to the obs unit, but then develops rhythm changes/worsening symptoms/an upward trend in cardiac enzymes ... they become a full admission and are transferred to tele or ICU. And I have not ever seen cardiac enzymes checked hourly.

I absolutely agree with you that the similarity between the ED and a CDU/obs unit is the turnover and the constant coming/going from various diagnostics. I'm noticing an incremental increase in the number of posts related to obs units here in the ED forum because of that similarity.

I don't mean to unnecessarily belabor a point ... but IMHO "hourly labs" are generally not part of an obs unit environment.