daily routine

[sweetieann]

Hey all!

I'm a student here and just wondering about nurses' daily routines (mainly med-surg, etc). Let me explain: last semester, we cared for only one patient at clinical; this semester, we're supposed to have two. Knock on wood, I think I will be able to handle that fine. What I'm worried about is "real world nursing" (ie-5-6 patients assigned to each nurse). I would love to follow a nurse around for one shift and just watch her routine.

Say your shift starts at 7a. By about 7:30 (to approximate), you get the report from the night nurse signing off. What do you guys who work morning shift do next? I know you obviously prioritize if someone has to be at say, the cath lab at 8:00, you'd go and get that person washed up and everything. But if no certain procedures were scheduled, do you think it's best to just go at 7:30 to poke your head in each of the pt's rooms to make sure they're ok, and then just head to the med cart (around 7:45 at this point), get all the meds out and ready, and then be on time to give them at 8am. Then, after ALL 8:00 am meds are give to your pts, THEN go in to their rooms and set them up to be washed/assist them with washing, etc.?

*One thing I think I do wrong is that as soon as I get report, I feel I have to take that 1/2 hr (from approx. 7:30-8:00) to get everyone bathed in a hurry and everyone done before I go and give the 8am meds. Of course, I haven't run into time constraint problems with this yet, because I've only had one measly patient, but I could foresee this "routine" definitly nto working out when I have more patients. I guess in that cse, I'd just get ready whoever I could before 8, pass the meds, then finish gettign the rest of the pts ready (prioritizing who needs to be seen first for whatever reason, of course). Which brings me to my next point (and this may seem like a silly question, but the hospital I have clinicals in now in KNOWN for their unorganization....)when someone has say, an MRI scheduled, does the nurse usually know what time the MRI lab wants the pt to be down their so that the nurse can plan their schedule of care for that pt around that? AT the hospital I'm at now, escort came up at 7:45am the one day and was kind of irked that the nurse didn't have the patient ready to be wheeled down...meanwhile, the nurse (who happened to be a new graduate) said that MRI had called and said they'd be up to get her "sometime in the morning" with no indication of WHEN exactly. I know MRI labs are busy,. but couldn't they have given a little smaller time frame or at least called up to the nurse to see if it was ok to take the pt then?

It may seems slightly nutty that I'm worried about all of this, but I get the textbook stuff...it's just this "real world nursing" that scares me because I know I won't fully experience it till I get my feet wet as a GN. So if ANYONE could just give me a run down of their routine (even though I know nursing isn't routine--anything can happen at any time and you have to be flexible:) ...), I'd REALLY appreciate it!

Thanks so much!

[willtm]

I think what's causing you the trouble is that you are talking about toal patient care--you the nurse are doing everything. If this is the case you will only be taking care of 3 patients--atleast that is our hospital policy. If you have 6 patients you have a tech who is doing many of the things you are talking about -- getting vital signs, filliing water pitchers, changing linens, getting accu checks and baths. The nurse is doing assessments, passing meds, dealing with MDs and orders, radiology, physical therapy, any problems and being aware of what's going on with your tech--abnormal vitals, accu checks.

Radiology usually does not give a heads up on when they are coming--nature of the department. ER has first dibbs (followed by stat inpatients), inpatients can and are bumped for ER patients every day so there really is no way for them to let the nurse know ahead of time.

Nursing school is not real world nursing. Students do total patient care because it's important that nurses know how to do all aspects of care and sometimes in the real world you do total patient care. Sometimes even when you have a tech you still want or need to on a particular patient. Dying patients for example--they must be handled with extra care and they deserve your attention, as does their family. As the nurse it up to you to prioritize and delegate--even personal care that within the scope of practice for a nursing tech.

When you get your first job you should get a good orientation. They may start you out shadowing a nurse, then advance you to 2 or 3 patients with them shadowing/guiding you and move you up to 6 patients a step at a time.

It'll be fine, it takes some practice and organization, but you'll find a routine and a way of doing things that works for you.

Good luck:)