How do you organize your day?

  1. Hi,
    I'm a new grad RN on a critical care step down unit. I'm trying to figure out how to best organize my 12 hour day. Any tips? Thanks!
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    About supernova004

    Joined: Mar '06; Posts: 32


  3. by   NotReady4PrimeTime
    You can start by designing some kind of worksheet that will give you an hour-by-hour breakdown of scheduled tasks. Everybody has their own idea of what this worksheet should look like so you may have to try a few before it works right for you. You could make a grid with the hours down the side of the page and the patient names/room numbers across the top. Then list things like meds, tube feeds, treatments, routine tests and so on for each patient in their column. That will tell you at a glance what you have to do in a given hour. It will also help to show the times that will be available for you to do things that aren't a regular occurrence. Cross out the things you've done as you've done them, and make a note of the time on your grid. You can also make notes in each person's column... things like vitals, ins and outs, need for PRNs, test results and such that will help with your charting. When I worked in the stepdown nursery, I made a worklist for each of my 3-4 patients and kept them at the babies' bedsides. This worked because the unit was one big room and I could usually see all my patients from wherever I was. It was helpful for the nurse who covered me for breaks to see what had been done and what was left to do. Now that I work in a PICU, I make my worklist on the flowsheet, and there are a lot fewer things that I need to remind myself of. Give it a try and see if it works for you.
  4. by   supernova004
    Thank you!
  5. by   liv2b
    thats awesome janfrn! thank you for your experience on the matter.
    i came across one a "paper brain" and posted it here:
    any ideas for improvment? notice this nurse puts everything down and not everyone wants to do that. these sheets really help with charting when you might need to know when you intervened. and they are more clear than writing it down on the back of a patient list.
  6. by   NotReady4PrimeTime
    There's way too much information on that paper brain! Mostof what's there I owuld be putting on my flowsheet and our unit nursing assessment sheet. The more times you write something down the more likely you are to make a mistake. But I suppose it would be useful in developing a rhythm to the shift so that after awhile you would be able to condense it to just the vital information.

    I've seen similar paper brains used to organize report on ICU patients and I used one for a while, then I only jotted down a few pertinent details and now I don't write anything down. Eleven years of using the same format for report does allow for some license, don't you think? Especially since a lot of what I hear in report I will be independently verifying when I do my assessment and documenting. I've learned that I can trust my memory for the important details ( and a lot of the junk too :imbar) and don't need notes for rounds. That level of comfort only comes with experience, though.
  7. by   nurseannika
    I've been out of the hospital for about 18 months now (been a nurse for 3 years), but I always felt like I was pretty organised as a new grad. I usually arrived to work about 15 minutes before report. This would allow me to collect all the pertinent data I needed from the Kardex, labs, meds. I also constructed my own brain which helped me organise everything.

    Also, I had one of those pens with 4 different colors...I used red for allergies/dangers/were in isolation, blue for diet (fluids, TFs, tpn, etc) black for patient history/dx/any scheduled procedures, and green for any meds. This was initially tedious but once I got used to my system, it helped my brain focus in on what I needed.

    Not sure how your exact unit worked, but my shifts were 7am-730pm with 9/12/5/9, etc med passes. After report, I would determine which patient was most critical to see (i.e., the day 1 trach pt versus the walkie-talkie appy patient), do vitals, blood sugars, and assessments, inquire about pain and get pain medicine. I would then go around to each patient so this would be from about 730am-830am if all assessments were ok. Then I would start on 9am meds. After meds were given I would chart, and then help out with baths while waiting for am MD orders. Then dressing changes and new orders, etc.

    One thing that always helped me was charting as the day went along. All of our charting was computerized and we had computers at every room and a few throughout the unit plus a computer room. I at least tried to chart 2-3x throughout the shift instead of all at once at the end of the shift when you just wanna go home. Also, if your unit requires notes our computer charting program allowed us to write notes but not publish them right away. So I would sometimes start my note at noon to cover all of my morning activities, and just update it at the end of the shift. So much easier to remember at noon what happened at 8am instead of trying to remember at 7pm when you just wanna go home. :heartbeat