Forgetting things...

[mcknis]

SO just last night I was giving report to the noc shift nurse and I forgot to tell her that there was a NTG patch on the pts chest, or that I forgot to hang a 1700 Levaquin dose and ended up getting a phone call at 2100 at my house to let me know about it. I forgot to restart it because the IV infiltrated and just did not hook it back up. The nurse was kind and compassionate about the issue, but i felt soooo horrible that I forgot these two important issues.

Is there a way that you guys have found to not forget info? I try to write it down, but sometimes I overlook the points. Is there a great way to organize info for care of 6-7 pts. I find I am overwhelmed with just the meds at times, let alone the actual care and decision making...

[DreamingTree]

Here's the sheet I use to keep myself organized (brainsheet2):

http://drop.io/ShiftOrgSheet

It has more space than most I see, but it's what works for me. On the left side, I list med times, fingersticks, & if RT sees the pt. Also in that left hand box, I check off whether I charted my am & pm assessments, updated the care plan, and completed the 8 hour chart check (this was added to a recent version). Everything else is pretty self-explanatory. I try to only write info that needs to be charted or reported -- brief notes to myself.

Despite my methods, I do forget things here & there. I try to glance over my sheets before I leave -- one last check that all is done.

[AddieRN]

Just reading this thread made me realize I forgot to do something this evening @ work. I'm also dealing with the same problem, Forgetting Things! It drives me crazy. I'm still in orientation, just trying to deal with my problems early. You're not the only one with the problem.

[locolorenzo22, BSN, RN]

we're only human...if it's something that isn't going to kill a patient..we have to deal. I realized the other day I forgot to mention that a patient was on a bicarbonate drip for 6 hours after a procedure....but I knew the nurse could look in the chart to find the rate...and go from there....and the patient was getting the whole bag. Once the bag went dry, that's it.

We use SBAR sheets to give report...I like em because they allow me to organize report. I usually use one when I get report, and I like to use one to give report....I don't always have a chance to rewrite it for the next shift, but I try to use my downtime effectively....The best I can.

Don't beat yourself up. If it's serious enough, you'll be told, and then you can work on it....it usually only takes one time.

[Surgical_RN08]

i think i am in the same boat as you guys. i am trying a few different things. i write down the patients room numbers across the top of a piece of paper. then draw lines down to divide them. i write all the things i do (as i do them soon after i come out of the room) i.e give pain meds, initial assessment, ambulate, started an IV, consults, even if i turn the patient: then write the time next to it . i put a check mark next to it when i have charted it. if there are any new orders, our charge nurses will make a copy and bring them to us (but i check often anyways). if its something very important i need to relay to the next shift i will highlight it or star it on my brain sheet. soooo in report i give the basics (past hx, surgical procedure, name, doctor, fluids, incisions,etc.) from the kardex then i scan down the list "brain" as i am reporting to make sure i am not skipping anything. then i read from the new orders. as far as the meds, when it is 6p i scan to make sure all meds are caught up. but if it is 645p and its time to give report and things got a little crazy, i will tell the next shift that i am overdue for this such med and what time and why. i mean things happen and we are not perfect. i try not to let it happen to often. it only happened once since i started orientation and i also went up to 4 patients that day. i do still forget to write down the simple things sometimes, like education or doing a transfer to the chair but time is sooo crunched...oh well you all get the picture. sorry to ramble:typing

ps. dang! i forgot to chart that IV i started today. lol!

[hikernurse]

I'll use a post it sticky sheet in bright colors to write down changes and info I need to pass on. I stick it on the pt's cupboard (I work in the NICU), but sticking it on your report sheet would work just as well. The fact that it's a separate piece of paper helps the info not "disappear" into the sheet I give report off of.

It's hard to remember everything, I still wake up in the night thinking "Oh no". If it matters, I'll call back the nurse, but usually by that time they've figured it out :).

[RheatherN, ASN, RN, EMT-P]

you just have to get the experience. i am learing that too! be organized and it will come. be doing the same routine with your sheets. find one and STICK TO IT.

at the end of the night, go thru each part of your records. like we have computer charting, so i go thru each tab and each menu i could/would possibly use and double check. i am getting much better, but there are still times where i notice i didnt confirm a stupid IV bag i took out and hung.

it wil come, heck, it has for me. piece by piece!

-GL!!!

-H-RN

[suanna]

I make a space on my report sheet for things that I don't want to forget to tell the next shift. I have another space for my "wish list" things I want the doc to be aware of that require a change in orders or require labs/x-rays, but that are able to wait for rounds. Forgeting the NTP-? wasn't that on you MAR? the nurse should find that stuff on her assessment. The forgotten levaquin -things happen. A blown IV can certainly throw off your routine. It won't be the last time you forget to restart an IV- that's why we have 24 patient care coverage- if I miss something the next nurse can catch it before it causes a complication and visa-versa.

[scoopyjosh]

I set alarms in my cell phone all night long for meds or anything else I need to do. It goes off at the time I set and every 5 min, just in case I'm busy when it goes off, until I look at it and clear it. I have never forgotten a thing since I started doing that!!!

[dianacs]

Are cell phones permitted in patient care areas where you work?

[scoopyjosh]

Actually I never thought of that I work night shift so no one really notices. I keep it in my pocket and it makes a small chime when it alarms.

[mcknis]

I don't carry my cell phone on me at work, but I have thought of bringing in a digital cooking timer that I could clip to my clip board and set for certain times, but haven't tried it yet. I have been using sticky notes to pass off labs or something small to the other shift. I keep my papers organized the same way so i try to stay on topic that way. My problem has been getting report from other nurses who don't always go in the same order each time. I wish we used standard papers with fill in boxes to make it easier for report. You guys are right, i am getting better with it just taking it with time. Thanks for all and the replies can still be coming...