Med-Surg, 3-11 shift:
-Arrive shortly after 1430, make assignments, print worksheets between 1445-1500.
-Receive taped or verbal report, hopefully beginning before 1500.
-Check charts (and if I have time, check the charts I'm covering for LPN).
-Check meds and make a list of meds/when they're due.
-Assess patients-- anywhere from 4 to 6 pts. (I carry the nursing flowsheet with me and try to chart while I'm in the room with the Pt; If I'm really short on time, I just jot down "abnormals" and chart the rest later. I give report off of the flowsheet so I don't have to write assessments twice.) I carry 1600 IV meds with me and hang them as I see the patients.
-Usually there is at least one discharge, PACU, or ED patient that I'll have to deal with in the first hour or so, and also, lots of patients still coming and going from tests-- radiology, GI lab, post-arteriogram, etc.
-Call docs for Coumadin or IV or other orders they've missed when doing rounds earlier after first checking labs.
-PCT's get vital signs and Accuchecks between 1530-1630, so deal with abnormals.
-Dinner arrives around 1730. Help set up pts., feed, if necessary, and give 1800 meds.
-On an UNUSUAL night, go for 30 min. dinner between 1800 and 1900 to the cafeteria. Otherwise, eat when able in the conference room. I almost always bring my dinner from home or if no time, always carry a "Kashi" bar (meal replacement bar) to cram in at a rapid rate, sometimes standing in our med room/kitchen.
-2000: meds, begin wound care, shave preps, etc. (Visiting hours are over at 2000), help with p.m. care, clean up rooms. (I usually tidy up earlier as time allows as I'm in and out of the rooms.) Deal with abnormal 2000 vital signs.
-If there's time, I clean up/update profiles and care plans
in the computer. If no time, I write on the profiles- lab results, new orders, labs due in a.m., etc. for 11-7.
-Write IV credits, I&O results for PCT to collect and chart by 2200.
-Deal with abnormal 2200 Accuchecks, give hs snacks to diabetic pts.
-Try to tape report before 11-7 is ready to listen at 2245.
-Put flowsheets back in the charts. Get any IV's ready (time-taped) to hang if they're due to come down near 0000 or so.
-Updates to 11-7 nurses after report received.
-Count narcs and leave sometime after 2315.
This, of course, is the bare bones and leaves out all the problems and chaos and surprises inherent to our wonderful jobs, as well as answering phones, taking off orders, answering call lights, ambulating pts., teaching, talking to family members, etc. etc. etc.!