How do you handle an admission?

[*4!#6]

I am a new nurse and still trying to get my routine and time management down. On orientation, I did not get much of a chance to have admissions. Now that I am off orientation I have had a few.

I feel like a train wreck when it happens. All my admissions have either at the very beginning of my shift or at the very end (within the last half an hour).

I am just wondering how you handle an admission. First, what are your priorities? Lets say you have a patient in for a pancreatitis. The patient is in a lot of pain, requesting pain medication. What do you do first? I always get a set of vitals, do a quick assessment, check orders, and order supplies. Then address the patient's needs. While doing that, that orient them to their room. Then when I have time, do the admission paperwork. Does this seem correct? I just feel really overwhemled when I have a patient that is in acute distress being dropped off on me.

And what about my other patients? How and when do I get a chance to see them? Sometimes admissions can be time-consuming.

And what do I do if the admission comes at the very end of the shift? For example, a patient came to me very very late in my shift. I got her comfortable, took her vitals, and gave her some pain medicine. Then I had to give report. Could not act on any orders. Does that seem reasonable?

[RNperdiem, RN]

If you are really, really behind, let your charge nurse know. Maybe she can help with giving meds or performing treatments.

My strategy is "do it now" as general practice if you are getting an admission or not. If there is a 1 hour window to give meds, then 10:00 meds start getting passed at 9:00. Assessments are charted right away.

Other than that, it sounds like you have the right idea.

[8mpg]

Pain never killed anyone...Not saying you should not treat it, but you should know their vitals before giving dilaudid. Dont need a slightly hypotensive patient come crashing down because you didnt pay attention.

Admissions are not a big deal and most people freak out over them for no reason. Get the settled, vitals, assessment, then history. Unless there are some crazy stat orders, I wouldnt worry too much about them on a med/surg floor. A quick glance wouldnt hurt before the patient gets to you.

At shift change, (we change at 7) if the patient comes after 6, settle the patient, get vitals and see if they need something. Oncoming shift will do admit history and assessment.

[Pistachio]

That's quite reasonable. If a patient comes after six I settle them attend to immediate needs and then if I can get more done I do if I can't I don't worry about it.