How do you all like to start your shifts?

[j_tay1981]

I'm trying to get into a fairly efficient groove while starting my shifts. My shifts start at 1900, but the majority of my patients don't have meds due until 2100. At or institution, we can give meds one hour before and after the time they are due.

My first assessment is done around 2000.

I'm trying to be as efficient as I can. I was waiting until 2000, (an hour into my shift) to do both meds and initial assessments for each patient. That way, I could wrap PRN pain meds they may need into their scheduled meds when I ask about pain during assessment. Sort of a 'one stop shop' method, I suppose. The problem here is that this seems to take awhile.

Some nurses, upon arrival to the floor, see each patient briefly and ask if they need anything OR do their assessment then and return around 2100 to give meds. To me, this seems like it would be slower since patients would likely ask for pain meds (or any other PRN) at this time, thus creating a situation where the RN would need to return to give scheduled meds.

I know it is about the patient and not about me, but I'm just trying to build a certain amount of efficiency into my shift.

How do you all like to begin your shifts?

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I'm trying to get into a fairly efficient groove while starting my shifts. My shifts start at 1900, but the majority of my patients don't have meds due until 2100. At or institution, we can give meds one hour before and after the time they are due.As a float nurse, the nurse managers seem to believe that I like to start my shift every night with an admission and they seem to believe that I love ending my shift the same way. Go figure....My first assessment is done around 2000.I'm trying to be as efficient as I can. I was waiting until 2000, (an hour into my shift) to do both meds and initial assessments for each patient. That way, I could wrap PRN pain meds they may need into their scheduled meds when I ask about pain during assessment. Sort of a 'one stop shop' method, I suppose. The problem here is that this seems to take awhile.Some nurses, upon arrival to the floor, see each patient briefly and ask if they need anything OR do their assessment then and return around 2100 to give meds. To me, this seems like it would be slower since patients would likely ask for pain meds (or any other PRN) at this time, thus creating a situation where the RN would need to return to give scheduled meds.I know it is about the patient and not about me, but I'm just trying to build a certain amount of efficiency into my shift.How do you all like to begin your shifts?

As a float nurse, the nurse managers seem to think I like starting my shift with an admission every night and for some reason, they feel the same way about my ending the shift. Go figure......

[MJB2010]

I really feel strongly that you can tell a lot about someone by how they treat the float or traveler. Some charges dump on them while others are fair. It is a good show of character.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Absolutely!

[PediLove2147, BSN, RN]

I work both days and nights but mostly days. I get in at 0700 and get report, we have something called "safety huddle" so I usually don't get in to see my patients until 0800. I do meds and assessments at the same time. I do all my charting after unless I have an early discharge. I've the chart as you go and I found myself getting too behind. It definitely works for some though.

[NutmeggeRN, BSN]

IN LTC I round on my pts right after report and narcotic count. I want to know they were all breathing when I took over the shift. Then I review the MAR for the shift highlighting any unusual times for meds or any treatments/dressing changes. I give report to the LNA's on my side (of which there are never enough) and what my expectations are. And then all bets are off! I try to have things wrapped up at the beginning of the last hour so I can make an easy transition for the next shift. Sometimes it works, sometimes not so much!

[mclennan, BSN, RN]

I'm a case management nurse. I work 9-5, M-F and I'm salaried so don't punch a clock. I roll in around 9am. Get settled at my desk. Turn on the radio. Make a pot of tea. Boot up computer and open email. Check for urgent referrals first, take care of those then start my task list I set up the night before.

[jennilynn]

First I visit my patients and assess/chart in the room. If they need any prn meds, I get them before moving on to the next pt.

I start my 2100 meds around 2030. I save the diabetics for last or after the accuchecks have resulted, in case I need to give insulin with the meds.

Then I do any dressing changes/treatments.

Make sure they're tucked in and comfy.

I'm usually finished by 2130.

[Good Morning, Gil]

It really all depends on the night. If I get there, and have a crashing and burning patient, then obviously, I assess them first, and pick up wherever the previous nurse left off. Get them stable, however long that takes, and then spend maybe 5 minutes quickly assessing my other patient and administering their meds at the same time. Then, on a night like that, I chart my assessments whenever I have the time, which may be at 2300, 0100, or 0700 lol if the patient is unstable all night long, and I still have my other patient to care for, etc. It's pretty atypical that I have to stay over my shift, but on nights when someone is very unstable or I get an admission at 0500, then I will be staying late to chart.

Typically, I get there, receive report from the offgoing nurse, do my chart checks to ensure everything has been done; if not, then I call the lab to see if labs have been drawn or whatnot; assess both of my patients, and if it's close enough to 2000 and 2100 to administer those meds, then I assess and administer meds at the same time, draw serial labs if applicable, blood sugars, etc. If it's still only 1915, then I assess that patient, and assess the other patient, turn/reposition, chart on both for a little while, and then administer meds. Then, the families come back around that time.

Really just depends on the night, and what's going on in the unit. If one of my team members has a more difficult or unstable patient, then I help them for a little while prior to going into my patient's room. You'll find a good routine in time.

[NewbieNeedsHelp]

I used to have 1030 meds, at that job I would do all the assessments and dressing changed or whatever I could fit in the one between 730 and 930. I would have everyone documented on and assessed well before 930 and usually ate breakfast and drank some coffee. The at 930 I would start meds...that's if I didn't have discharges and admissions or blood or someone getting cathed etc.

At my current jobs the am and pm meds are 830 so I can assess/give meds/dressings/etc in one fell swoop right after bedside report. 830 made me anxious at first but I quickly realized it was more efficient.

I'm all about getting **** done fast

[jennilynn]

If I get an admission at shift change, that delays things a bit. As long as they are stable, I allow them to get settled, eat something, get orders straight, then reformulate. I don't tend to stray too far off schedule though.

[wanderlust99]

5 cigarettes in my car before I go in and a redbull.

[loriangel14, RN]

Coffee and a good gossip before report starts.