Published Jan 23, 2013
staceym
271 Posts
Hello Med Surg RNs! I am a nursing student beginning her first (of 2) quarters on a med surg floor in a local hospital. Our instructors have been highlighting the importance of organizing your day when you have 4+ patients. We start out with helping take care of 2 pts this quarter. My question is: How do you organize your day with giving meds and everything else that pertains to taking care of your patients? I know this is a loaded question but any help you can give (or outline or resources) would be absolutely amazing! I'm trying to really grasp the day of a Med Surg nurse! You are all incredible with your time management skills! Thanks!
evolvingrn, BSN, RN
1,035 Posts
I look at my patients and what they have due in terms of meds, if im working with an aide I'm going to hit those with blood pressure meds first so that i give meds within 30 minutes and don't have to revitalize. If im by myself I am going to choose to knock the easy more independent pts out and do my assessments with them during morning meds. i tend to go to my heavier pts last so i can spend more time with them and that way everyone's med are usually given close to on time. my goal is going to be and try and knock out their bath sometime in the morning and walk them at least once before lunch (dependent on their PT time) . after lunch i get those second walks in , check my urine outputs and follow up if their are concerns, put my notes in, (usually in this time i have a d/c and get a new post-op)
My schedule is a little different every day i prioritize base on who im caring for. What i see people I'm precepting struggle with is to fit baths and everyday things in. they always leave that for the end of their shift. that isn't okay because things get busy at the end of the day and you can't count on having that time available. I try to do as much as possible in the morning. occasionally i get a really quiet stress free afternoon but more often than not i have a new post-op or other health issues that i have deal with and really pushing things in the morning allows me to end on time and feel that i have met most of my patients needs.
87Belle
1 Post
I look at my patients and what they have due in terms of meds, if im working with an aide I'm going to hit those with blood pressure meds first so that i give meds within 30 minutes and don't have to revitalize. If im by myself I am going to choose to knock the easy more independent pts out and do my assessments with them during morning meds. i tend to go to my heavier pts last so i can spend more time with them and that way everyone's med are usually given close to on time. my goal is going to be and try and knock out their bath sometime in the morning and walk them at least once before lunch (dependent on their PT time) . after lunch i get those second walks in , check my urine outputs and follow up if their are concerns, put my notes in, (usually in this time i have a d/c and get a new post-op)My schedule is a little different every day i prioritize base on who im caring for. What i see people I'm precepting struggle with is to fit baths and everyday things in. they always leave that for the end of their shift. that isn't okay because things get busy at the end of the day and you can't count on having that time available. I try to do as much as possible in the morning. occasionally i get a really quiet stress free afternoon but more often than not i have a new post-op or other health issues that i have deal with and really pushing things in the morning allows me to end on time and feel that i have met most of my patients needs.
Hello! I'm a RN in NYC! I just joined this and would like to get more organization when I'm working bc I've been working for 8 months and it's still a challenge to organize my work. Sometimes I feel like I'm rushing with everything and I super woman bc I have to be in million places at one time
Susie2310
2,121 Posts
Did your instructor teach you about prioritizing care, i.e. determining who is your most unstable patient and doing urgently needed care first i.e. fluid boluses and antibiotics for a patient with sepsis?
A lot of people find it helpful to use a brain sheet to organize their care. Listing times of meds, treatments/procedures, abnormal labs, abnormal assessment data etc., is helpful for many people. That way you know what needs to be done and when. If you search on allnurses you will find examples of brain sheets that other people have posted.
N1colina
222 Posts
You will definitely need some form of paperwork to get organized. Whether you use a clipboard, or just staple a few sheets of paper together. The instructors in our hospital (and I'm sure in most) are big on infection control, and HIPAA so you want to make sure you're not leaving your papers anywhere. A lot of the students like to keep them folded in their pocket (I know, one more thing for your pocket!) Other essentials for your pocket would be at least 2 pens, a few 3 ml NS flushes, a few red caps, tape, and alcohol swabs. I never go a day without stocking my pockets with any of these (unless I'm in charge). Then, you want to write down all of your med times (noting any critical meds that have to be given on time, such as antibiotics, Parkinson's meds, seizure meds, BP meds, etc.) Some meds are given multiple times a day, and giving them late would screw up the patient's whole schedule. Everyone has their own way of organizing and you will find yours. A good tip would be to watch others. Observe those that appear the most organized, calm, and collected. That's what I did. I looked at several of my orientor's sheets (with their permission) to get an idea of how I could organize my own. They will help you determine which things are crucial to write down for that specific floor (such as a Hct/Hbg level for a post-op, recent V/S, any drains, O2, diet, how they ambulate). Having organized sheets and writing everything down, I found to be the most helpful way to prioritize, and maintain good time management skills. This way you have a plan, you know what you have to do. Of course there will be the unknown, unexpected events that occur, but that's the fun part! And that's what helps you learn! Good luck!
Also- BIG deal on our floor- you want to check who is being discharged that day. There should be a list of people going. You want to make sure those patients are seen first, given all their meds, and whatever else that floor requires with their discharge planning. This is where delegation comes into play, as well. As the RN, you would communicate with your nursing assistant on who is being discharged, so that they know who to wash up/ get dressed first. As the student, you may be doing all of this yourself, depending on your instructor, how many patients you have, and what semester you are in.
Jon J
14 Posts
Well I had written a long paragraph but I got tired..
1. Receive report
2. Check charts
3. Assess patients
4. Pass meds
These 4 steps to start the day.
If you want rationales or have f/u questions just ask. I'm too lazy to commit to fully answering this right now. I don't know how everyone else does it lol -.-
turnforthenurse, MSN, NP
3,364 Posts
I agree with stocking up my pockets. I remember as a student we weren't allowed to wear scrub pants with cargo pockets, but I personally prefer them. Perfect place to hold my NS flushes and I grab a whole bunch of them. Sometimes I stick my scissors there, too, along with my work phone (we all have little portable cell phones). I grab some alcohol swabs and some IV caps (at my facility they are blue) and stick those in my pockets, too. A roll of tape is usually on my stethoscope.
Also, get a good brain sheet, or make your own. Search "brain sheets" here and you will find a lot of options. Sometimes institutions have their own templates for brain sheets. One of the hospitals I worked at had those templates and they were tailored to your work area. So the monitored units included spaces for telemetry, the ICU sheets contained spaces for vent settings, etc.
NurseLatteDNP, MSN, DNP, RN
825 Posts
I recommend grouping your tasks together. That has been a life-saver for me.
I agree with this. I've been practicing this for time saving purposes. This is more advanced stuff though Get a hang of the basics before you start grouping tasks. I've been a nurse for like a month now. I'm still trying to get a hang of grouping stuff.