How to stay organized

almostanurse · Nov 5, 2002

this RN I work with, she is sooo organized. one thing she does that I have started to do is puting everything that has to be done on the scedual. as things are done she highlights them. as things are charted she puts a c through the task.

NancyRN · Nov 5, 2002

Prioritize, prioritize, prioritize! I'm overwhelmed too. I have to stay focused all the time. Don't let bossy unit clerks stress you out. You are the one responsible for your patients. If people have to get to X ray but you have a patient in pain, let X ray wait and give that pain med.

Remember you have about an hour of leeway for meds, so you can start hanging most antibiotics early. Make sure you chart the correct time the med is started. Take the IV meds in at the same time you bring in PO meds.

If your IV antibiotic is hooked up to a pump with a bag of saline set at KVO, that'll buy you some time to get in there and DC the line.

Have a place in your mind where you can go. Shut out distractions and focus on "what's the most important thing I have to do RIGHT NOW?" You know what it is.

Tweety, BSN, RN · Nov 5, 2002

I've let go of being organized a long time ago. LOL. To me it helps to prioritize what must be done, for instance patients waiting for pain medicine get my attention first, then I just go from there.

The thing I've learned over the years is to not freak out when there is too much to do. I deep breathe, stay calm, run to the the bathroom to stretch my back, and try to stay in the moment doing one thing at a time.

I get unglued when I see a co-worker freaking out over too much work, and especially unglued when they get all b*tchy and bent out of shape about it. I've done more than my share of that. One thing at a time, with full concentration, and I don't freak. There is always too much to do, and sometimes, I just have to face the day shift with things undone, get attitude, then go home. I'm very very forgiving and understanding when the dayshift leaves me things to do in return.

prmenrs, RN · Nov 5, 2002

WORKSHEETS.

Use a 5x8 piece of paper or card for ea pt. Smaller is ok--whatever size will allow you to fit any info you need. some people use a notebook, allows them to keep track of all their assignments for as long as they need to for evals, etc.

Back side is history and demographics. On mine for NICU (you'll have to figure out what info you need), I had date of birth, gest age, birth weight, resuscitation in DR, Apgars, initial problem(s); also had Mom's gravida, para, route of delivery, complications; social info, esp drugs. Language spoken if not English.

Front side is current staus: today's date, current wt, current gestational age, resp support needed, IV's, labs pending, feedings, projected d/c (for teaching purposes).

On the long side of the front, draw a line vertically about the middle on the card; on one side of this card, make horizontal lines so that you have 12 spaces for a 12 hours shift, 8 spaces for an 8 hour shift. In the upper left corner of each box, write the clock hour for that time of day. Go through any meds or treatments pt needs and write them in the approp space. For me, that would include when feedings were due, also. As things were done, they were checked off. You can make little notations in the correct spot, too, if you can't get to the chart right away, and you're worried about forgeting.

Once you've gottent a system that works for YOU, it will provide a structure that will make it a bit harder to for get stuff.

whipping girl in 07, RN · Nov 6, 2002

I really hate our computer system at work; however, it does have one good attribute...it prints a patient care summary at the beginning of each shift. It lists any labs and tests that are ordered or pending, IVF, meds ordered and what time they are due, doctors on the case, medical and surgical history, and allergies. It also has all the md to nurse orders, like frequency of vital signs, neuro checks, CBGs, etc. If everyone enters everything into the computer like they are supposed to, then everything you need to do for the shift shows up on the patient care summary. I still need to check the chart for new orders and to make sure all orders are in the computer correctly, but once I have done that, I know that on that little piece of paper is listed everything I need to do. A lifesaver, to say the least. Believe it or not, it was one of the things that helped me decide while I was doing clinicals in nursing school that I wanted to work at this hospital. And despite my occasional complaints, it's one of the things that keeps me there. :)

lisamcrn · Nov 6, 2002

I have found that I quickly jot down of current info on my census sheet, this includes code status, chem strip schedule, ivs/lines, tube feding,appointment labs, diet, assist of __, therapies ordered, wts, I/O..just basic stuff, a spot for bm, treatments sites,prn pain meds and then I jot down anything unusual from taped report...this is all done in red. I leave a little blank to jot in my info collected. Then I have a small area to jot down my vs and assessment and all of my data is done in black for easy reference. I then take a blank piece of paper and make my notes on it for reminders to do or whatever and cross out as completed. Then I just dedicate my first few hours completing these tasks and assessments. This, o fcourse, is the ideal...it hasn't gone that way for weeks now...busy busy busy with 6 pts today..sigh..anyway. This is how my plan is formulated. Then I am one of those annoying people that continually talk to themselves throughout the shift and mumble my thoughts/plans of what needs to be done out loud. But I just keep going and will no longer let the attitudes or unexpected get my goat. When I am stressed (honest to god) I have now started humming some tune that I always remember. I hum this thru the unit going from room to room and while checking my meds....whenever. It is one way I focus on my duties and block out things/noise that interferes with calm. I have had a heck of a time getting used to the hospital setting with all the interfereces...dr., nps, therapists, dietary, pasotral care, whatever.....This puts me into my 'happy place' and I remain calmer and focused. My coworkers all like me and think I am a riot. Several just start singing along to my tune and it calms some nerves. Yes, this is strange advice. But, one thing I have learned about turning almost 33 and finally overcoming my fear of changing nursing fields from LTC.....I am a good nurse and I don't care what anyone but my patients, boss, supervisors think. When I am drowning I ask for help and delegate. I pass on to the cnas what they can do letting them know I am getting into trouble for time of pt X needs me a lot because of and they are great about assisting me with that. (with bladder scans, chems, o2 sats whatever is safe and permissable). I also always help out fellow nurses in a rough spot however I can. This assures me that I always get someone willing to help me when I am the one sinking. (except for one....what's up with her?? she always is done way to early with everything>>and never offers to help out others?? ) Above all, I always smile and roll with the punches.

Ok...maybe wierd advice, but it has helped me.

NurseDennie, BSN, RN · Nov 7, 2002

I made myself a pre-printed jot sheet. I had a section for each patient, with name, room #, Dx, Doc, IVfluid and rate, and then a little space for each of the times I'd need VSs. I also had a space for if the patient was DNR, and if there was something that was really important, like Nimotop Q4, or if they had a CSF drain.

I had a vertical column for each patient in which I'd write the times that meds or tx's were due, which I'd circle and then cross out as I administered them. I even had a little code for my assessment and for charting the assessment for each part of my shift. In the middle was room for a quick summary for giving report. I even got in the habit of checking off the summary when I gave report, which came in handy when the bytch that I was reporting to missed a med and told the bytchy NM that I hadn't told her. Well, I showed her my jot sheet where I'd checked it off. Not to mention that report doesn't include every little detail!!

*sigh* Anyway, At the top of the page, above where my patient-squares were, were some things that I have trouble remembering - telephone numbers, codes for labs, codes for the beepers! Sheesh - I worked there for years and years and never could remember what the codes meant.

I could either fold it in quarters and put it in my pocket, which is what I ended up doing most of the time, or I could leave it open and stick it on a clipboard. Easier for writing on, but more likely to be lost.

I also bought a tool belt to wear on duty. We had nurse locators, and I had that permanently on a velcro loop, and I kept my calipers, scissors, several clamps (I worked with a nurse who refused to buy any and used mine all the time), dead-ends (which I guess you don't need anymore, with these needle-less systems whoo hooo!) and alcohol preps and... stuff like that. When I was researching nursing school, I read that the average nurse walks 7 miles a shift. And I don't know if that's an 8-hr or a 12-hr shift!! But I learned very quickly that the unorganized nurse walks a LOT farther than the organized one!!

The thing is, you'll work out the rhythm and the system that works for you.

Love

Dennie

I'd tried the cards, but I found that it was easier for *me* to be able to look at all the times on one page of paper in order to decide what was going to be done in what order.

adrienurse, LPN · Nov 7, 2002

I don't start my shift without taking a big breath and planning out my shift (as much as you can do in psychogeriatrics LOL the Pts have other plans). I take a look at what needs to be done paperwork-wise and make that my priority for while I am able to be at the desk. Then I look at what care needs to be done at what time. Putting anything off is just a BAD idea, because it is so easy to get waysided by some mini-crisis or another. I make a pile of charts and paperwork at the desk (if I have to leave them unfinished -- as a reminder), and everyone knows not to disturb this pile for fear of death. I tape little reminders of things I have to do and people I have to call, to a specific area of the desk.

Then the real fun begins.

SmilingBluEyes · Nov 7, 2002

I use my report sheet to help keep me organized...but let us face it, things come up. You get new admits, patients change status, etc. You just have to do the best you can and be ready to re-prioritize when you need to. I always say, the floor I inherit at 7p.m. is likely to be VASTLY different than the one I leave for the oncoming shift at 7 a.m......this can make it difficult to always be on top. Just keep it all on a cheat sheet, by patient/room number, if you can. It works for me most of the time! Also, do NOT be afraid to ask for help when you are sinking...your coworkers can be your biggest boon in times like this!

donnaharris · Aug 24, 2005

I always start my day by writing down things Ineed to do for the patient (ie dressing changes, PTT for heparin infusions, things I need to pass on to the DOCS.) By my list of things I need to do i put a little square and check it off when a specific task is done. I also delegate early. I tell my CNA's who will need baths, feedings,who will be discharged and who needs turns ect. If I get a little behind, I ask someone who doesn't look to busy to help me. I am also very kind to my coworkers. If they look like their busy or have an unstable patient I offer my help without being asked. When the same thing happens to me, they are very willing to do the same. Always say thank you to people who help you as they will appreciate it and will always be willing to help you out when you get in a jam. Prioritizing is very important. Always take care of a pt's pain immediately. Always remember in a very busy day, remember the this, there is always the next shift that can take care of certain things for you and it won't kill your patient if they missed their bath today.

ragingmomster, BSN, MSN, RN · Aug 24, 2005

I have always made my own report sheet.

It lets me keep what I think is priority in order that I can find every time.

I take report in red, can write over and around it in black and still usually see what is written in red if I need to refer back.

Last hospital had a small computer table for each nurse to drive the laptop around the halls from room to room. (Laptop connected to intranet for meds and labs.) I'd put a 1" tape strip vertically down one side of the table and split it up into squares with my sharpie and put a room number in each square, then list scheduled meds down the side of the block. Cross them off as they are done.

A second piece of tape horizontally across the front of the table with add on's like reassess pain relief and increased VS for fresh post ops and blood admin's.

Without a table top, I have used the back of a fillable clipboard for the same info.

Patient sheet on the clip side of the board, tape strips on the back of the board and notes taped inside like infrequently used but important phone numbers (MIS, CT, etc). Also loose inside clipboard I would carry my kelly, scissors, chewing gum and whatever else I thought was important like pics of my kids.

Lots of people will tell you exactly how to do everything- like my info here, but it will take years to get everything in a pattern you like.

LAST PIECE OF ADVICE, READ IT ALL, TAKE WHAT YOU LIKE AND REVISE YOUR RUT WHEN YOU START GETTING BEHIND.

Good Luck, and Best Wishes!