Managing Patient Assignments

xos4eva · Sep 4, 2008

Everyone has their own method but what i found helpful for me is that once I got handoff, I would make my rounds, see if any pt needed something immediately and if not then go and check my orders and proceed to get ready to give out medications, as I give my medications I would do a quick assessment of the pt including their vital signs and once done with morning meds, I would check again to see if there were any new orders. During the 1/2 hr or 1 between that and noon/1pm meds I would try to write a note on at least 1 or 2 pts. Give out meds again, reassess any pts that need to be reassessed, check for new orders, do any dressings, etc... and so on and so forth. Not saying this will absolutely help you but when you have a system, which ever one that may work for you, it makes your day go smoother. On that note, nothing is set in stone and remember that nursing is fluid and always changing so there are days that your system will not work. Doesn't mean you are a bad nurse just means things are a little hectic. Most importantly never ever be afraid to ask for help or for clarification if you don't understand or know how to do something.

Sorry for the long post but hope it helps.

Ericka

I_love_my_job · Sep 4, 2008

Thank you for taking the time to reply. I feel overwhelmed myself and this suggestion helps. I do a lot of what you suggested also. I find that my papers given to me in the morning are a mess at the end of the day. I have so many notes I write down throughout the day and there is not much organization when I look at them for hand off to the next shift. Does anyone have an organized template you use that helps keep you organized? I typically have 6 patients on a tele floor and never seem to feel relaxed and on top of everything. I have 4 weeks of orientation left so I am really getting worried about being on my own.

missmiamoore · Sep 4, 2008

Thank you Ericka, I appreciate your response.

Another aspect that I find quite stressful is how the other nurses on the floor will expect certain things done by first break. For example, the rehab floor I was on wanted everyone washed before 9 am! I found this extremely hard, as the patients are quite slow in ambulating and need supervision assistance doing their ADLs. Other nurses on the floor seem to be able to get so much done before first break and then tell me to pick up the pace when they see I am struggling. This is one particular nurse I am referring to. It just seems impossible sometimes! Anyone else have this kind of experience?

Christen, ANP · Sep 4, 2008

Keeping organized and developing your own routine is the key to getting off of work on time!

My routine:

Get report with the chart, so I can go over any old orders/make sure the chart check is done/go over am labs/etc. Check out my med sheet, see what times I'll be giving my meds so I can cooridnate them together as much as possible. Start my "to do" list, where I put any goals (such as Incentive Spirometry), any orders I think the MD should write (such as Speech Therapy on a trach, downsizing a trach, etc). I then start my assessments, have them all done by 8am (and charted if nothing else immediate is going on). Pass all my am meds, hopefully by around 8:30. Check my charts again, as the MDs have usually started rounding and have written a bunch of new orders. Start my day!

All day, I keep my charts closely at hand so I can make sure I don't miss anything. I also make sure I go into the room anytime anyone else does (MD, PT/OT/ST, etc). It's my responsibility to make sure the pt gets through the day safely and have all of their care provided for and all of their orders complete.

My biggest advice:

- Stay organized!

- Write down the times you've done things (assessment, meds, I.S., therapy, etc) so you can chart them at the time the interventions were done! You won't be charting in "real time" for a while, so it's a good way to make sure you chart correctly.

- Group activities together! Got a med due at 8, 9, and 10? Give them all at 9.

Don't expect to have everything done as quickly as everything else. My first 6 months, I never left before 8 or 8:30 because of charting! Your goal should be to have all of your interventions done on your patients then charting. Unfortunatly, patient care comes before your paperwork. You'll get quicker, though, so don't be too hard on yourself.