Med/Surg nurses! How do you organize your day and use your time wisely?

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Hi there! I'm a new grad RN, about to start in Med/Surg/Tele in a hospital that doesn't have a new grad program. I will, however, be assigned to a preceptor. I don't start until another week or so, and I want to be as prepared as possible. I have some questions and would appreciate any help:

1.) How do you organize your patient's info onto a sheet of paper? do u have a format? If you have a link or can email me what you use I would really appreciate it!

2.) What meds should I study up on? Anything specific?

3.) In what format do you give report on a patient? I want to report the right information in the right sequence...although I've done this in nursing school, I've heard of nurses who laugh or think that new grads are too informative or give information in the wrong sequence...

4.) How do you make sure you have enough time for charting, passing meds, taking care of patients without feeling overwhelmed? Any secrets? lol

5.) Anything else that I should know or be prepared on so that I can be as best prepared as a new grad could?

Thank you so much!!;)

I know very few nurses who use a special system for organizing patient info. This was a big thing when I was in nursing school, and sometimes I see our float-team nurses using worksheets (I'm not sure why it's more common with them, maybe because it's harder to organize when you have to change the flow more often), but almost all of us just print out our med-list, write down when each med is due, and make notes from report on that paper. Many of the nurses write down when each accucheck is due and leave a space to write what it is. Many of us will write down "BID W-D" (a wet-to-dry dressing change twice daily) and then cross it if when it's done. But that's as fancy as we get. Not saying there's anything wrong with a worksheet, but I don't find them as useful/necessary anymore.

Meds? I look 'em up as I go along if I need to know something. Studying them out of context doesn't work for me--I'm unlikely to remember the information. I give a ton of IV antibiotics and blood pressure medications on my mostly-surg floor. Personally I wouldn't stress over trying to study them now.

When I first started on my floor as a new grad, I would make notes before giving report so I wouldn't forget anything and would be organized. Now I find it fairly easy. We do bedside report; if it's a very complex patient I will say "I'm going to start at the top!" and go literally head to toe explaining what the nurse needs to know about that patient. (Neuro issues, NG tube, swallow function, trach, heart problem, lung crackles, feeding tube, abdominal incision, colostomy, foley, edema, compression boots, diabetic foot.) I like my reports short and sweet and get irritated by reports that include a ton of information I can see immediately or can look up (don't tell me the lab values or vitals unless they're "interesting"--high or low, and significant).

Sequence? Tell the most important stuff first! Don't go on and on about minutia and then, at the end, say "oh, and you have to suction him every hour or he desats". That changes the nurse's whole perception of the patient! Start every report with an overview: what the patient came in for, and why they're still here. Nothing about your report makes sense until the oncoming nurse knows that information.

How do you make sure you have enough time? practice, practice, practice. On the average patient, I prioritize things like medications (especially antibiotics and pain meds, which need to be given in a timely manner) in organizing my day. Other things flow around those set times. I also make sure I get my dressings done early, because you never know what's going to come up later in the day, and it isn't fair to either the patient or the next nurse to leave those for the next shift. While med times are generally not as strict as one might think, you just can't say "I'm charting now and that antibiotic will have to wait until I'm done". A short time, sure. But you have to be able to start a task, stop to do something that needs to be done right away, and then return to it later.

Ask lots of questions, and communicate with your preceptor if you're feeling overwhelmed OR like you aren't being challenged enough. If your orientation is of a decent length and quality, you won't miss being in a new grad program. I had an excellent and thorough new grad program, but the truth is, most of specific new grad orientation is not going to be that different from an individualized orientation that ISN'T new grad specific.

Thank you very much for your informative answer! :yeah:

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