Need help with paper I am writing

Trauma Columnist · Apr 3, 2006

Okay - I'll bite, here are some broad-based ideas:

Decision making - as in which arm to start an IV and which gauge IV to place

priority setting - ER triage is the best example

time management - ability to incorporate triage concepts to decide who needs what done when and how to get all the work done in an allotted time frame

organization - the ability to have all the needed materials prior to going into the patient room and knowing what you need to do prior to going in there - making one trip do

delegation - I equate this with unlicensed co-workers

critical thinking - ability to incorporate all the above principles to provide good, safe and effective care

roswell · Apr 3, 2006

Thanks for the input. Much appreciated.

Blee O'Myacin, BSN, RN · Apr 3, 2006

Decision making - making the staff assignment for the oncoming shift, when to stick an unmonitored patient on tele because of objective and subjective data (while we need an order for tele, we do it first, then have the doc put the order in)

priority setting - do I hang blood products or give chemo first? Do I see the patient with the horrible nausea and vomiting first, or do I see the patient who needs 5 IV piggy back meds over the next few hours (we can program our pumps with up to three meds at a time)

time management - planning my day so I can give the 2000 chemo, the platelets for another patient, all my meds (most are IV where I am) and still have time for notes, labs and be able to roll with it if someone crashes.

organization - that goes hand in hand with time management. I used to make a list for each patient - one hour at a time and planned my day out during my first half hour. This way if I knew it was 2200, I better be done with the med pass and my assessments and getting my I/O's into the computer.

delegation - I'll ask the tech or the nurse extern to take the 15 minute and 30 minute vital signs when I'm giving blood, PICC line dressing changes, help with turning and bathing a vented patient, helping someone with a shower, accuchecks, making a bed - I have to say that most of the time I don't need to ask. These are also things that I'll do for my patients, especially if we have a full house and there is only one tech to go around. We'll talk ahead of time about what they have time to do and what I can do to make their lives easier.

critical thinking - taking all your data along with a patient that just isn't looking "right" and making the decision to insist that the resident come in a take a look before going to the fellow or the attending. Looking at labs and seeing that the electrolytes are off and taking the initiative to call the doc for the order for replacements. We can also order blood for patients who need it based on preestablished parameters.

Good luck with your paper.

roswell · Apr 5, 2006

Thanks for your help.