New Telemetry Nurse

oldiebutgoodie, RN · Aug 24, 2008

Hi Angelfish,

Here is what I finally came up with. Some people made grids and stuff like that, but that got too complicated for me.

I had a legal pad, and made 5 or 6 columns on it (holding it so longest part is horizontal). Each column was a patient. I put pt's name and room number at the top of each column, with diagnosis, and then numbers corresponding to when their meds were due. (like 9 - 12 - 4 ) Put a big D on the column if diabetic. Put a big heart if on tele.

Then, the rest of the column for each patient was either todos (like, call MD with noon vitals), or "Correct Potassium!". or stuff like that.

Hopefully, by the end of the day, I had crossed off all the todos and all the numbers corresponding to the times meds were due. If the pharmacy was slow getting a med up, I just put that med on my todo list.

Any interesting info (such as "CT scan showed patient swallowed scissors") I also put in the column, but circled it, as a pertinent piece of information for report, as opposed to a to-do. Of course, it could also be a todo, such as "Call MD to tell her patient swallowed scissors".

Anyway, it wasn't too glamorous, but it worked for me.

You can also put little hints at the top of your column, like "LOM (little old man) with obnoxious adult children": or somehting like that.

I remember once having 3 LOMs in a row, all bald, all looked alike, and all with similar diagnoses. Had a heckuva time keeping them separate.

Good luck!

Oldiebutgoodie

KaliNurse · Aug 24, 2008

Organization should come with more experience. I know that you are new, but you are seeing firsthand how important organizational skills really are. Don't sweat it. You'll get it!

First, I agree with AngelFish. Your report sheet should be to your level of comfort. You should have your report sheet listing all body systems. For example: for each patient have a small section for neuro, cardiac, respiratory, skin...etc. With each patient, you should be writing down everything you do for that patient during the day. I found in the beginning that using the mulit-colored pens helps alot! I use a different color for different things. Like AngelFish said, maybe you could list a patient's medication times in red, their lab results for the day in blue pen....etc.

It sounds pretty overwhelming at first. But, know that once you've established a routine, things become easier to organize. You'll see.....

Hope that helps! ~ Kali

KBRN413 · Aug 24, 2008

where i work, we all have our sbar's attached to our orders and we clip them to a clip board that our nurse manager gave us. i have my assessment, pmh, admission diagnosis, and meds on my sbar for individual patients. i write things that need to be done and put a box next to it and highlight it. i then check off the box when done. i also write changes and things that i have accomplished on my shift. i use this when writing my notes and when giving report to the next rn.

it definetly takes time to get organized and you will find your comfort zone! it took me a little while to get comfortable and find what worked for me. :yeah:

BelleKat, BSN, RN · Aug 24, 2008

Re Oldie but goodie; LOM swallowed scissors? Yikes! :rotfl:

medsurgrnco, BSN, RN · Aug 24, 2008

Since you get patients mixed up, be sure you check namebands/allergies when giving all meds. You need to use brains to write stuff down as there's no way you can remember everything for all your patients during an entire shift. I prefer brains with the patient info horizontal, while others prefer vertical formats. On the back side of the sheet, I write down any phone calls to MDs or test results I need to pass on to the next shift.

Anyway, my columns on an 8x11 sheet of paper for 6 patients are:

Patient/Room (includes dx / med hx / allergies)

Assessment (includes time of assessment, only abn written down)

O2/IV/Drains/Skin (includes IV site & IVF, skin abn)

Pain/PRN (includes pain assessment & times of pain/PRN meds)

I/O

VS (with time of each set)

Tasks (includes contact precautions, turn q2h, times to check labs, lab draws)

Med Times (includes notes like FSBS, BP/HR for those meds)

My brains have been modified for every nursing job I've had, and I've received numerous compliments on my brains. The current brains were developed when I had computer charting which would be done whenever I found time later in the shift. I cross off times/tasks when tasks are done. Hope this helps!

nyrn5125 · Aug 25, 2008

Thank you for all the help, I have had 4 shifts so far with a preceptor and I'm trying to put it all together so I dont start sinking.

BLSQUEEN · Aug 25, 2008

angelfish I feel for you! Hang in there and you will see that it does come together. You have received some great organization tips here! I am sure you will, but checking name bands each and every time you treat a patient will help you with your fear of mixing up a LOM or two. My patients were often times able to tell me their medical record number because over an 8 hour shift I checked it at least 5 times! I was always able to go to bed, pull up the covers and sleep soundly without worry that I had mixed up my patients!

Good Luck and hang in there!

deanna.wallace24 · Aug 23, 2012

Thanks for this post I just started on a Telemetry Unit and I am praying I learn how to manage everything!! It's definitely overwhelming!!

JKohler0206 · Aug 23, 2012

I'll be starting my nursing career on a med-surg floor and I'm thankful for all the great tips I read here on allnurses.com!! It seems that everyone needs some time to get the organization and time management skills down. While I'm nervous, I'm also very excited to get started. Orientation is Sept. 10th!!