Nurse Report please answer

[Wantoknow-rn]

I'm a new nurse at an ER, since patients are coming and going you may not necessarily have everything done for a patient that you just got at 1630 and got admission ordered at 1700(for example). Sometimes the nurse at 7 comes and gets upset because some stuff have not been done on this particular patient lets say some meds have not been given like antibiotics maybe, or nexium. My question is; what is expected to be done and what can be something that u do not necessarily may complete before 7, leaving this task to the coming-in shift. For example a triage definitively has to be done and some VS as a blood sugar if pt is diabetic or some basic labs like troponin if pt is chest pain.. But as far as meds? and everything else I'M not clear if there is somebody out there that can answer this question to me and tell me how they do it i will appreciate it thank you.

[Rikirescue]

I agree with the previous posters that this is definitely a prioritization question. First things first, always go back to ABC. If any of those things are compromised, then that patient gets your attention. Do those things first. Assuming all of your patients are stable in that regard, my suggestion is to take a quick second and make a list. As a new nurse you won't be able to mentally prioritize like some of us old salty dogs can do at first. This will come! Now, the thing about the ER is we do FOCUSED assessments and FOCUSED treatments. So ask yourself, what's my pt here for? If the order treats the answer to that question DO IT! As far as abx go, it is a JCAHO national standard and core measure that abx go up on certain patients within a certain amount of time. Be mindful of that. If your pt is a GI bleed, then yes get them the nexium, protonix, etc. One thing new ED nurses have the hardest time with is asking for help and/or delegating. But the best ER nurses do this well. If you have a CP patient that you are actively treating and you know the pt next door has pna, but you don't have time to grab the blood cultures and hang the abx, tell your charge. Thats shows us as charge that you know what's important and are handling your assignment. ER nurse or not, we still only have 2 hands and can be at one place at a time. Now having said all that my other piece of advice is every day start looking at your patient and anticipate what's going to happen. For example:

89 y/o male with fever and cough. You AUTOMATICALLY know this is a septic workup. This will get easier with time and seeing more patients. To be super successful as an ER nurse you have to anticipatory and proactive and not reactive. Best of luck and hang in there!