Published Jun 25, 2008
SoundofMusic
1,016 Posts
I've been on my own now for about 2 weeks and doing fairly well -- but I always, always seem to forget one or two things each assignment.
Sometimes it's a med, last night it was a blood sugar that was q 6 vs. ac/hs. Mostly it's due to a weak report, but also due to my weak skills -- no one seems to call me on it -- YET.
How do I do this and what should I do when I miss stuff? I always tell them in report if I remember -- but sometimes I don't remember until I wake up the next a.m. like the other day when I woke up at 6 a.m. remembering I didn't give the 1800 PO caridizem? By that time an entire shift had gone by ...
It's little stuff, but really, nothing is "little stuff." It's all important.
I always catch the "big stuff" of course - like V-tach, or calling docs w/ critical values, etc. It's just the little stuff that will slip.
eccentricRN
174 Posts
find a system to organize your self... what did you do during clinical so you wouldn't miss something??
some do it by hours, i do it by shift. i carry a clipboard & i write the times & # of meds to be given for each pt... i also write times for next set of surg vitals or bs, drsg change, etc... as i give a med i circle it, then when i have a chance i chart it given & the x it out, i cross out treatments as they are completed once i charted them.
example:
mr. holdover
meds
02-2
05-1
07-2
bs 00, 06
resp tx 00, 04
i put all my pts on the same sheet if possible so a quick glance let you know what you've got coming up this hour & allows you to plan as needed. hope this helps.
I have a sheet I developed myself, and even have these meds LISTED on it ...I will just still let things slide no matter what.
Not EVERY time -- just once or twice.
My sheets just get so messy -- I write all over them and my handwriting is horrid.
It's like my brain is just messy .... I just haven't developed a good "brain sheet" yet that works for me.
30 mins in the a.m. just doesn't seem like anywhere near enough time to get organized at the beginning w/ so many patients.
I think I need to simplify my sheets like this, or something. I'm taking report AND making to-do lists on the same sheet.
This is just my top sheet, on my cardexes I put all the other info you're talking about... it's still accessible, but you have a cleaner more easily read flow sheet to organize your shift.
cursenurse
391 Posts
Daytonite created a wonderful report sheet that could help keep you on track. I put the link below.
https://allnurses.com/forums/f50/report-sheets-136677.html#post1465857
Nurseismade RN
379 Posts
Daytonite created a wonderful report sheet that could help keep you on track. I put the link below.https://allnurses.com/forums/f50/report-sheets-136677.html#post1465857
yep that's the one I use too...thanks again Daytonite!!!! I just tailor it to my shift which is 3-11. I also change blood sugar time on mine....I removed the lines and added info like check coumadin amount....code status etc. I am still experimenting.
SassyJennRN
37 Posts
I agree you just need to find a system that works for you. The report sheet on the link above wouldn't do it for me. I prefer to have 1 sheet divided so I can look at all of my patients in a quick glance. Try using the pens that have the four colors of ink in one pen and using differnt colors for differnt things. The trick for me is not losing the pen halfway through the shift. Don't be afraid to ask the people that you work with if they have a system that works for them. Take bits and pieces from each of them to personalize something that works for you. Get to work a few minutes early to organize yourself and refer back to papers often throughout the day. Make an hourly list and cross it off as you go. Don't worry you will figure it out.
Daytonite, BSN, RN
1 Article; 14,604 Posts
you need to either develop a worksheet for yourself that you continually edit to include the things that you tend to forget, so that you don't forget them. or, make todo lists for yourself and remember to check them periodically to see that you are getting the things done.
here is a copy of the report sheet i made and used. it is a result of many years of experience: [attach]5032[/attach]
http://www.ehow.com/how_3812_make-list.html - how to make a todo list
http://www.mindtools.com/pages/main/newmn_hte.htm - time management from mind tools
Daytonite's attachment 5032 uses only 1 sheet for 5 patients............click on that.....
I love it.....just edit it to your shift and preferences.
TX_TeleRN
30 Posts
I'm still a fairly new RN on days, and I especially forget things when my orders change. Just do the best as you can, but the key thing (as many others have already mentioned is to find a management system that works for you.
I use a separate report sheet that I made for each pt I get for the assignment. I reuse them as I get the same pt again and discard them after pt discharges or transfers.
Then after I get report, it now takes me about 15 min to get organized on a single time grid page that has spaces for 6 pts. At the top, I have space for name/room #. I use top margin to write extra codes for me (i.e., TC=total care, iso=isolation, NT=non-tele, DNR, etc.). I have space for PRN meds, blood sugar (i write Q6h or ac/hs in corner of box and draw 2-3 lines needed for my shift). I can write names of meds in squares, tasks, doc name/time when i called, etc. in appropriate squares. At the bottom, I have blank spaces for whatever I want to write in it (i.e., Foley, IVF-type @ rate, PICC, JP, HD, dsg chg, NPO for test-name, specimen due, etc.). Don't need to write a novel, just key things needed for pt this shift. I can always refer to my report sheet for details.
This time grid helps me keep tract of who I should see first, and keeps me on tract from forgetting things. I've seen other seasoned RNs use something similar w/ less writing on them. They make their own time grids with a list of tasks checked off for each pt. Just take the idea and make it into what you need it to be.
Ask other RNs how they manage their time. Try their system to see if and what works for you and incorporate it into your system. Good luck!
Perhaps I'm still new, I need more info than a check mark so I prefer to write things in. And when you see your pt at start of shift, scan the room to note what supplies you'll need for tasks you have to do on your shift. It'll help keep you from running back and forth all the time.
onyx77
404 Posts
I had a sheet and system that worked wonders for me in clinicals, but now I am working in LTC and don't even know where to start to even try to get a worksheet together. Does anyone have anything that works for them in the LTC setting?