Organizing the team for the day

[IndymamaNrn]

Hi Everyone;

I am a new nurse and I am still learning the ropes. I could use some advice. I am on an ortho/neuro unit. We typically have 4 patients and I have a preceptor and patient care tech on the "team". I am almost done with orientation, so my preceptor is there if I have questions or need help, but for the most part I work on caring for the patients. The tech may have my patients and a few for another nurse. I have noticed that there is not much consistency in when the blood sugars are checked, vital signs are taken, safety checks are done and documentation of a patient's input and output. I realize that we are understaffed and at times may have only one tech for the entire unit. With that said, there are times that I can not pull a patient's insulin while pulling other meds, because the patient has not been checked yet. Or, I have to find the tech and ask if the patient has voided at all that day. Or, I am having to check blood pressure before medication administration because the tech has not entered the vital signs yet. I feel as though as a team we could run smoother. Please understand that I am in no way bad mouthing our techs. They have a tough job. I was a tech before becoming a nurse, so I sympathize for them when they are handling the entire unit by themselves. They are truly hardworking and a blessing.

So, here is my question, is it uncommon or typical to have a team meeting after report? What I am thinking is that after we receive report, I could have a little meeting with my tech. I could go over the game plan for the day. For instance, I like to pass morning pain meds to the patient that I know will see therapy first and then work my way through the list. Also, this patient may need to be cleaned up, have breakfast and their insulin injection before therapy as well. So, in my meeting, go over this information. To just set the expectations for the day. If I did this, would it be conceived as beneficial or that I am being selfish and putting my patients first?

I would love to know what other nurses do. I know that this is long, but I am really wanting to find an easier and smoother way of getting through the day.

[A&OxNone, MSN, RN]

In my experience, I do try to touch base with my tech before the day gets started just to go over certain things and get a gameplan together. For instance, if you are really busy and theres only one tech, you can say,"hey, I have to give room so-and-so BP meds anyways, so why dont I get those vitals if you can grab my AM blood sugar before (whatever time)." If you come across as if you are sharing the duties, I find it works a lot better.

It's always a balance. Some are easier to approach than others. You will find your grove eventually, I promise!

[IndymamaNrn]

Thank you. I am certainly trying to learn how to balance it all. As a former tech, I do know how it feels to work with a nurse who either expected you to do everything and more no matter the patient load or would jump in and help. I know which ones I liked working with. And, I always told myself that I would remember how that felt and promised that I would be not be the first.

[TheCommuter, BSN, RN]

Usually, I never spoke with the tech assigned to me after I received report unless there was some pressing issue involving crazy family dynamics or complaints of substandard care. I received report from the offgoing nurse while the tech received report from the offgoing tech.

[IndymamaNrn]

Thank you.

That is what has been going on. With the more experienced techs, this seems to work out. Unfortunately, there are newer techs that are still learning. Since I am still learning how to best manage my day and time, this combination can become frustrating. No one complains, but I feel that together we can handle our day more effectively if we are working together. Instead of feeling as though we are both spinning our wheels.

[Been there,done that, ASN, RN]

Stop sympathizing and start organizing. Give your tech report with specific times you expect blood sugars, etc.

You can't make the tech completely responsible for nursing observations. What are you going to do if you "find them" and their answer is the patient hasn't voided all day?

Feel free to take your patient' s pressure yourself.