Preparing for the 1st Day

GatezRN · May 27, 2015

What an exciting time for you!

Bring your stethoscope, a few pens, a highlighter, and good pair of bandage scissors. When I was a new nurse I had a new drug book... but that before the age of smart phones. There are some really good apps that may help you for quick reference..... I personally like Medscape. However, some places don't allow you to carry your phone, so check with your preceptor to see if that is allowed. Your unit should have reference books if you need... there's always Google which many of us use to look things up quickly.

Your brain.... Some nurses have made templates that they have tailored to their preference. Don't be afraid to ask them for a copy if it's something you think you could use to organize your shift. It's basically a sheet of paper that provides a written report of your patient, their diagnosis, labs, med times, pertinent history, ect. I add alot of info to my brain during report. You make it what you need it to be. I tend to write a lot as I go about my day, but others do not. It will take some time, but you will find what works best for you.

When I worked Med-Surg the typical day would be something like this.... I arrived early to research my patients for the day and jot things down on my brain. I was ready for report at the start of the shift. After report, if not doing bed side report, I would always pop in and lay eyes on each patient before I began my day. A quick introduction and to let them know that I would be back shortly and make sure they knew how to use the call bell. You will need to prioritize your day to get a plan. For example, if a patient is scheduled for surgery I would assess them first, make sure all their paperwork was complete, and check on preps and antibiotics. I would try to assess and pass meds for one patient at a time. Document as you go if you can to avoid end of shift cramming. You will be busy! Ask questions and offer to help. Treat your CNAs with respect, help them out when you have a few extra minutes, and know that they are doing back breaking work. Get on the unit secretary's good side.... they can be amazingly helpful, or make your life miserable. Most of all, don't pretend to know something you don't. If a doctor gives you an order you don't understand or is talking about something you are not familiar with, ask them to explain. Most doctor's and seasoned nurses are happy to teach. Jump in with an open mind, embrace this learning experience. Best of luck to you!!

blackribbon · Jun 13, 2015

I don't have time to use books. For drugs, I use Micromedex on the eMar. Organize your pockets. I know my multi-color pen, my penlight, and my highlighter go in my right shirt pocket...I also put my alcohol wipes in that pocket. My permanent marker, and my dry-erase go in the left shirt pocket along with other things I don't need as often (I am right handed). I put a role of tape and my phone in my jacket pocket and carry my notes and any bagged meds in the opposite jacket pocket. My extra saline syringes and my scissors go in my cargo pocket on my right leg (and I don't buy any pants that don't have this pocket).

I went through a number of brain sheets before I got to the one I use now. Initially, I needed the brain sheet to organized more info but have recently modified the one most our nurses use (so we handoff info in the same order) so that I can fit all 6 pts on one piece of paper. I have a second sheet that I organize med schedules ... I can also write down when prn meds are available so with a glance I can tell a patient that her next dilaudid isn't available until 2:17...or whatever it is. I also keep the various IV bags and the rate written on this so I can have an idea when I need to be grabbing the next bag and what is in it. Other people just use the eMar but I'd rather be aware that I have an antibiotic due at 00:00 and another one at 00:30....and it helps me decide whether or not I really need to wake a person up at 5am for a heparin and a flush or if I should hold off because they have a 6am thyroid med due and a 7:30 Prilosec or Protonix due (what idiot schedules those?)

The best advice is to keep reorganizing until you find a method that works for you. Good luck.

jessRN465 · Jun 27, 2015

Best advice- get to the unit about 15 minutes early and review your patients for the day. When your day starts, sometimes it can get hectic and you aren't able to read up on their history or progress and key information can be in there. (ALWAYS CHECK LABS AND RADIOLOGY).I also ALWAYS make it a point to read the "physician progress" note sometime during the day because many times they will write a plan there but will neglect to give those orders.

Brain sheets- using a few different and seeing what works best for you is my best advice.

adamRn79, BSN, RN · Jun 27, 2015

Stethoscope, pens, highlighter, scissors. Advice: consolidate your meds and tasks (ie: give 9am and 10am meds together, draw blood and do dressing change at same time). Find out what MDs you typically call, write down important numbers, ask tons of questions. The hardest part is figurin out where everything is

thenightnurse456 · Jun 27, 2015

Things to carry: Stethoscope

4in1 pen

Sharpie

Medical tape

Sanity

A brief view of my night when I was a floor nurse:

6.15:arrive early. Check assignment. Check charts. Check orders. Check labs. Plan my night using brain.

6.30: Report. Insist on walking rounds and bedside report. Eye ball the patients. Check wounds/drains/IVs

7.00: Assess+medicate based on priority. Vitals. Chart as I go. Receive an admission. Receive a post op patient. Family members want to talk. Confused patients are climbing and wandering.

9.00: blood sugars. Hygiene. Settling patients for the night. Kicking visitors out. Put out any remaining fires from the busy day. Call Drs. Get orders. Attempt to get a sitter for the patient climbing/wandering. Attempt failed.

10.00 Dressings. IVabx.

12am: 24hr chart checks. Fluid balances. Assessments and vitals.

1.00-4am: Anything could happen.

4.00: Assessments and vitals. Hygiene cares. People starting to wake up. Chart as I go.

6.00: IVabx. Change bags and lines for day shift. Medicate. Dressings. Prep patients on morning theatre list. Prepare for report. Receive admission right before change of shift.

6.30 Report.

7am Run to car.

excited1 · Jun 27, 2015

Things to carry: Stethoscope
4in1 pen
Sharpie
Medical tape
Sanity
A brief view of my night when I was a floor nurse:
6.15:arrive early. Check assignment. Check charts. Check orders. Check labs. Plan my night using brain.
6.30: Report. Insist on walking rounds and bedside report. Eye ball the patients. Check wounds/drains/IVs
7.00: Assess+medicate based on priority. Vitals. Chart as I go. Receive an admission. Receive a post op patient. Family members want to talk. Confused patients are climbing and wandering.
9.00: blood sugars. Hygiene. Settling patients for the night. Kicking visitors out. Put out any remaining fires from the busy day. Call Drs. Get orders. Attempt to get a sitter for the patient climbing/wandering. Attempt failed.
10.00 Dressings. IVabx.
12am: 24hr chart checks. Fluid balances. Assessments and vitals.
1.00-4am: Anything could happen.
4.00: Assessments and vitals. Hygiene cares. People starting to wake up. Chart as I go.
6.00: IVabx. Change bags and lines for day shift. Medicate. Dressings. Prep patients on morning theatre list. Prepare for report. Receive admission right before change of shift.
6.30 Report.
7am Run to car.

I love this SO MUCH!!!!!! Lolololol. Notice how eating and bathroom breaks werent listed? Get used to it. Thanks for the realistic humor!