Prioritising complex workloads

Just depends on the patients and the task. A daily dressing may be put off until last but if the dr comes in and rips off the old one at 0900 then the dressing change gets moved up the list. Some daily meds can be given late but if you have antibiotics that are Q6hr then they need to be given at the right time for therapeutic levels.

When you have heavy workloads, what tasks do you typically prioritise first? Medications? Dressings? etc.

I agree with the first response. Beyond that, I also consider the patient's habits and preferences. If they stay up all night and call on the dot for narcotics, I might do their dressing at 3AM (after an administrated dose). If they go to bed by 9PM, I'll put a rush on it if I can.

I also learned the hard way that doing a daily dressing change first thing in the morning isn't always the best- it really sucks when the doctor comes and rips it all off and it needs redone again.

After report, I make assessments my first priority. If the workload is heavy, I will do some but not all of the first round of charting, even if it just vital signs and a few other bits of documentation. (I spend more time than ever charting on computer than I ever did with paper charting).

Timed meds are my next priority if no crises or big interruptions happen.

I feel I have reached a milestone in my day once all assessments are done and charted, all first rounds of meds are given, and the doctors have rounded and I have new orders for the shift.

Only after that point do I deal with things like changing lines, changing dressings etc.