Here's Mine I mostly work 12's on Days
I work 7p to 7a on Tele.
For what it's worth. I do a lot of fill in in the areas without actual headings that way I can tweak it on the run. The far right column is to make sure I get all the required charting done.
Tom
oops...guess allnurses can't rez an excel file. It's a screenshot. PM me if interested and I can email it to ya!
I never liked "brain sheets" I don't like the space siuation with them. I start my shift with a plain sheet of paper stapled to each patients nursing worksheets. I write in the same spots all the info needed... patient activitys and orders in a list at the left corner with a line for me to add in my info such as I&O, accuchecks, tele reading, cardiziem drip rates, ect. Bottom of page left corner goes hx old labs the sory if you will. right upper corner goes all new orders, next to that the things still needed pending labs, stool sample ect. down the center is assessment info iv spot O2 spot and I write report I recievd in red and anything new in black. I then stack sheets cut the corners for easy access to each patients pages and place on a cip board which I carry as a tray for meds water iv eqipment, basically for what ever I need to bring into each room.
It takes a while to find a system that works for you. Most nurses at my new hospital carry around very large three ring binders, that just blows me away but it is really a peronal preferance. I worked floating the house for 10 years and now have settled down to the tele unit. My paperwork is able to chage for every situstion and worked well for me on all types of units.
I work on a Cardiovascular/Medicine tele floor (40 beds, 24 of which are 5 lead tele). I have 2 report sheets that I use (one that "holds" 4 patients, one that only holds 1 patient). I work 7a-7:30p Fri-Sun, so I need lots of space to write. I also have a clipboard that I lose all the time! I am new to the site, so I can't figure out how to attach the files, if anyone wants them, please let me know!
I work 12hr day/night rotations. I use this brain sheet I created in addition to the one our floor uses which outlines all the body systems.
You will notice small boxes so I can make checks when I complete the items. For example, on the right side where VS, Med, mar, etc... two boxes that need to be checked. Once for AM, once for PM so I know I did them. I used to have a problem of quadruple checking if I documented things. Now I just check the box so I know if I did it, and I don't look again!
nurseJ88
57 Posts
Hello. I want to see how your Organization/Brain sheet is set up to get ideas before I make my own. Sharing this will be of great help.