How do you manage your time while working on the floor? Do you use a PDA? Do you use a clipboard? Do you use a folder? Do you just use scrap paper?
How do you keep your patient's seperated from another without getting information for one patient mixed up with another?
Does anyone have any tips or suggestions for time management?
I Just started nursing management, my final semester and it all seems so overwhelming! We start out with 2 patients then gradually work our way up to 6 over a 10 week span. And the instructor gives us more patients when she feels we are ready so we are comfortable with it. But geez, I've only had more than one patient ONE TIME on clinical! Theres a few people in my class who have never had more than one patient.
I have a PDA so hopefully this will help. Does anyone have any tips how to use your PDA to managetime?
Specializes in home & public health, med-surg, hospice.
the key to organizing is to be flexible and flow with it. if you can tell me how to hold on to a pen i may have this mastered.
okay, i know you were probably sayin' this in jest but...i use a pull top pen that hangs around my neck from a stretchy cord, it's so convenient!
this nurse gave me a great tip today. i have this report template that i use with my pts. info. anyways, she recommended taking report in one color and then anything you add to it during the day, use a different color. tried it out today and it worked pretty good!
We computer chart at my facility. With computers in the patients' rooms the secret is- CHART AS YOU GO! no sense writing everything down on a cheat sheet and then transfering all of that info into the medical record. Too much time wasted and transcription errors are too easily made.
I like the the hints written by the nurse who has trouble keeping her pen. My suggestion for her: just take someone else's pen. Eventually they will all circulate around and yours will come back at you. Kinda like musical chairs!
Well, let's see here. Where I currently work, we have a Kardex system. It is a preprinted form with most of the pt's info on it. I staple each pt's Kardex in each pile. Then I use colored tabs for the side of the Kardex with the pt's room number on it. This helps me keep each pt's Kardex seperated. Then I use a clasp ring to hold them all together. I jot down information that I feel is important on each pt's Kardex as the day goes on. It could be anything from what doc's I have called to what prn meds I have given with their times, etc. I periodically check labs and new orders throughout the shift and jot anything down that is new or concerning to the pt's condition. I use this as a system and just keep updating it as the day goes on. Just FYI, I always write down what I found on my assessment on each pt right after I do it. This way,, if I can't chart right away, I have a reminder of what I observed. Sometimes it's hard to remember details if you have a heavy team or a lot going on with one of your pts.
Now, at my previous job, we did not have a Kardex system. Everything was pretty much handwritten. So, I made up my own little paper or graph if you want to call it that. I would start with a computer sheet of blank paper. I would take a bold colored marker and draw a line down the center. Then I would draw 3 lines across measuring out to give me 6 equal squares on my sheet of paper. Each square was a space for my pt. You have to write small obviously. I would write down the pts name, age, doc, admission date and diagnosis. Then I would designate spaces for certain things like labs, blood sugars, vital signs etc. Any other info through out the day, I would write on a seperate sheet if I ran out of room.
You know, everyone has their own little system they use to help them keep track of things. You'll find yours and what works best for you. Hopefully you'll find some ideas throughout your clinicals. If you see a nurse that's not too busy, (Yeah! Right!...LOL!!) ask her/him how they do it. Good luck.
Okay, I know you were probably sayin' this in jest but...I use a pull top pen that hangs around my neck from a stretchy cord, it's so convenient!
I actually tried that one time but felt really silly when I reached for the pen and all that was hanging there was the cap. Yesterday a doctor gave me 5 pens and 2 for my co-workers I couldn't find one three hours later. Ususally I do have to resort to just picking what whatever gets left lying around. Thanks for the tip though.
I'm having a really hard time with my time management, still.
We just started our clinicals with more than one patient and I already MESSED UP on the FIRST DAY!! I tried to carry around a folder and keep each patient's info on a seperate side of the folder.
The 2nd patient had to have a 730 med which I tried to give right away right after giving report. Then I had to get the first patient packed up because she was being transferred. So I had to get all of her transfer information ready and get her packed up. Then I had to call and give report on her as well. I did all of this and then I had to give the second patient her 8 o clock meds. There was only 2 so I thoguht id give the two 8 o clock meds and then give the 9 o clocks a lil later. Then I find out that the 2nd patient is getting discharged. So I have to give her the 9 o clock meds too and get her packed up. Then I also have to do assessments on patient 1 and 2.
Then after getting patient one packed up and ready to be transferred to another floor we find out that the doctor wants to send her back to the nursing home instead of being transferred to another floor. So then I have to get her 9 o clock meds out as well.
When I was getting the 2nd patient's 9 o clock meds ready .. I ended up making a med error. I think it should be considered more of a near miss but hey, what do i know? I got all of the meds ready and then the instructor was going over them and I ended up missing the last med because it was on the last page of the MAR all by itself. I totally effin missed it! I double checked the meds and everything. I'm really parranoid about getting a med error. But I ended up getting a med error because of that. I realyl don't like that policy though. I think that the instructor should give me the chance to notice the mistake on my own. Like after giving the rest of the meds to the patient and I sign the MAR that I gave them.. I should have one last chance to look at that MAR and notice that I did not give a med. I'm not saying that this would have happened in my case , but I think it would have been more fair. Ehhh I dunno.
But I just felt soo disorganized, rushed, confused, incompetent, ... oh the list goes on and on!!!
I have a PDA... i should be organized but I don't know what to do!
Try looking up "report sheet" and "brain sheet" in the search feature for this site. There's good stuff to be found.
I've had fun with a lot of different types of organization. I'll list 'em and you can already see that there's a lot of variety.
1. different size index cards with patient sticker on top. I would stick report on one part, assessment somewhere else, VS, and what times I was in the room. Actually, on any brain, paper, whatever you wanna call it, I have that little feature. I'll scribble a time down and next to it, will be some abbreviated mess that nobody else can read, but basically is what I did or found, or both. It'll be a couple square inches sometimes on a piece of paper, but I can actually chart a whole shift from that.
2. little bitty notebook. About 4x6 inches or so? that fits in pockets. On each page I date it, put patient sticker, and proceed to use it like an index card. Plus is that if I do something for someone else's patient, I have plenty of paper to write it on. That helps in emergencies, or if I'm getting admissions, etc. Also helps because I used to be good about not setting it down anywhere. It was in my pocket or in my hand, but I did NOT lose it.
3. Clipboard. Fun stuff. Clipboard doubles as a drink tray, set your meds on it, gather glucometer, meds, snack, drink, and take it all in the room at once kinda thing. Of course, the paper on the clipboard is going to have some smeared spots, and some sticky spots from all the crap you'll spill on it, and be careful where you set it down. Just get in the habit of wiping off the back of it when you clean your equipment. The paper you use, well that's why I said to look up "brain sheet" and "report sheet." It will differ, and don't be afraid to try something new. Eventually one will click with you.
4. Binder. I bought my own binder 'cause not all the ones we use have a clear thingy where you can stick paper on the front of it. Plus I know mine's clean, since I keep wiping it off. Not being paperless, this facility has MAR's and nurse notes. Most nurses keep the binder at the desk with this stuff in it. Hah. I have been doing this a few months, it works nice and buys me some time. I stick the brain sheet in the front and MAR's and notes are in the binder. There's a zip pocket in there too with odds and ends. I can chart IN the room or just outside it. I can go down the hall, do VS and assessments, stop at the computer cart, put 'em in the computer, stand there 5 extra minutes (maybe 10) and write a note on everybody. It is quite a bit faster and if a patient has questions about meds then I have the answers in front of me. And, my brain sheet is protected by the clear cover so whatever is sticky is easily cleaned off.
5. Paper in pocket. Usually this is whatever form the unit has available to take report on the patients. A lot of nurses use this, its probably one of the most common things. People grab rulers and line the report sheet in whatever fashion they like, front and/or back, and use it all day, folded up in the pocket. Of course, if you lose it, you're in deep doodoo. But it's lightweight and flexible.
As far as the other end of being organized goes, you have to develop a routine that makes sense to you and your unit, and incorporates getting stuff done on a stable group of patients that will be there all day, and get in the habit of charting as soon as possible after you do stuff. Meaning, if you don't discharge and admit constantly, your stuff will be done and you'll have time for TLC, bathroom breaks, and eating your lunch. If you do have discharges and etc. then you'll be able to work them into the routine.
One thing: know who's supposed to go home and when you first see them, tell them about what time you think it's going to be. Like, don't say "within a half hour" or any kinda mess like that. My favorite is "after nine AM" and the reason is, we make their followup appts (the secretary does) and doc's office open at nine am. So that gives you time to assess, get VS, feed, and medicate before you D/C anyone. Hopefully.
Also, see the sticky post in the "first year of nursing" forum for some really good tips on organization. Hope that helps.
how do you manage your time while working on the floor? do you use a pda? do you use a clipboard? do you use a folder? do you just use scrap paper?
how do you keep your patient's seperated from another without getting information for one patient mixed up with another?
does anyone have any tips or suggestions for time management?
i just started nursing management, my final semester and it all seems so overwhelming! we start out with 2 patients then gradually work our way up to 6 over a 10 week span. and the instructor gives us more patients when she feels we are ready so we are comfortable with it. but geez, i've only had more than one patient one time on clinical! theres a few people in my class who have never had more than one patient.
i have a pda so hopefully this will help. does anyone have any tips how to use your pda to managetime?
sad fact: pdas quit, run out of battery, break, stop working, or develop problems the minute you're dependent on them for everything. murphy's law. so you can use the pda for a quick reference, like when you want to let a patient know what that med is for and its side effects or just how to spell something or whatever. it's great for calculating drips, but you'd have to double check those with another nurse or the pharmacy anyway.
that little alarm on the pda comes in handy if i have a timed lab or if i have to remember turning heparin on or off, or to remind myself to check a lab result, but some watches have that feature too, and when my pda quit, i found an equally useful alarm on my cell phone.
for keeping organized, i use kardexes and i fanfold them so each patient has a little space, where i'll write whether they're a daily weight (this warns me that they're probably a chfer and all that goes with that), accucheck times, then each person's med times, ivf's, output source, labs, name and room number.
and so on, but i try to line everything up in the same columns so i can see right off who gets 1800 meds, for instance. (i had to put x's in this because otherwise it wouldn't line up, but i don't do that for my cheat sheet.)
then i get fancy -- important drips are in red. accuchecks are in red. labs for line draws, i highlight in yellow.
when i do the first assessment, i write a check mark. after it's charted, i
If i only had a dollar for every system ive been through! Nothing works every day for every shift. But ive found my current experience of chart as you go on the computer most helpful.
WRITE DOWN ANYTHING OUT OF THE ROUTINE.
I guess that's what's the toughest thing about being a student and then a new grad was... NOThin was routine, haha. So i guess the most helpful in the beginning chaos was to find from other nurses on the floor what their "brain" was like.
The most universally useful was that personal Kardex with the with a stick man or chalk line of a generic man to draw on. You draw on it. and then you dont mix up pts. Then you need. A designated place on your 'brain' for each pt, so if you expect to have up to six patients that day, you need a brain copy that makes enough room for all that day on one sheet. I cant emphasize enough, the beauty of a single sheet of paper. YOu can fold it and fit it in your pocket and check stuff off on it all day. But to fill it out, every brain has the same basic elements litterred about...
1-Basic pt info) Name/room#, doctor, code status. Alerts (like isolation/contact precautions, pregnancy, VIP etc.) Diagnosis, admitting or otherwise- and Some answer the to the question, Why are they here?
2-Delegatable stuff that a CNA can help with) Diet, activity. I&Os and Baths if on days. (Blood sugar checks if CNAs do that on your unit)
3-stuff i need to know or DO as the nurse) scheduled medication/feeding times and Blood sugar check times. Running IVs. Pain and prn pain meds (when was the last one, good to know) as well as other PRN meds in the orificenal, there's a reason for them otherwise they wouldnt be ordered.
You need a blank spot to put labs. (just depends where you work how much room you need) Then a spot to write Extra stuff like dressing changes. AND as spot for DISCHARGE PLANS (helpful when a charge nurse or instructor asks "what's the plan for this patient?"). Does that cover almost everything? The back of the sheet was always for scratch paper for phone calls, telephone #s, MD communication, whatever was not 'direct nursing' kinda stuff.
Eventually, you get tired of filling out all these boxes and blanks and just write down a portion of these things on scratch paper as needed. but until i had a 'routine' down, the 'brain' was essential.
Specializes in med/surg, telemetry, IV therapy, mgmt.
luv2shopp85. . .hey, kiddo, this happens to be one area where i shine. i always carried a clipboard around with me that had important stuff on it that i absolutely felt i needed to carry with me at all times. time management is mostly a labor of love that you will work to perfect throughout your entire career. every time you change jobs or get floated to another unit to work you have to tweak your system to fit the current situation.
here is a copy of the last report sheet that i used to keep my day organized. all are welcome to download and use it.
[attach]5032[/attach] shift report sheet (brains)
when i first started working as an rn i used to make physical "todo" lists of things on the back of my report sheets that i had to get done during my shift and crossed them off as they got done. these lists will help you focus on what you have to get done when things get crazy and your mind seems to go blank on you. believe me, it happened to me plenty of times! my little lists saved me more than once. as time went on and i got more organized i didn't need to write the list down every day. i would still write important items somewhere on my report sheet and circle them in red so they would stand out. i would cross them off when i got them taken care of. i referred to the report sheet frequently throughout the shift. by the end of my shift my poor report sheet looked like it had been through a war! but, i was getting everything done that i was supposed to do. one rn i worked with used to just write stuff in ink all over the inside of her arms and on the palms of her hands! i wasn't willing to go that far. the only time i wrote on my palms was during code blues or an emergency like a seizure where i needed to remember an exact time or a b/p or something like that.
i haven't checked it out, but i have heard a number of newer nurses raving about a book called training wheels for nurses. i don't think it's very expensive or very big either. from what i've read it sounds like it gets down to the basics of what you need to get started as a hospital rn.
When I was getting the 2nd patient's 9 o clock meds ready .. I ended up making a med error. I think it should be considered more of a near miss but hey, what do i know? I got all of the meds ready and then the instructor was going over them and I ended up missing the last med because it was on the last page of the MAR all by itself. I totally effin missed it! I double checked the meds and everything. I'm really parranoid about getting a med error. But I ended up getting a med error because of that. I realyl don't like that policy though. I think that the instructor should give me the chance to notice the mistake on my own. Like after giving the rest of the meds to the patient and I sign the MAR that I gave them.. I should have one last chance to look at that MAR and notice that I did not give a med. I'm not saying that this would have happened in my case , but I think it would have been more fair. Ehhh I dunno.
But I just felt soo disorganized, rushed, confused, incompetent, ... oh the list goes on and on!!!
I have a PDA... i should be organized but I don't know what to do!
Sounds like you had a very busy morning. One thing that helps me is to come in early and check the MAR and other charts. Pre-filling in information such as signatures at the bottom of MARs and check sheets when I can helped me save a couple of minutes when I was doing clinicals. I wouldn't worry too much about the near med-miss, as it happens to all of us, especially when we are in a rush. That's why writing down all meds and their times before the shift starts and you aren't in frantic-rush mode is helpful.
I have to disagree that the instructor should wait till after meds are given to check the MAR, especially when you were given a chance to double check the meds before having her approve them... What would have happened if you ended up giving an entire pill instead of one that was supposed to be halved? What if you gave a blood pressure pill to a patient with a sbp of 95? What if you drew up and gave the wrong dose of insulin? What if you gave lasix but failed to give the potassium with it? Or, what if you held the lasix but continued to give the potassium even if labs were ok? What if you are preparing a med to give it by the wrong route? Sometimes the MAR is wrong and a good instructor can help catch these. This happened on one of my last clinicals, and was not an obvious error by any means. She realized that for my patient's condition, the route/dose (don't remember which it was) listed on the MAR was not correct. This spurred an investigation and my instructor was indeed correct.
Better for the instructor to catch any of those errors beforehand than after the damage has been done.
Hi everyone...I am a new nurse and really appreciate the information about time management. I am having a problem opening the forms that have been listed. Can anyone send me a copy of a worksheet? I have tried googling to find one, but not having any luck. Would appreciate it very much. Thanks and have a wonderful day.
Hi, Glad I found this thread! I just started at a long term care facility 2 days ao and while I already like the job, being assigned 25 to 35 patients is a bit overwhelming! I am concerned about managing my time and thought the notebook idea great.Going to the office supply store today!
but...I use a pull top pen that hangs around my neck from a stretchy cord, it's so convenient!.thumb.jpg.6eeb2c01c27cfd151d706238b7f6d6b7.jpg){kind=small}
Kelly_the_Great
553 Posts
okay, i know you were probably sayin' this in jest
but...i use a pull top pen that hangs around my neck from a stretchy cord, it's so convenient!
this nurse gave me a great tip today. i have this report template that i use with my pts. info. anyways, she recommended taking report in one color and then anything you add to it during the day, use a different color. tried it out today and it worked pretty good!
i included an attachment of the template. also, there's a thread that's got some great ones on it too here: https://allnurses.com/forums/f224/seeking-assignment-worksheet-form-208051.html
Reprt Template.doc