Jump to content

Tips for a good shift!

Nurses   (15,832 Views 30 Comments)
by Good Morning, Gil Good Morning, Gil (Member)

Good Morning, Gil has 3 years experience and specializes in Rehab, critical care.

14,095 Visitors; 607 Posts

advertisement

You are reading page 2 of Tips for a good shift!. If you want to start from the beginning Go to First Page.

Ruby Vee has 40 years experience as a BSN and specializes in CCU, SICU, CVSICU, Precepting & Teaching.

11 Followers; 65 Articles; 170,459 Visitors; 13,938 Posts

take your breaks. cpr can't wait for your lunch break, obviously, but most else can.

laugh when you can.

the worse shift in the world makes a very good story some day.

Share this post


Link to post
Share on other sites

Sewbusy~RN specializes in Orthopedics.

2,255 Visitors; 65 Posts

1. Keep in mind that nursing is a 24 hour job and you can't and don't have to do everything.

2. At the start of the shift, sit down and write yourself a skeleton schedule; include when you expect to pass pain meds, do dressing changes, pull catheters etc. Highlight things that are your highest priority.

3. Pee if you need to pee, for goodness sake! Your patient can wait three minutes. Two bladder infections taught me this lesson.

4. Have a roll of paper tape, a couple 2x2s, alcohol wipes, stat locks, IV caps and flushes in your pocket at the beginning of the shift. The first 4 hours are usually the busiest and the last thing you need to be doing is running back and forth to do minor things you notice need to be done during your initial assessment.

5. When you have an older confused patient that keeps trying to get out of bed or pull lines etc., take the time to do a bed bath if you can! Then cover he Pt with a couple of warm blankets and turn on some classical music if your hospital has music therapy. This usually puts the patient to sleep and almost always is more effective than Haldol or Ativan. However, if your patient is pulling lines/taking a swing at you or jumping because of withdrawal, go with the meds, lol!

6. Gain the trust of your patients right away, by doing what you say you will do, and little things like wiping their bedside table down with an antiseptic wiper giving them a warm blanket. If they can see you care and want to make them comfortable, they will generally stay off the call lights. Caution: this can backfire at times so be sure to assess your patients psychosocial needs as well as the physical when you first go in the room.

7. Accept the fact that you are only one person, and it's ok to ask for help. You are not super man/woman.

8. Realize that some shifts you will spend the entire time putting out fires, and you won't be able to do any of the things you want to do. On those days/nights, just let it be what it is and remember the shift WILL end!

Share this post


Link to post
Share on other sites

Cuddleswithpuddles has 11 years experience.

12,491 Visitors; 667 Posts

ok this is sneaky: for M/S etc. - get there ten minutes before report. Figure out which pts exceed 200 lbs, avoid them at all costs.

For ICU, take the two messiest pts.

I don't understand the 200 lb thing. There are plenty of walky talkies over 200 lbs. Could you elaborate?

Share this post


Link to post
Share on other sites

brandy1017 is a ASN, RN and specializes in Critical Care.

37,321 Visitors; 2,270 Posts

I'm scared of the 300-500 pound patients, 200 pounds is about average it seems. It's such a delight to get a little old skinny lady, light as a feather, safe on your back.

What's up with taking the two messiest patients, that doesn't make sense? No doubt they are obese and incontinent, unless your plan is to put tubes in them and fix it that way. lol I don't understand why a foley is so bad, they have silver antimicrobial ones these days and if it were me I'd rather have a foley than wet the bed! Just sayin.

We do have a nurse where I work that would come in early and change the assignment to avoid the heavy patients (complex dressing changes, etc). This went on for a long time till finally the supervisor put an end to it. We have another nurse that comes in "late" and then has a meltdown and demands certain patients because she had them before, etc and her coworkers have already gotten report, but they just give in and change the assignment or even float out of turn rather than deal with her drama!

My feeling is, hey if your going to be changing the assignment, at least have the courtesy to come in early! I think it is reasonable to say, please don't give me this patient I've taken care of him and I just need a break! WE are human after all! I think that is the proper way to go about it rather than just sneakily changin assignments!

Share this post


Link to post
Share on other sites

Good Morning, Gil has 3 years experience and specializes in Rehab, critical care.

14,095 Visitors; 607 Posts

Good posts! I think maybe she meant the messiest patients as in most critical? So, they're more likely to be sedated, and not thrashing about in the bed? lol. Maybe that's not what she meant, but that's how I took it.

Good luck everyone!

Share this post


Link to post
Share on other sites

latina2brn has 1 years experience.

1,649 Visitors; 29 Posts

Hi LobotRN,

I am curious what do you have on your laminated card? Please share it would help me and I'm sure many others! =)

Thanks!

Share this post


Link to post
Share on other sites

AICU RN specializes in ICU.

3,633 Visitors; 78 Posts

Ruby,

You're comment about the worst shifts making the best stories made me smile. I've had two in the past two months that I've earned some good-natured teasing over.

1. I was in my very first code in our ICU. We were giving RBCs left and right and someone handed me a bag that we just checked. She didn't tell me they weren't clamped. I splattered blood everywhere. Before I realized what I was doing, I turned slightly toward my right and squirted blood all over one of our trauma docs. I wanted to cry. She was cool about it though. Now everytime she sees me she teases that I owe her a shoe shine :uhoh3:. Some of the nurses thanked me squirting her (hehe).

2. I made what I thought was a huge mistake that ended up working out for the best in the end even though I didn't realize it until later. I was really upset about it that night and on my way out one of the experienced nurses made a comment about it and I thought she was serious. When I realized that she was joking (and that it's something that happens kind of frequently on our unit) I was fine but it has earned me a nickname of sorts.

So thanks for reminding me that there's always something to be taken away from a shift, good or bad. :heartbeat

Share this post


Link to post
Share on other sites

carolmaccas66 is a BSN, RN and specializes in Med/Surg, DSU, Ortho, Onc, Psych.

14,145 Visitors; 2,212 Posts

- Start everything early on ur shift. Do IV meds first: they take up the most time, ie: mixing, checking & setting up the pump.

- Use a good cheat sheet to get yourself organised.

- Don't let people/patients/families etc manipulate ur time. Learn how to say no or how to handle people.

- Get to work a bit earlier 4 handover & to get ur pt load.

- Learn to prioritise your work.

- Time management & people management will be your 2 biggest hurdles to overcome.

- If u make an error, say something. Don't try 2 cover it up. Report med errors immediately - the outcome won't be as bad as you think. Covering up med errors especially looks worse than not reporting it.

- People will always be annoying, impatient & demanding. Learn how to handle them quickly, talk to a psych nurse if unsure how to do this.

- Always start writing your notes EARLY. The earlier the better. If you forget something after u have written ur notes, you can always add it in later.

-Always call the doc for anything necessary even if it is 3am, and yes...they will be grumpy so expect it. Just have all your facts in front of you & apologise for disturbing them & remain professional. Use a walkabout phone next 2 the patient's bedside so if u 4get anything the doc wants to know, you can access it right away @ the pt's bedside.

- Old patients will take up A LOT of ur time. They can be petulant & very demanding. They love to talk about anything: the weather, their grandchildren, their pets. Do not let them take away ur time - you can be talking whilst doing ur work. Learn good work & people habits, and if you need to get away from a particularly chatty person, just cut them off and say: I will be back Mr/Mrs later on as I have to go see my other patients now. Do not stand & hope for a break in the conversation, cos it won't come - time will fly away from you otherwise.

Cannot think of much else at the mo.

Share this post


Link to post
Share on other sites

Perpetual Student has 4+ years experience and specializes in PACU.

9,269 Visitors; 682 Posts

Use down time (make a little if you have to) to keep yourself hydrated, toileted, fed and so on. There are few things more annoying than worrying about wetting your pants while doing a jaw thrust, for example.

Have fun. Chat and joke around with your colleagues and patients while your hands are busy with tasks that don't require much thought.

Be flexible and roll with the punches. Few things ever go as planned.

Share this post


Link to post
Share on other sites

AnonRNC specializes in NICU.

7,267 Visitors; 297 Posts

Prep your uniform and lunch/snacks the night/sleep before. Get up on time. Leave on time. Arrive on time. Plan, PLAN, PLAN as soon as you get report.

Find what you love about your job and focus on those moments.

Share this post


Link to post
Share on other sites

6,186 Visitors; 85 Posts

Always bring a tasty, nutritious lunch. It's something to look forward to, and gives you energy to get through the day. I usually make a batch of salad (something with protein, like a quinoa or chickpea salad), and then i have enough to last me 3-4 days.

Also, wear quality, comfortable scrubs. It always makes me feel better about my day.

Share this post


Link to post
Share on other sites

13,677 Visitors; 652 Posts

I LOVE this thread! Your suggestions have been noted.

Personally, I noticed that if I TRY to complain less (muttering to myself, gossiping with other staff, venting my frustrations every chance I get), I tend not to get wound up in negativity and my shift seems like it went a lot better in retrospect

Share this post


Link to post
Share on other sites
  • Recently Browsing 0 members

    No registered users viewing this page.

×