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tips for prioritizing

Med-Surg   (1,056 Views 4 Comments)
by Shelly0928 Shelly0928 (New Member) New Member

Shelly0928 has 18 years experience .

300 Visitors; 7 Posts

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HI. So I recently took a job in a hospital after being away from that environment for over 12 years. Its a night shift job which itself poses it's own challenges for me since I am an early bird day person, but I digress..

We see med surg and post ops , ratio is 1:6. What are your tips for the best way to organize your night?

By the time we get report on all our patients, it is usually arleady 8pm. I usually will take about 15 mins afterwards to review anyone's info that I didn't get to prior to the start of shift. D o you do a 9 pm med pass on each patient and then go back to do assessments, or do you try to tackle both at the same time, finishing with assessments around 10 pm ?

Just trying to keep myself from double work.

Any tips are greatly appreciated.

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Sour Lemon has 9 years experience.

733 Likes; 2 Followers; 28,858 Visitors; 4,076 Posts

HI. So I recently took a job in a hospital after being away from that environment for over 12 years. Its a night shift job which itself poses it's own challenges for me since I am an early bird day person, but I digress..

We see med surg and post ops , ratio is 1:6. What are your tips for the best way to organize your night?

By the time we get report on all our patients, it is usually arleady 8pm. I usually will take about 15 mins afterwards to review anyone's info that I didn't get to prior to the start of shift. D o you do a 9 pm med pass on each patient and then go back to do assessments, or do you try to tackle both at the same time, finishing with assessments around 10 pm ?

Just trying to keep myself from double work.

Any tips are greatly appreciated.

My strategy changes daily based on the exact circumstances of the moment. My default is to round and assess before doing much of anything else, though.

That way, I have a heads up on any issues that require calls, know what PRNs and "comforts" to bring, and can pass meds without dealing with a lot of extras.

I typically start charting after med pass or during it if I'm delayed for any reason.

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24 Likes; 1,088 Visitors; 41 Posts

HI. So I recently took a job in a hospital after being away from that environment for over 12 years. Its a night shift job which itself poses it's own challenges for me since I am an early bird day person, but I digress..

We see med surg and post ops , ratio is 1:6. What are your tips for the best way to organize your night?

By the time we get report on all our patients, it is usually arleady 8pm. I usually will take about 15 mins afterwards to review anyone's info that I didn't get to prior to the start of shift. D o you do a 9 pm med pass on each patient and then go back to do assessments, or do you try to tackle both at the same time, finishing with assessments around 10 pm ?

Just trying to keep myself from double work.

Any tips are greatly appreciated.

As Sour Lemon said, it's a good idea to make rounds on patient's first to get an idea on what PRNs you will need to bring on your med pass. That's a potential time savings of 6 pyxis trips! I typically will try to do assessments as I do intial rounds if time permits. Sometimes I have an admit or discharge right at the start of shift which I will priortize first. If not, I do med pass first and then chart assessments. I have had bad experiences with doing a late med pass and then something else comes up like a code, admit, or even getting floated!

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Persephone Paige has 15 years experience as a ADN and works as a Med-Surg.

305 Likes; 3 Followers; 1 Article; 3,145 Visitors; 578 Posts

I'm new like you and just barely holding on. I am an organized person, I am an adult ADHD. My day starts at 6:30am. I come a little early and it makes a difference. The first thing I did was found a "brain sheet" that works for me. I get 6 patients and take a couple minutes each to get a mental picture of why they are admitted. I can also see Vanco Troughs, etc... I get report quicker that way. Typically done by 7:30 am, then I do Accu-checks so I'll know how much Insulin to pull with the scheduled meds. Then, I pull meds... We have the typical 09, 13, 1800 meds, but in between all day long are Antibios, K+type IVs. I pass the meds and shoot to be done by 10am. All along, I am assessing. I can check capillary refill during an Accu-Check, I can listen to lungs a minute longer while I check an Apical Pulse. At 10am I try and chart. If I can at least do the Assessment and Teaching part of the charting during this time, I leave sooner at the end of a shift. At 11-11:30am I do Accu-Checks and then pull 12-1300 meds, then I give them. Any 'free' second I have after 1300 med pass is padding for when the shit hits the fan. If I can pull my 14, 16, 17, 1800 meds early, I do. If the shit hits the fan early, I say what can wait? D'cs get priority because they want another patient to fill the bed, they're relatively quick. If I get an admission, I do a quick assessment, get them comfy, IV fluids, Tele, a med going and then go back to what's left of my routine. I can do the admission questions later. If someone codes, septic, etc... all that goes out the window. As soon as one domino falls, they all start falling. As your peers: I've got X,Y,Z happening all at once. Help me prioritize? They will.

I'm practicing clustering my care. So in so wants a blanket, pt X want's Milk Of Mag PRN, Pt Y needs a new bag of NS. I make a circle and hit the med room first, pick the blanket up next and the NS last. Pt X needs a drsg change, I'd do it when I hang his IV and take his BG.

I waste a lot of time making trips, I'm getting better at making those trips count.

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