Tips and tricks

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Hey guys! I'm just wondering if I can get some helpful tips on how to manage a shift. Especially time-wise. I'm re-entering the profession and have only a little bit of experience as a CNA. My biggest problem were managing and prioritizing my tasks.

So... I am interested to know how you guys do it?

How do you prioritize and time manage? How do you know which patients/residents you should attend to first? And what are the things that will help me be more efficient in performing tasks/procedures.

I welcome all answers whether you're a CNA, LPN, RN, etc...

Also would like to get input from agency nurses... Thanks!

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Specializes in CMSRN, hospice.

Patients first, charting later. Trouble breathing, lots of blood, and big safety issues before pain meds; pain meds before, "Can you fluff my pillow?" And as much as I do not want to leave big urgent stuff to the next shift, it's okay if you don't finish every last little thing. Nursing is 24/7 for a reason.

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Patients first, charting later. Trouble breathing, lots of blood, and big safety issues before pain meds; pain meds before, "Can you fluff my pillow?" And as much as I do not want to leave big urgent stuff to the next shift, it's okay if you don't finish every last little thing. Nursing is 24/7 for a reason.

This is great... thanks!

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Specializes in PACU, pre/postoperative, ortho.

So, this what I TRY to do, but doesn't always work out...

I glance over my pt summary/orders before report to get an overview of the type of pts I have for the shift. After report (unless there is something that needs done ASAP), I look over the meds for each pt to avoid missing any that are due right away. I then choose the order I want to see them based on status - new surgicals & whoever is considered least stable first typically. Also factor in pain status, medication schedule & anyone that may be getting ready to leave the floor for surgery or tests.

I agree with the sentiment of patients first before charting. HOWEVER...do not wait until you have "free" time or the end of the shift. Make time. For me it usually works best to try to chart what I consider "essential" charting right away. I try to put in my system, wound & pain assessments after seeing each pt if possible. Usually only takes a few minutes & doesn't put me behind. The other charting can wait. Sometimes, I'll see half my pts, chart their assessments, then see the other half. Being able to do this really depends on the status/acuity of your pts & how demanding they might be.

Taking lunch can be tricky. I try to make a goal of being caught up by a certain time to take lunch, like trying to schedule it in as if it's another task. Sometimes that works... You really just have to stop & think, "Will there be catastrophe if no one sees me for 30 minutes?" Probably not.

Dressing changes I save for mid-shift. I usually try to help out the cna with 1 or 2 baths by taking the bed bath to my A&O pts when I first see them; I also try to meet up with the cna to bathe any total care pts to do the assessment at the same time.

Sometimes it works out, sometimes it doesn't.

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Specializes in Med-Surg, Emergency, CEN.

1. Sickest pts first

2. Meds, VS and charting together (take a mobile computer with you, always assume they want their PRNs if they are due)

3. Settle all of your pts (bathroom, food, etc) so you're already done with that for a while.

4. If they ask during 1 or 2, ask someone to help them

5. Start again

**always assume that you are getting a new admit and plan accordingly! Then you are never overwhelmed when it does happen**

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So, this what I TRY to do, but doesn't always work out...

I glance over my pt summary/orders before report to get an overview of the type of pts I have for the shift. After report (unless there is something that needs done ASAP), I look over the meds for each pt to avoid missing any that are due right away. I then choose the order I want to see them based on status - new surgicals & whoever is considered least stable first typically. Also factor in pain status, medication schedule & anyone that may be getting ready to leave the floor for surgery or tests.

I agree with the sentiment of patients first before charting. HOWEVER...do not wait until you have "free" time or the end of the shift. Make time. For me it usually works best to try to chart what I consider "essential" charting right away. I try to put in my system, wound & pain assessments after seeing each pt if possible. Usually only takes a few minutes & doesn't put me behind. The other charting can wait. Sometimes, I'll see half my pts, chart their assessments, then see the other half. Being able to do this really depends on the status/acuity of your pts & how demanding they might be.

Taking lunch can be tricky. I try to make a goal of being caught up by a certain time to take lunch, like trying to schedule it in as if it's another task. Sometimes that works... You really just have to stop & think, "Will there be catastrophe if no one sees me for 30 minutes?" Probably not.

Dressing changes I save for mid-shift. I usually try to help out the cna with 1 or 2 baths by taking the bed bath to my A&O pts when I first see them; I also try to meet up with the cna to bathe any total care pts to do the assessment at the same time.

Sometimes it works out, sometimes it doesn't.

Thank you... There are a lot of great tips here that I would try out. I'm trying to get like a realistic, holistic idea about what goes on within a shift... and this is great!

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1. Sickest pts first

2. Meds, VS and charting together (take a mobile computer with you, always assume they want their PRNs if they are due)

3. Settle all of your pts (bathroom, food, etc) so you're already done with that for a while.

4. If they ask during 1 or 2, ask someone to help them

5. Start again

**always assume that you are getting a new admit and plan accordingly! Then you are never overwhelmed when it does happen**

Awesome! Yeah... with the admission... a friend gave me like points and tips for it. But I have to review it again just to make sure I get what needs to be done. Thank you!

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Patients first, charting later. Trouble breathing, lots of blood, and big safety issues before pain meds; pain meds before, "Can you fluff my pillow?" And as much as I do not want to leave big urgent stuff to the next shift, it's okay if you don't finish every last little thing. Nursing is 24/7 for a reason.

I really like the last part you said. lol I feel like everything needs to be done within a shift. I mean, it's no excuse to slack but you get swamped sometimes. Thank you for saying that... it's pressure that's off my shoulder. And thanks for the tips :)

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When I first started out (and even sometimes now), I use a paper check list. Little boxes and everything. Sometimes having a paper brain really helps, and makes sure nothing gets lost in the shuffle. I also use it to jot down notes if I can't get to a computer so I can transcribe later.

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