What is your daily routine?

AGUIMAN3MM · Dec 18, 2007

:icon_wink:Having been working for 8 yrs in California,I discovered few effective ways to have nursing routines in my field of work in an acute hospital setting-Actually,not all the times you have the control as nursing is always unpredictable in an acute hospital setting, but at least you can have a structured routine to enable us do effective and satisfying nursing tasks to our patients and into ourselves for peace and sanity! That's what nursing vocation is all about! Well, when I first arrived in the station-I will first check my assignment-----(the ratio/the name alerts/to cover LVN (if any))/the dnr/the isolations/the possibility of admission ),then I go right away to the pts' hard chart--------(the md's orders in that day!(stat orders/standard orders)-this way I will have an ideas what the md's is going to do!---check the latest lab values! esp the SERUM K,H&H,LYTES,CHEM-7!----these will guide you allow the way!------------Then, I will get reports from previous shift(bedside report-see iv's/foley's,tubings,feedings,shunts,call lights,side rails,restraints,name badge,dressing stuffs,room flags-fall risk/npo's/pt's needs:pain meds!water!blankets!etc!)------then, I go to my pts' MAR's--(IV'S/TPN/ANTIBIOTICS)---jot down there time of adm! the need to have pharmacy assist you!--------then,give all the prn meds for pts who are asking if time is permitted-all the pts request for there comfort like water/ice/blanket and all special request that you can help your pts stabilize there comfort/stay------ then,check your pts v/s from your aides! check the abnormal ones!medicate if necessary! prioritize the unstable pt------do quick assessment/medicate and call md if needed-------then start from there! ------medicate each patient as ordered/applicable! and do assessment as you go along the medication! /accuchecks as well! ------before mid night!follow up pharmacy for your needs/pass diabetic snacks as ordered/feeding tubes- renew/dressing change/pre-op patients flags/orders! -----------then do charting30-60 min! by then you are ready for your midnight med runs! -------make sure you have v/s from aids possible! visual check your hard chart of your pts once again! THEN-----after the midnight run! do quick charting 15-30 min,then go for quick snacks! then make nsg rounds after you take your quick break! then do your M.A.R 24-HR CHECKING!--against the pts hard chart! focus one at a time to MAR/ LABS/PROCEDURES! Avoid distractions when doing these! do not talk and socialize! then---do nsg rounds again! then take your long 30-min break!------then do nsg rounds again! THEN DO CHARTING MORE! (V/S,I&O'S)--------After that ready for AM NSG CARE assistance /MEDs&PRN MED rans! / CHARTING! AND last round before you give report to the incoming shift! THEN,finalize all you documentation then.Thank yous to you CNA'S and Charge would be refreshing too!

nckdl · Dec 18, 2007

I work in a nh dementia unit, here is my day 5:30a to 6p---

5:30-6a give report

6a-6:30 grab mar and head to common area with med cart and everything else i might need. Then I watch over the 1:1 pts to make sure they don't fall while straightening up the living room, ordering stuff we need from kitchen, talking with wandering pts.

6:30-9a pass meds, pass trays, help feed people, watch over 1:1 still trying to fall, answer phone and doors multiple times.

9a-11:30a care confrences, charting, faxing Drs on various items, tx's if i have time, occasionally watch 1:1 pts if cnas need break or to do something else.

11:30a-1pm pass noon meds, pass lunch trays, feed people

1pm-2pm chart, tx's if i have time

2p-2:30p lunch if i'm not behind, if i am i eat at my desk while working.

2:30-4p write up any orders from previous faxes, finish my tx's for the day, order meds we might run out of, chart, call families, sit with 1:1s if needed

4p-5:30p pass supper pills and pass trays and feed.

5:30p-6p give report to oncoming shift.

Note that this schedule does not call for any extra time for breaks, dr rounds, unscheduled meetings, falls, skin issues, fights, activities, if we are an aide short, if someone dies, or for family members to complain.