Published Oct 13, 2012
BiohazardBetty
171 Posts
I'm a new nurse on a busy oncology unit about to get out of orientation and be on my own on the floor for the first time...! I'm looking to improve my patient education by developing better shift goals to write on the white boards in the patients' rooms. My preceptor and the other nurses on my floor write the generic "call for assistance" on every white board... For example:
Saturday, October 13, 2012
RN: Nancy
CNA: Patty
Goal: Call for assistance
We do have a very limited amount of space on the boards, but I'd like to be more specific, and still patient friendly. Do you write very specific statements like "maintain pain level between 3-4 on 1-10 scale" or things as simple as "Turn, cough, & deep breathe every hour"?
What are some examples of shift goals that you write for your patients?
turnforthenurse, MSN, NP
3,364 Posts
Since you work with oncology patients, I would think most goals would be related to pain/nausea & vomiting management or some as simple as being able to rest. One thing you can do is ask your patient, "what is the most important thing that I can do as your nurse today?" and then you can turn that into your goal.
liveyourlife747
227 Posts
I write things like: get out of bed and ambulate as tolerated, use IS 10 times an hour, pain control etc. just basic stuff. Sometimes I get creative, but usually I don't have a lot of time.
Aurora77
861 Posts
I put the goals for my shift. I work post surgical, so my morning of POD (post op day) 1 goals are "remove catheter, IV fluids, and drains in the morning." POD 2 is "pain management and walking." I'll vary these to make them more specific to the patient, but basically try to put what we're going to do that night. I always go through the plan for the night with my patients, so this just condenses things and makes them easily readable for them.
HjojoBien
1 Post
I am a brand new RN and began working 3 weeks ago on a med-surg/neuro floor, and I HATE it!!! I am soooo disappointed. I thought I would atleast like it. I loved nursing school and enjoyed learning everthing, but I HATE the job. I want to spend more time teaching people about their disease, and I know I would enjoy educating people. What do I do?
tokebi
1 Article; 404 Posts
Some nurses on my unit will write things like transfusions or electrolyte replacement. I find cancer patients/family like knowing those things, and also want to know their "numbers." If they're on chemo, we write which ones they'll be getting during that shift as well. It's also nice to write down what medications they have available for pain and nausea, and what time they can get the next dose.
hallgirlz3
I love your comment "what is the most important thing that I can do as your nurse today?", this really allows for your patients to be involved in their own care. It conveys to them I care about your wants and needs and you are not just another patient in a bed to me! Kuddos to you! I intend to steal and use your awesome suggestion! Thank You!
I actually watched a vignette where a nurse asked her patient that question and I thought it was brilliant so I implemented it. Patients get really surprised when I ask them this question because I guess they're not used to being involved in their own care at times, which is a shame. Patients should be involved as much as possible. Sometimes they don't know how to answer, so I pick up on other clues..."you said you didn't get much sleep last night. how about that being our goal? we can try to minimize interruptions as much as possible and I can speak with the physician about getting you something to help you sleep if you'd like." I also put a sign on the door telling lab not to draw until a certain time because they are notorious for coming in the middle of the night Now of course, if something NEEDS to be done, it needs to be done...
tinks599
35 Posts
My experience with our inpatient oncology residents was to manage their toxicities. (Of course, we had the same goal with our outpatients as well.)
I'd say, evaluate the patient and if they are at risk for nausea, then making sure they help stay on top of PRN meds for nausea, since the alternative is vomiting and higher risks for dehydration. These proactive types of things would be my concern. If you have someone having problems with dehydration or anorexia we would recommend taking a sip or a bite of something at each commercial, since it would increase their intake and a sip or a bite was an easier goal than a whole meal.
Ultimately, I think you would want to focus on the most important thing that would influence their care (proactive or reactive) since whiteboard space is limited.
eatmysoxRN, ASN, RN
728 Posts
My goals tend to be manageable, especially since many of my patients are ffs. Reduce pain level. Decrease shortness of breath. Keep o2 sat >90%. Reduce nausea. Sit in chair for 30 minutes. Ambulate to nursing station without difficulty. Keep right leg straight until (time). Urinate by (time).
I also print teaching sheets and set a goal of when to read them if it's possible. If I think they may go home the next day, I encourage them to choose PO pain meds rather than IV. I write goals about fluid intake if they are dehydrated and for diabetic patients, I try to encourage them to choose water over juices.
I try to personalize goals and communicate things with my patients when possible. If they have a complaint that can wait, I write it down on the board as a reminder to discuss it with the physician, especially when someone complains of something unrelated and non emergent in the middle of the night.
I love the idea of asking the patient what they would like for me to do for them. I'd love to implement that in my own practice.
~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~
Kyrshamarks, BSN, RN
1 Article; 631 Posts
Mine are real simple. I do not even fill out the damn whiteboards. I hate those things.
TnMomWith3Kids
2 Posts
Love it! Our boards have a spot for date of discharge... like we really know that in advance enough to write it down!