Published Jul 19, 2004
Butternut
62 Posts
If you start your 12 hr shift at 6:00 PM, what then is your usual routine, after you clock in? Any info will be appreciated.
What times do you do assessments, Vitals, check meds, etc...
I have been off the "floor" for a few yrs and now will be returning. Wanting to be prepared and just curious as to how hospitals vary.
Thanks
at your cervix
203 Posts
Well, I work LDRP so it may be a little different setting. Our assessments/vitals are due at 2100, I go in and see each of my patients to introduce myself, take out their dinner trays, get them meds, fresh water and linens if needed etc. Once I have seen all of my patients, I start over with the first patient again and do assessment/vitals on mom and baby and work my way through again. I then chart and then go back to check on them again. Hope this helps!
rEAL nUT
13 Posts
:) I work the 7p-7a shift and I always "try" to start my shift by first getting report, then checking my med sheets to see what times I have meds due, and check my kardex to see if I have any procedures (dsg. changes, tube feeding ect). I write this information on one sheet of paper that I keep with me throughout the shift before going to see my pts. This also helps when the pt has questions about a medication or plan of care for the shift because I already have an outline of what I would like to do and when for that pt. As you know things can change quickly, so be flexible. I ALWAYS, ALWAYS, ALWAYS use my 30min window in case the whole shift just goes to h***.
JBudd, MSN
3,836 Posts
I've been off the floors for a lot of years too, but the way I kept my time organized was with a grid. I put all the hours of the shift across the top, and each patient down the side. After I got report, I put in all the treatments, dressing changes, meds & routes (IV takes longer than po usually), VS & NS, for each pt on their line under the hour it needed to be done. I could see ahead of time when I'd be busiest, and plan for it.
I taught that to every grad I mentored, and now the floors have printed up schedules for their rooms. Too bad I don't get royalties!
Good luck with your changes.
SmilingBluEyes
20,964 Posts
LDRP nurse here too (also do GYN surgical). Here is my typical night shift routine:
Get in at 1900, get report, hit the floor by 1930. Make rounds, doing vital signs and passing pitchers of fresh ice water all around unless NPO. Ask about comfort needs, pull overfull trash bags out, and medicate everyone ON SCHEDULE. Usually done w/this by 2030-2100 or so. Chart for another however long it takes and then if it's slow enough, restock shelves, make gift packs, etc.
If I have a labor patient, I see to her needs first, then make rounds on my couplets or GYN patients. (most of the time, we try to have 1-1 labor nurse to patient, but if it's busy, we have to juggle a wee bit, just like anyplace).
Vitals are due on everyone who is freshly delivered or less than 24 hours post-op q 4 hours. After that, it's q shift. So, after being done making rounds and medicating everyone the first time, by the time I finish charting, by golly, it's darn near time to round AGAIN on everyone (who are on q4 VS that is).
One thing I have learned--- seeing to small comfort needs, e.g. clean linen, fresh water, pain meds ON SCHEDULE etc., reduces the call lights ringing a bit. I have a very sound routine, but as we ALLLL know, at any moment, the Labor Bus, esp on those full moon nights, can pull up and disrupt the WHOLE process with patient after patient coming in. Just have to take it as it comes. That is ANYwhere in nursing. Once you get prioritizing down, you learn what can wait and what must not. It just takes some time and experience!
Tweety, BSN, RN
35,420 Posts
I'm hopefully going back to floor nursing soon. But when I have an assignment, I get out of report by 7:15 and then make a quick walking round where I see all my patients very briefly, make my introductions and then can prioritize my needs (i.e. if someone needs pain medicine, if an IV is about to run dry, etc.). Then I check out the med sheets.
If all goes well then I pass pm meds, do assessments and get everyone settled for the night. The techs to the vitals and the accuchecks.
But it's never that smooth. There's always an admission, someone falling on the floor, irate patients, phone calls, etc. etc. etc. I usually just fly whichever way the wind blows and throw organization out the window. LOL