Thursday, April 9, 2009

What I do with my shift (in an ideal world....)

1450 - Arrive on the floor. Put backpack in break room, glance briefly at notices on the board

1455 - Go to the station to get my assignment. Construct my "brain". Paper folded into quarters like a book, Room #s in the top left corner. Swipe patients' cards at the top of each quarter so I have their name and MR# easily accessible later in the day.

1500 - Get report, ideally at bedside so the manager doesn't get grumpy. If the patient has some private-type issues or the leaving-nurse doesn't want to say something in front of the pt we'll do it outside the door. Go meet patients, put my name and phone number on the board in the room. Tell patients I'll be back in a bit to check up on them and make sure they are still alive.

1530 - Claim an "office" space at the station. Print EKG strips and put in chart to analyze later. Go through the Medication Administration Record (MAR) and RAND (I still don't know what that stands for....) for each patient and make an hourly to-do list of their meds and dressing changes, if they need turning and tape the paper to the grey binder housing the MAR and RAND.

1600 - Assess patients. Deal with simple pressing needs like new grippysocks or a refill on water. Wish that we had more CNAs on the floor to do stuff like this. Turn the patients who require it.

1630 - Analyze EKG strips, chart patient assessment info.

1700 - 15 minute break

1715 - Check fingersticks (blood sugars), check vital signs to see if I should skip certain blood pressure/heart rate meds. Start pulling out medications for all my patients.

1730 - Begin administering meds to patients. Ideally this is done without interruptions.

1830 - Done with meds, time for dinner so the resource who leaves at 1900 can go home on time.

1900 - Dinner's over, back on the floor. Check in on my patients, attend to needs. Turn the patients who require it, which should've been done at 1800 but I can't give meds and turn people at the same time...

1930 - Print out 2nd batch of EKG strips, put in chart.

2000 - Chart again (our unit is q4h charting). Write progress notes where applicable. Turn patients who require it

2045 - 15 min break

2100 - Fingersticks for before-bedtime sugars. Start pulling out 2200 meds

2130 - Med pass. There are generally fewer this time of night, so it doesn't take as long. Thank god.

2200 - Turn the patients who require it. Finish up and close out charting. Do 8-hour orders checks. Make sure vitals have been entered in the chart.

2230 - Check on patients, make sure they don't need anything before change of shift

2300 - Shift change. Give report to the ladies of the night (ok. there's one guy too lol.) Say g'night to patients

2330 - Freedom!!!!!

I just realized that I made my ideal schedule without putting in my hard-won 15 minute breaks. I totally forgot that I am supposed to get them. I don't know where they would go since i rarely get them, so I put them in where it seems like they might work lol.

Stay tuned for the "real world" shift breakdown! Full of confused patients, disappearing charts, missing medications, and doctors who don't call you back!

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