Oh no! You were scheduled multiple 4 hours shifts. Or worse, you floated for 4 hours, and floated for another 4 hours, with report putting that down to 3 hours (minusing your break). How do you optimize workflow and get everything done and know what you are doing? Don't fret.
1) Look at the patients. Do a quick scan. Then rapid fire quick scan of their chart: Look for abnormal labs, Pending procedures, Diet, Code status, Vitals.
2) Quick assess: Mental status, IV Site, Airway, Drips running, Drains, pain, and skin assessment.
3) Cluster EVERYTHING. This is key. Cluster all your meds passes, fluids, glucose, assessment, Emptying drains, repositioning, vitals if needed. Do not return to pt's room unless necessary. On a 4 hour shift your goal is to be a task monkey and prioritiziation. This is not the time for customer service, getting warm blankets, and getting snacks, or getting stuck in patient rooms. Delegate more due to time limitations.
4) Deal with your disaster patient first before your shift spirals. Pain, behavioral, confused fall risk, etc.
5) Chart immediately after each room. Your brain is fastest when info is fresh.
6) Accept that some things won't get done. No time for long conversations with patients, deep chart review, whiteboards, blankets, non-urgent care tasks. Focus on meds, assessment, safety, acute changes, and documentation.
7) Utilize relief nurse. IV out? Don't even try. You don't have time. Get relief nurse to help with labs and IV's.
8) Walk into the room knowing already what to do: Assessment, flush IV, meds.
