How to Organize or Prioritize Patient Care
November 20, 2008
How to Organize or Prioritize Patient Care
A common thread on nursing forums, especially among new nurses, is how to organize and prioritize patient care for a shift. No matter what type of setting you work in, this is essential to the successful completion of the daily tasks.
One of the first rules of prioritizing is to expect the unexpected. And the primary unwritten rule is NEVER to say how quiet it is! In expecting the unexpected, you will always have a Plan B in your back pocket and won’t be quite as affected as you would if you were expecting everything to flow according to the schedule.
Most days you will have to deal with something unexpected, if that is only a new admit who needs to take precedence now over the 3 dressing changes you were just getting ready to do.
Time management and organizational skills are essential for nurses and yet they are not often even discussed in nursing curriculum. Time management courses are available through college or university extension courses, adult education programs and online. If you seriously lack organizational or time management skills, you may benefit tremendously from one of theses classes.
At Home
Away from your job setting, use your critical thinking skills to consider the basics of your shift. Try to plan out a typical day. Take a piece of paper and divide it into two hour increments. Pencil in patient meal times, and the hours in which primary ADLs take place on your shift such as AM care or HS care.
Next consider medication schedules. For instance, will you likely have ac or pc medications to give? What about HS meds? When will your patients be most likely to go for tests, therapy or other events? When do most of the MDs make rounds? What time of day do you usually get bogged down with discharges or new admits? What part of visiting hours usually lets you slow down and catch up? Allow for these and now when looking at a specific assignment, pencil these in.
At Work
Arrive early for your shift to get settled and to get a feel for how the previous shift has gone. The tension and chaos or calm and quiet may flow over into at least the beginning of your shift. In learning to expect the unexpected, it’s important to get a feel for the pace at which things are going at any one time. If you need to hit the ground running, you need to be prepared for it, and not arrive running late.
Listen carefully during report or rounds to get a feel for:
- how busy everyone is going to be
- the general acuity level of the patients today
- who might have time to help you out if you get overwhelmed
- what treatments, assessments, or procedures may be taking place today that you could learn from if you have a chance
Look over your assignment and begin to plot items on your schedule. Look for
- time specific events
- patients who may require more of your time for teaching, hand holding, etc.
- new patients, diagnoses or treatments you need to look up
- things you want to put off until last or hope you don’t have to do
- things that can be delegated to an aide or LPN if necessary
Make rounds and quickly assess your patients for any additional information you need to help you set your schedule. Try to get the things you dislike out of the way first. This can include distasteful procedures, dealing with impossible patients, and anything you are uncomfortable with. The longer you put these things off, the more they will weigh you down during your shift. Get them out of the way and move forward. You’ll feel the load lift off your shoulders.
Schedule your meal break and other break times and try to stick to this. Meals and time away from patient care is important to your well being, your morale and your ability to provide quality patient care.
Make sure you leave time for charting at least three times during your shift and chart any PRN meds immediately. Review your schedule every two hours to make sure you’re on track and make adjustments for changes. If you’re getting behind, ask for help early on instead of waiting until near the end of the shift when everyone is pressed for time. Remember to thank those who help you out.
By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and is the author/owner of TheNursingSite.com
©2008 by UltimateNurse.com All Rights Reserved.
Some No-Brainer Interview Tips
November 14, 2008
Some No-Brainer Interview Tips
Whether you are interviewing by phone for a travel nursing assignment, or in person at a local health care facility for a nursing job, there are a few do’s and don’ts for your interview. These may seem like no-brainers to many, but there are a frightening number who must be told and/or reminded of basic social skills.
First of all, turn off your cell phone! If there is the possibility of an emergency during your interview, either postpone the interview or notify anyone who might need you that you will be unavailable for about an hour. Otherwise shut it off. Any calls can be returned when your interview has concluded.
In any social setting it’s just plain rude to interrupt your conversation to take a phone call or respond to a message. Yet, sit and people-watch in any public place for just a few minutes and you will see a multitude of people suddenly ignoring their present company and answering their phones. Sometimes they even wander away and talk for a really rude amount of time. This is simply not acceptable in the workplace. Turn it off and give your interview your undivided attention.
Second dress appropriately. If you’re on the phone this may not matter, but in person it says a lot about you and your professionalism. Even on the phone, however, if you’re uncomfortable, this may come through in your voice or intonations.
In person, the way you dress will tell a lot about who you are, your habits and values. If you look like a slob, this reflects that your work style may be very casual and sloppy as well. If you are well groomed and well dressed you tell the interviewer you take pride in yourself and in your work.
If you will be going to an interview straight from work, make sure that your scrubs or uniform is neat and clean. If you work on a unit where this is not possible, take a change of clothes with you. At the very least warn the interviewer that you will be coming straight from work and won’t have time to change first.
Third check your teeth in the mirror. Take a last look at yourself before you go in to any interview. Do you have food stuck in your teeth from lunch? Were you literally pulling your hair out all day? Do you need a little makeup? Don’t overdo any perfume or scents! Are your hands and fingernails clean? And what about your shoes?
Body language is another important issue to be aware of. Even when speaking on the phone, sit up straight and pay close attention to the conversation. Offer a firm handshake, make eye contact often and smile.
Be prepared for the questions. If you don’t understand any question or don’t know how to answer it, be honest. Ask for some clarification. If you don’t have an answer, make a note and tell them you’ll find out and get back to them. Don’t try to bluff your way through. Take a deep breath and think about your answers before blurting them out.
Have at least a couple of questions prepared to ask the interviewer. Do your homework and know something about the facility. If all of your questions were already answered in the interview, it’s Ok to say something like, “I was going to ask you about your staffing ratios and how you determine acuity, but you’ve already covered that.” It still shows you are interested in this position and this facility. You might also just go back to an issue you want to be very clear on such as whether travel nurses are expected to float.
Never bad mouth any previous or present employer. If you are leaving because you can’t stand the place, that’s your issue. As far as anyone else is concerned you’re looking for new challenges, different opportunities, a change, r other positive note.
Always say thank you for the interview, offer a firm hand shake and again make eye contact. Ask when they will make a decision. Tell them to please let you know either way.
By Kathy Quan RN BSN Kathy is the author of The Everything New Nurse Book and is the owner/author of TheNursingSite.com
©2008 by Ultimate Nurse.com All Rights Reserved