Goals and Objectives

[Old_School]

When I get up in the morning on a workday, I have three goals for the day. 1) Get to work on time* 2) Leave the unit in which I'm working, in better shape than the way I found it. 3) Make sure my patients make it to 3:30 alive. The objectives have to wait until I get to work and get my assignment.

The first thing after coffee (black, hot, american thank you very much) and getting report is to go through the chart. If it's a patient I'm not familiar with, that means every scrap of paper in the chart gets my scrutiny. The first thing I look for is a medication error. I'm usually never disappointed. I always say if you can find a med error before 7:30, you've earned your pay for the day.

The next thing to look for is the missing test. There is usually a CT report or an obscure reference lab test that was ordered a week ago that even the doctor forgot about, that is no where to be found on the chart. I'm always pleased when I find one of those. The radiology file room enjoys those calls from me at 7:45.

By this time the routine labs start printing out. The values get placed on the flow sheet and compared with the previous few days. Anything abnormal gets called to the physicians then and there. By now it's 8:00 and time to see the patient.

Just like everybody else, I'm sure, the patient gets a head to toe. Sometimes I find what I expect to find after making a mental image from what is described by the off going nurse. Other times, it's not quite what I expected. So there is another 30 to 45 minutes putting thing in order.

So it now 9:00, time for a break. Then its off for tests or whatever. Maybe get some charting done. And watch, watch, watch. At one hospital I worked at someone had placed a big sign over the monitors. NOTICE: Rythmns subject to change without warning ! I liked that, because it is so true. The trick is to catch it before it turns into something severe. Like I always say, "If you patient is coding, you're not doing your job."

That's it, if you're lucky and/or good, 3:00 arrives with the patient still breathing and you can get out while the gettin's good. Anybody else have any good routines that you've developed and want to share with us?

BTW . . . I have a goal on this forum. It's to bump 1mg.epi's tired old threads off the first page of this board. Anyone want to help?

O_S



* We're not a closed unit so we have to float. If you punch in late, you get put on a float list and have to float first. How's that for an incentive to get to work on time.