For all the Registered Nurses out there!?

I am a nursing student. I was wondering how you all develop a routine (MAR's, tests, baths, meds) etc. to keep yourself organized throughout your shift? I find myself getting overwhelmed at clinicals keeping everything straight and orderly. Please give me some advice, thanks!

Change your profession to become a doctor then you will not have to worry about all this.

Im not a nurse!!!!!!!!!!!!!!!!!

paper & pen, prioritize.
list interventions and check off as you go and serves as a reminder through the course of yor clinical shift.

Set a schedule plan.
I set my schedule plan in Microsoft Spreadsheet and all activities that I have are set.

I am a Nurse

Hello there,
You will need time to set your own pace as you get to know your patients likes and how they respond to you.Some are impatient,some just slow and afraid of newcomers,but listen and learn from them and it is THEY who will keep you organized and you'll fall into your own space soon and you will all be comfortable.
God Bless and good luck sweety..............................Anne...

You know your duties and you know a lot of crap is going to be thrown at you throughout your shift. Take notes and prioritze. I am telling you that there will never be a day in your career as a nurse in which you can schedule or plan your day, nor will there ever be a day that at the end of your shift you can say I got everything done I needed to. You can forget about keeping things orderly, too. Nursing is not a tidy profession. You need to learn quickly that when you are overwhelmed you have to take a deep breath, pull yourslelf together and move on. Suck it up lady, get a tough shell. There is no other answer to this question. Good luck.

I'm a new grad, so I've had to do a lot of thinking about this lately. Here's the daily routine that works best for me.

1. First thing: poke your head in and visually check on all of your patients. Do they look ok? Good. If they're sleeping, let them sleep. If they're awake, introduce yourself. Glance at the equipment in the room. Is everything going in (IVs, tube feeds, oxygen) connected and set to the appropriate setting? What about everything coming out (catheters, wound drains, suction)? By checking on your patients and their treatments, you've addressed your first priority and have given yourself some time to prepare for the rest of your day. You've also given yourself the opportunity to intervene immediately if something isn't right. At this point, if your patients are already asking for something that will take a significant amount of time (bath, meds, etc.), let them know you've just got to review their orders and that you'll be back soon. If it's something like needing a cup of water or help ordering breakfast, of course you do this for them as it doesn't take much time.

2. Review your patient's orders and see if there's anything you need to do asap. This includes drawing blood for stat lab values, preparing the patient to go down for a test, giving a x1 dose of a med, etc. Reviewing these things in addition to their level of acuity will help you to prioritize who you see first.

3. Get your a.m. meds for the first patient ready. Check the patient's lab values (if they're back). Review his or her vitals and do his or her head-to-toe assessment before you administer anything. That way you know whether to hold a med (digoxin or beta blockers, for example). Also make sure they're squared away with breakfast so that they eat while you're in with your other patients. I like to do all of this in one visit to the room-- I find that the more you can cluster your care, the better. As a student, you might not have as much control over when you give meds as you will when you're an RN, so you may have to re-work this part. When you're done, document as much as you can in the flow sheet as soon as you can. If you leave it until later, you may never get to it! Repeat for each of your patients.

4. Start doing your a.m. care. If you have any patients who are independent with their hygiene, stop in to give them their supplies before you move on to someone who's totally dependent so they won't be waiting all morning for them. If you need to feed someone who's also dependent on you for a.m. care, feed them before you wash them up. Not only does this prevent your having to scrub oatmeal out of a gown later on, it also prevents your patient from being too tired from a.m. care to eat.

5. Do any one-off things you have to do. This includes getting your patient up to ambulate, giving chest PT, teaching, etc.

6. By now you should be ready to give your noontime meds. Check their vitals, rinse, repeat.

7. EAT AND GO TO THE BATHROOM. Seriously. Don't forget to cater to your own needs.

8. Begin to wrap up your documentation. I usually begin to write my nursing notes 2 hours before the end of my shift.

9. Come to terms with the fact that your day will rarely be as predictable as this. For me, this guideline is something to aspire to. You can't plan for or predict the thousands of ridiculous things that can happen over the course of a shift, but that's part of what makes nursing so exciting. You have to be flexible. You also have to prioritize and ask for help when you need it. I can't stress this enough. Your co-workers will be your lifeline after graduation, particularly the nursing assistants. If you're allowed to delegate, begin now-- it takes a lot of getting used to. If you're not, try to use your classmates as a resource. Most are happy to help, and some great friendships can develop this way.

10. Make yourself a checklist to help yourself keep track of all of your to-dos. I used Excel to design a sheet of my own, with enough space for 4 patients. I provided blank spaces for 8 am and 12 pm vitals, important lab values, diet/activity orders, code status, patient name/room number, and anything I had to make sure to do over the course of the day. It really has helped me get into a routine and organize my care. It's also made me appear much less forgetful.

Good luck!