Every shift I use a shift planner to plan out all the things I need to get done. They're available on the unit, most people use them I think, but generally just for medications. Some will circle the times on the side when things are due and others jot them down. I kinda go into a bit more detail and I love it. I've created a version filled it in for a pretend patient to show you how I colour code and annotate it.
The top photo shows what our planners look like, pretty simple and lots of space. I use my 4 coloured pen (the one with cuter colours) and first add a few things to the sides. My general to-do list goes on the left, anything that isn't time specific but needs to be done on my shift. And on the right, my to-gets. We can't leave our bed spaces so I keep a tally of the things I need to grab, and when I go for break or someone close by is going that direction we can get them. I make the dotted line down the middle to split my tasks on the left, and things that happen during the shift on the right. You'll see what I mean further down.
First, I always start with medications. I go through the drug chart and write down all the things due, and what route. This is always done in purple. I also go through my infusions and write when they expire, I put them down in capitals and add it to my to-do list because I want these done at least 2 hours before they expire (for inotropes the general rule is to be made up and started to double pump with 4 hours spare).
Anything nutrition wise goes in blue, and these are things like if we're on hourly feeds, if the feeds are meant to be increased at certain points, when to aspirate the NG tube and if we need to do our PN.
I then add in any normal day-to-day things and paperwork. So the safety checks (although I've already done them, I still like to add it so I can tick it off), patient assessment, tissue viability scoring, 4 hourly cares, completing my chart, any chest drain readings, EVD readings, log rolls due etc.
I will tick everything off in the left hand column/to-do/to-get in pink, and cross off the hours as they've gone. In the right hand column I write in pink anything that has happened, like desaturations, low BP, parents arriving and leaving, ward rounds and plans, gases due as a consequence of new developments etc. and these are ticked off in black. By the end of the shift, my planner looks a bit like this...
It makes it easier to write my notes at the end of the shift, when I've got the major things written down. It makes me feel calmer knowing I have everything I ever need to do that shift written in front of me and I don't have to try and remember and panic that I've forgotten anything. Love to be organised.
My flashcards hold all the secrets for me to get through my shifts, everything I need to remember (and more to come, probably for ever!). For this post I'm going to show the ones that are under my general PIC knowledge, although they can be transferable to other specialities and wards.
The link below will take you to my step-by-step post about making the flashcards :)
1️⃣ You will love it here! Eventually. You will go through so many emotions and feel like quitting. But if you just stick with it, sometimes just getting through the next hour. You’ll cry a lot and debate leaving nursing all together. It will take nearly a year, but you’ll love it.
2️⃣ It takes time to make friends. We’re a big team and it just takes a while to see the same people on shift and to become friends. PIC friends are some of the best though, they understand the highs and lows of the job.
3️⃣ Some people seem rude, and some just don’t like new people. Don’t take it personally. Some of those that appear rude you’ll actually learn to like, it’s just their ways. Some are just rude and probably will always be. I’d rather be the person that smiles than the person that doesn’t smile back.
4️⃣ Spend time learning outside. You can’t just learn it from the shifts. There are so many drugs, write them down and learn what they do. Learn anatomy and how to position patients. You don’t have to know everything, but you gotta try with what you see.
5️⃣ Understand why you’re doing something, and if you don’t understand why, ask! You should know your rationale. And people will ask you to justify things.
6️⃣ It’s okay to make mistakes. Everyone does. You just have to be honest, tell people, so that if anything needs to be done to help rectify it, it can be done. People won’t hate you. Parents might be angry, and you’ll feel so rubbish. But it’s the right thing to do to be open. Learn from the mistakes you make.
7️⃣ Don’t bring change with you! Fight the urge to buy chocolate. You can do it.
8️⃣ Learn how to document effectively. And write your notes in any quiet time you have, don’t wait until the end of the shift when it goes pear shaped. If things are documented elsewhere, you don’t need to rewrite it, but learn to write legibly and to the point.
9️⃣ Your shift planner will be your best friend on the shift. Colour code it, annotate it to help with note writing, don’t try to memorise when your drugs are due.
🔟 Your colleagues are amazing, and most will help you in anyway you can. Make sure you’re a team player. You have to learn to prioritise your work and be able to support those who need it. But also, check infusions and drugs when you come on shift for yourself, don’t just trust their word for it that it’s right!