3 Essential Steps for a Strong Nursing Shift Start | Straight A Nursing

Mastering the Start of Your Nursing Shift

• 💡 The beginning of a nursing shift sets the tone for the entire day; a rocky start often leads to a chaotic shift, while a solid start generally allows for smoother operations.
• 🎯 A structured approach, like the one outlined, provides a roadmap to navigate the dynamic and fluid nature of nursing care.

Key Information Gathering at Shift Start

• 🩺 Review the most recent physician progress note (or H&P for new patients) to understand the patient's history, reason for admission, and the physician's plan.
• 📊 Quickly assess key laboratory values, including white blood cell count (for infection), critical electrolytes (sodium, potassium, magnesium), blood glucose, creatinine (kidney function), and coagulation/platelets (for bleeding risk).
• 💊 Examine the patient's medication list and administration times to anticipate needs, identify unfamiliar medications for research, and ensure timely administration.

Developing a Shift Roadmap

• 🗺️ After gathering initial information, create a loose schedule or roadmap for the day, which can be documented on a run sheet.
• 🚀 This roadmap helps in planning interventions, incorporating other tasks like medication administration, and anticipating potential patient issues.

Enhancing Patient Assessment and Intervention

• 🧠 Having a 30,000-foot view of the patient's status allows for proactive problem-solving and steering patients away from potential complications.
• ⚠️ Cultivating a high index of suspicion based on the patient's history (e.g., recent surgery, coagulopathy) enables more targeted and effective assessments and interventions.
• ✅ A few minutes spent at the beginning of the shift familiarizing yourself with these key details significantly boosts confidence in assessing and intervening for patients in a timely manner.