October 15, 2010
I’ve noticed via recent blog stats that posts featuring nursing brain sheets have been quite popular lately. ‘Guess that’s due to the beginning of fall clinical rotations. 🙂
So while I’ve been piddling around I thought I’d post one more…
As I adapted to routines in the PCU, I found that the more detailed brains I was using became too cumbersome. It felt like just another place where I had to chart lab values, vital signs, etc. The more comfortable I became with our own charting system, the less I found myself recording and the more trees I killed. Not to mention we were given printouts at the beginning of each shift with system-by-system rundowns on each patient.
Instead I started relying on brains for time management – as cues/triggers for when meds were due, when patients were going for procedures, issues I needed to follow-up on, etc. I also needed a place to jot notes if/when patients’ conditions changed or they had wonky lab values I needed to tell the doctor about.
So I borrowed one of my preceptor’s brains and made my own adjustments. Here is the final product (as per usual, in both PDF and Word formats, should you need to make edits of your own).
This one is double-sided and designed for 12-hour shifts (can be easily changed for 8- or 10-hour shifts as well). There is space for 4 patients per brain. We typically had 3 patients, so I had an extra column if I discharged one patient and then admitted another.
- Side 1 is laid out by hour, so that you can write yourself reminders and see your to-do lists for each patient side-by-side. This helped me anticipate when I would be busy.
- Side 2 is for recording changes in patient condition, abnormal system assessments or lab values that arise throughout the shift, or changes in the plan of care that you need to pass along. It’s meant to help you give report that is accurate and up-to-date.
I hope these are helping! Don’t forget to send your own clinical brain to firstname.lastname@example.org, and I will post it to the Brainiacs page to share with others!
December 7, 2009
I just have too much fun with this brain design thing.
Yes I’m a computer nerd. If you haven’t figured that out by now, you haven’t been paying attention. 😉
The newest version is basically the same as my last brain, but I changed the look of the backside. Lab values now take up the top half and CBC/Chem7 results can now be noted in shorthand (don’t worry, I indicated what goes where for people like me who haven’t figured it out yet). This is an oncology brain, so the lab section includes values such as ANC (absolute neutrophil count). If you download it in Word format, you can substitute in the labs that your unit frequently uses.
SBAR is now on the bottom half, and breaks down the assessment portion by body system – it’s been much easier to give report since I changed this part.
And then there’s an added bonus. My preceptor asked me to redesign the brain she uses, so I thought I’d post that too (as usual, in Word and PDF formats), to give you yet another option. This is still a work in progress, so keep an eye out for updated versions in the future.
By the way, if you’ve downloaded a brain from this blog and made some improvements of your own, I’d love to see what you came up with! And I’m happy to post your changes or your own brains if you’d like to share them with other readers. This blog is all about helping each other along the journey!
Just shoot me an e-mail (email@example.com) with your brain attached, and a little narrative about it if you’d like to “guest post”.
But hold on to your actual brain, you’re gonna need it for nursing school. Hardy har. 😉
October 26, 2009
The quest for the perfect brain sheet continues…
Following my first few shifts in capstone, I have been continuing to adapt my own time management brain so that it is more-user friendly and attuned to my time management needs on this particular unit.
Some key changes to this latest incarnation, Nurse Teeny’s Brain 3.0:
- This tool allows for the management of three patients on one sheet of double-sided paper. This works for me because the typical patient load on our floor is 3. I keep a blank copy handy in case of admissions/discharges. Obviously if you have more than 3 patients, you’ll either need two sheets or adapt this to meet your own needs.
- The far left side of each patient’s “block” includes data such as name, room #, medical record #, age, and sex. The box is big enough in most cases to just place the patient’s sticker there if you prefer.
- I got rid of the time management 1st page from a previous version. I found that it was cumbersome to have an extra sheet of paper in my pocket, and time-consuming to check for information in two different places.
- Instead, I incorporated the 12-hour sheduling piece into each patient’s block. For each hour, I can write in scheduled meds/procedures/nursing tasks AND record data that I am unable to chart right away (I&O, vitals, abnormal assessment findings, etc.). Then I check it off once it’s documented in the chart.
- The pieces of information that are most important to know are on the front side: Diagnosis, code status, current weight (critical in peds), allergies, diet, IV fluids/access, and PRN meds. There is also a little extra box for jotting down notes.
- I included check boxes to remind myself to do a safety check in each room, check tubing to see if it needs to be changed on my watch, and to encourage oral care and hygiene (both very important in oncology).
- Lab results go on the back side. I usually only note abnormal or borderline labs in case I need a quick reference. It’s easier than printing out the most recent results and having MORE paper to carry around and fumble with. I also try to indicate which direction the results are going in (up or down), and whether the result is too high or low compared to the reference range.
- I kept the SBAR section on the backside for each patient. It has helped me tremendously for updating doctors and delivering end-of-shift reports.
The brain can be downloaded in PDF format if you like it the way it is, or in Word (.doc) format if you’d prefer to tweak it for your own needs.
I’ve noticed a lot of traffic on the brain posts, so I’ll continue sharing as long as y’all are finding them helpful…
Happy Time Management! 🙂
August 20, 2009
So I’ve been a slacker about my “evidence-based blogging” thus far. I blame the tonsillitis I contracted last week, which has kept me from working, having fun or being at all useful. (Note: That is the THIRD case I’ve had in about a year…ugh).
But I did want to post another version of a nursing brain sheet that I have been toying with since my Family Nursing class. I’ve noticed a lot of downloading traffic of the previous brain, which is awesome!! I’m glad folks are finding it useful. The important thing is finding something that works for you…
This one is a wee bit different – the first page is a “time management” brain. On it, you list all of your clients (or up to 3), plus a few critical details about each one/space for making notes, and then use the time columns to indicate when each client has meds due, procedures, consults, etc. That way you can visualize who-has-what-when, and plan ahead, especially for those times when ALL of your patients have something due (0900 meds anyone????).
Pages 2 and 3 are meant to be printed double-sided. You can fit information about 3 clients at once, including vitals, CBGs, I&Os, etc. The backside has a space to jot down lab results you need to know, plus a hopefully useful “SBAR” section for each client. SBAR is the gold standard in nursing (and much of health care) for giving and receiving report. It stands for Situation, Background, Assessment, Recommendation. You can use this section when getting report at the beginning of shift, and it has handy information that you can use when giving report as well.
Give it a shot (in Word or PDF formats) and see what you think. And please let me know how the brains are working for you once you start clinical! I love tinkering with these and coming up with new layouts where you can fit as much useful information into as little space as possible. Hmm, maybe I should copyright these… 🙂