7 Ways to Organize Your Nursing Shift Like a Pro
It can be overwhelming to start out on your own as a new nurse. We all know that the typical nursing shift contains a lot to do in a limited amount of time. So, it’s absolutely crucial to work out a strategy for tackling your shift.
Granted—your shift will almost never go as planned, but a game plan will keep you as close to being on track as possible.
No one wants to be that nurse that’s still drowning in charting at the end of the shift.
It’s okay, it happens to the best of us every once in a while.
But if you have a couple tricks up your sleeve, those instances of staying late will be few and far between.
Here are 7 super helpful tips to organizing your nursing shift:
Show up early to read up on your patients
A good motto for any nurse should be “trust but verify.”
The best way to know what’s going on with your patients is to read up on them before you even get report. That way if the nurse reporting off forgets to mention something, you can already be prepared to ask about it.
This doesn’t need to take 20 minutes. Just quickly read over their admitting diagnosis, relevant history, medications, imaging reports, labs, and their plan.
Pay special attention to anything that either needed to be done during the shift prior to yours or during your shift.
A prime example is your patient’s trough levels for medications like vancomycin. As you’re looking through the patient’s chart look at when the last trough was drawn and when their due for another one.
Don’t be the nurse that gives another dose of a medication without drawing the necessary labs first!
If you’re really nice, you can even add it into your report for the next nurse to make sure everyone is on the same page.
Once you’ve read up on your patients, you’ll have a better understanding of what you’ll be dealing with during your shift.
A bonus tip—I often saw a lot of nurses on my unit (new and experienced) writing down each medication and time that they were due. This can take up a ton of time that you can use to dig deeper into the patient’s chart.
I’ve found it’s much faster (and time effective) to simply write down what time the patient has medications due.
For example: "Room 710-Mr. John Doe 2000, 2200, 0300, 0600 (last pain med given 1930 prn q4h)"
2. During bedside report, ask your patients about any immediate needs (pain, etc.)
This one is huge!
If you don’t do this, you’ll be answering call lights during the entire first hour of your shift.
While you and the other nurse are in the room with the patient, ask the patient if they need anything right now.
Are they in pain? Do they need water? Do they need a pillow?
If they have any needs you or your nursing aide can address them now or you can at least give them an estimated timeframe so they won’t press their call light a few minutes after you leave the room.
3. Take care of your patients’ needs during assessments
Address pain and any questions
If your patients are due for pain medication, make them your first assessment and bring the pain meds with you. Answer any questions that they may have.
We don’t always get a lot of time with our patients, but during the assessment is a great time to chat with them and build a rapport.
Inform your patients about what to expect
Most people aren’t too familiar with being in the hospital.
I have saved so much time by letting my patients know what to expect during my shift. I would let them know what time they had medications scheduled and went over who to call for what.
When people press their call lights, their automatic response tends to be “I want to speak with my nurse.” Even if they just want a pillow or a water refill.
You can avoid being called on specifically for every request by letting your patients know that they also have a nursing aide on their care team that can help them with these needs too.
Ask about sleeping meds at the beginning of your shift!
For my night shift nurses, this is a lifesaver!
It can be so hard to get the on-call to give orders for sleep meds in the middle of the night. While you’re in with your patients performing their assessments and it’s still early in the shift, ask if they need any medication for sleep.
For good measure you can let your patients know that if can sometimes be very difficult for people to fall asleep in the hospital. It can be noisy, and the bed is not as comfortable as it might be at home.
It doesn’t hurt to have something available PRN just in case they need it, and it can be tough to get ahold of the doctor after a certain time.
I’ve had a lot of success with this and it is helpful to you, your patients, and the on-call provider.
4. Get any order requests in early
This tip is closely aligned with the sleep med tip above.
If you notice that you don’t have any necessary medications or the patient reports that they take additional medications that aren’t on his med list, get these requests in at the beginning of your shift.
It will save you the hassle of trying to get an order exactly when you need it.
5. Cluster your care like a pro
Meds, dressing changes, drain checks, turning, the list goes on.
The biggest tip for organizing your shift is:
Cluster. Your. Care.
It will save you a ton of time and will keep your patients from getting annoyed with you. This is also where your pre-shift chart review and observations during bedside report come in.
If you notice during report that Mr. Jones is running low on his IV fluids, he is asking for his Miralax and has a dressing that needs to be changed. Grab the Miralax (and any other meds that are due), grab a new bag of fluids and any dressing supplies.
Now you’ve taken care of his needs and checked some tasks off of your own to-do list!
6. Chart as you go if you can, or cluster your charting
Do not fall behind on your charting. You will be so sad when you have to give report at the end of your shift and go off to finish your charting instead of going home.
I’ve heard nurses (usually nurse managers) suggest charting as you go, but I’ve found that this isn’t always possible in practice.
But definitely try to cluster your charting if you have a few minutes of time here and there.
Of course, you should always at least have your assessments written down in case of a rapid response or code. However, the slow period in the shift can be used to get through all of your charting if you still need to.
7. Take lunches and breaks during slow periods
Take your breaks if at all possible (15 minutes will not make or break your shift)
For the love of Florence Nightingale—take your breaks!
I totally get it. Everything is coming at you all at once and you feel like you can’t spare 15 minutes for a break. But trust me, it will do you good.
When you work without breaks it exposes you to decision fatigue and lack of focus both of which are essential for nurses to provide good patient care.
You’ll come back with a clearer head and renewed focus to take on the rest of your shift.
If you feel yourself start to get overwhelmed, go and hide for a minute or two. My favorite hiding places are the nutrition room, the med room, and the supply room.
Take a beat, take a few deep breaths, and get back out there!
Do you have to do all of these things?
Of course not.
But if you put even half of these tips to good use, you will be surprised by how much more smoothly your shift goes. Being a new nurse starting out on your own can leave you feeling like you’re drowning in an endless to-do list every day.
And when you’re running around all shift, those 12 hours fly by in no time.
Having an idea of how you want to organize your shift will help to keep you as close to being on track as possible.
Is there another tactic that has helped smooth out your shift flow? Share in the comments below!