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 nurseteeny@gmail.com, and I will post it to the Brainiacs page to share with others!

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:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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).
7. 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.
8. 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! 🙂