The system I used to organize important information about my patients before and during a shift was not exactly high tech.
My charting system consisted of a clipboard and a sheet of plain blank paper that I would methodically divide into squares with a ruler before my shift. Each patient got a square wherein I would write clinical data such as diagnosis, vital signs, medication times, procedures, IV information and other “need to know” facts to keep my patients straight.
I would continuously update the squares with the most pertinent information throughout my shift. It was like “Hollywood Squares” meets “ER,” and yet it was effective for providing organized, quality patient care. It also kept all my patient information right at my fingertips for a smooth, streamlined shift report to the nurse taking over my patients.
Thank goodness someone has had the good sense to update my little arts and crafts project shift organization system. Actually two “someones” – a pair of RN, BSN sisters from Florida have accomplished this. The Elson (not Olsen) sisters have invented a product called “RNReport card” to standardize patient note taking and shift reporting. This will especially benefit nursing students and nursing new grads, finding their way through the often daunting process of thorough and accurate patient documentation.
The product is a 5×7 booklet that fits easily in uniform pockets and standardizes how patient information is recorded and then communicated at shift change. It is also useful for having the most critical patient data available in the same standardized format at a moment’s notice to share with physicians or other members of the patient care team.
Standardized tools for reporting patient information also reduce the likelihood of a medical malpractice action due to inaccurate or missing patient documentation. After all, even as I was dividing my sheet of paper into squares at the beginning of each shift, the adage – “If you didn’t write it, you didn’t do it” – was always on my mind.
Unlike many medication dosage formulas, the math about how to fill the gradually growing number of available nursing jobs is simple. In order to graduate nursing students into the workforce, nursing schools need to be able to accept more students. And in order to make a dent into those increasingly common nursing school waiting lists, schools need nursing instructors.
The main challenge faced by understaffed nursing schools, is making instructor jobs attractive enough for nurses to leave (or cut back to part time) hospital and clinical jobs with higher salaries. Some U.S. states are providing financial support for nursing schools by offering additional financial incentives for nurses who choose to teach. In Rhode Island, a legislative commission created to find solutions for that state’s nursing shortage, has proposed a $3,500 tax credit for nursing instructors.
The idea is that with the tax credit, the salary disparities between being a clinical nurse and a nursing instructor would be much less. In Texas, lawmakers have already passed a bill that gives nursing schools financial incentives that would help them hire more instructors.
Although many new nursing school graduates are having trouble finding their dream jobs at the moment, industry forecasts predict a need for significantly more nurses to keep up with health care demands in the coming years. But, in order to translate those waiting lists into actual nurses who can meet this demand, there need to be enough nursing instructors to meet the mandated ten to one student to teacher ratio.
While educators and lawmakers are doing their parts to make this happen, the best thing aspiring nursing students can do is get on the waiting list. Then, use that time to gain as much health care experience in other positions (such as certified nurse’s aide), so that when your school of choice does have an opening, you are the most qualified applicant to fill it.
“You’re a nurse, right?”
This is how a recent conversation with a relative who was seeking medical advice started. I’ve always found it amazing how those series of letters after my name (RN BSN) translate into a combination of “webmd,” “ask jeeves,” and “wikipedia” all in one. Of course with the intensive curriculum, covering everything from nutrition and sociology to pathophysiology and microbiology, it is easy to feel like a walking encyclopedia.
I feel proud to have earned the knowledge and nursing experience I have and I am honored to share what I know to help others. The warning I would give to nursing students who are just beginning to realize their perceived role as “ask a nurse” is this: Do not overstep your boundaries, especially from a legal standpoint.
As much as you are eager to share all your new found knowledge with anyone who asks, remember that this is not a casual conversation you have entered into. These are not friends and family members asking for dating advice. Whether they indicate it or not, they are looking to you as a “medical expert” of sorts when it comes to the medication, illness, surgical or any other type of advice that you are so eager to share.
Here is the remedy. Feel free to share what you know. If you want to really show off, feel free to whip out your nursing school textbooks as visual aids. But always, always, always strongly advise the advice seeker to check with their doctor (or health care provider) for a definitive answer. It doesn’t matter if you are absolutely confident that the advice you are giving is solid – cover you license, cover your reputation and cover your conscience. Make sure that whenever you give your best medical words of wisdom, it comes with a disclaimer.
Why you need such a diverse, intensive education – because patients and their families (and your family and friends) will ask you EVERYTHING – the nurse as a walking, talking resource – legal liability – being careful to refer to MD or resources.
