Unit two: Strategies for Professional Practice I. INTRODUCTION: Challenges of Handling Multiple Patient Assignments

SITUATION INDICATING CHALLENGES OF BEING A NEW NURSE Inez is a new graduate registered nurse. She has completed her orientation; this is her first shift without her preceptor. She is frightened feeling she is holding up the world on her new graduate shoulders. She really is not alone. Inez and Carole, an experienced RN, along with one certified nursing assistant are responsible for 10 patients on the unit.

SITUATION CONTINUED They are expecting a new admission, and another patient is returning from surgery, the dinner trays are arriving, medications for 1800 are due. Just as the dinner trays arrive, a patient’s family member runs out to Inez stating that her mom has become confused, incontinent and has pulled out her IV. What would do if you were Inez? What would you do first?

CARING FOR ONE PATIENT VS MULTIPLE PATIENTS Identify how this is different Identify characteristics in the caregiver necessary to provide care to multiple patient assignments Identify stressors that the caregiver feels when providing care to multiple patients Identify approaches that will make this successful for the caregiver

ORGANIZATION How to organize multiple patient assignments? What obstacles are in the way for the caregiver? What are the advantages of organizing?

EVALUATE OUTCOME ACHIEVEMENT If at the end of a shift the nurse did not accomplish the desired intended outcomes, the nurse should review the shift activities to see what time wasters interfered with outcome achievement.

SITUATION INVOLVING FLEXIBILITY HOW DO YOU HANDLE? Being floated from maternity to med surg? Working short staffed Responding to a disaster Responding to 4 admissions within 2 hours Computer system goes down Patient goes bad Someone calls in sick

INCREASING INDEPENDENCE Breaking the umbilical cord Speed at which you develop independence