Nursing Tips for Great Care

Nurse smiling with a patient

Becoming an LVN isn’t easy.  You want to learn from the best and CDI’s nursing program in Los Angeles is an accredited program in southern California.  We continue to look around the web for interesting articles that further the education of students here on the west coast and across the globe.

Once graduating, your everyday practice is filled with assessments, documentation, planning, interventions, and evaluations. Then there’s patient and family education, medication reconciliation, communication with other healthcare professionals, and transferring and discharging patients. The list goes on and on. The point is that as nurses, our days are full!

The clinical team at Lippincott NursingCenter.com has assembled a list of nursing tips to help make our days run a little smoother, improve your practice, and optimize patient care. Here you’ll find handy mnemonics, definitions, practice pointers, and more.

Professionalism

 1.  The nursing process: assess, diagnose, plan, implement, evaluate (ADPIE)

 2.  Nursing is a 24/7 operation that requires teamwork – do your best to prioritize and work safely & pass on the rest.

 3.  Organize tasks by “must do” (within 30 minutes), “should do” (within 4 hours), and “could do” (before end of shift)

 4.  When the number of tasks to be done seems out of control, stop and take a deep breath, even a 5-second break can help!

 5.  Five rights for delegating care: right person, right task, right circumstances, right direction, right supervision

 6.  Take the lead to inspire teamwork – pitch in and help your colleagues. Perhaps others will follow your lead!

 7.  Key to a fulfilling work life…have a goal and focus on working toward it; goal should be realistic & attainable.

 8.  When caring for an abuse victim – establish trusting relationship, treat immediate injuries, record factual account, & refer.

Assessment

 9.  A successful assessment requires critical thinking. Think “how does this finding fit in with the big picture?”

10.  A patient’s behavior & appearance can offer subtle clues about his health. Carefully observe for unusual behavior or signs of illness.

11.  When assessing the abdomen, inspect first, then auscultate, percuss, and palpate.

12.  In general, the younger a child, the higher the pulse and respiratory rates.

13.  Accurate measurements of height and weight are important for evaluating nutritional status, calculating medication dosages, and assessing fluid loss or gain.

14.  Four parts of nutritional assessment: health history, lab tests, body systems assessment, anthropometric measurements.

15.  If a patient is frightened or ticklish, begin palpation of the abdomen with your hand on top of his or her hand.

16.  When listening to heart or breath sounds, close your eyes to help focus your attention.

17.  Use the bell of the stethoscope to hear low-pitched sounds; the diaphragm to hear high-pitched sounds.

18.  When assessing a patient, palpate tender areas last.

19.  Percussing over a solid organ, such as the liver or kidney, should create a dull sound.

20.  For complete pupil assessment, think PERRLA: Pupils Equal, Round, Reactive to Light and Accommodation.

21.  PQRST to evaluate symptom: Provocative/Palliative (what makes it better/worse), Quality/Quantity, Region/Radiation, Severity, Timing.

22.  Think “CURVES” to evaluate decision making ability: Choose & Communicate, Understand, Reason, Value, Emergency, Surrogate.

23.  Suspect abuse? SEE: Screening, Evidence (gather it), Effort (to report findings & direct patient to appropriate agencies).

Documentation

24.  When documenting a patient’s behavior, include only the facts – not your opinion on why the patient is behaving a certain way.

25.  When documenting the reason for seeking care, record the information in the patient’s own words.

26.  When in doubt, spell it out. Are you familiar with acceptable abbreviations where you work?

27.  PIE – Problem, Intervention, Evaluation – include all 3 in your documentation.

28.  The null sign (Ø) is on the ISMP’s List of Error-Prone Abbreviations, Symbols, and Dose Designations. Write ‘0’ or ‘zero’ instead.

Communication

29.  At start of shift, tell patient what is expected to occur and what treatments & procedures are planned.

30.  Don’t forget common courtesy – introduce yourself to patients and identify yourself as a nurse.

31.  Believe in yourself and your instincts, but always listen to the patient.

32.  Consider asking, “Does anyone have any ethical concerns with this patient’s care?” to open dialogue during rounding.

33.  Communication technique – Clarification – For example, “I’m not sure I understood what you said.”

34.  Working with students? Offer warm greeting, include in daily routine, treat with respect, and model professional behavior.

35.  To conclude history taking – “I think I have all the information I need now. Is there anything you’d like to add?”

36.  Humor can help put a patient at ease, but avoid sarcasm and keep jokes in good taste. Know where to draw the line.

37.  Closed questions elicit yes/no or 1-2 word answers; can help you zoom in on specific points, but don’t allow patient to elaborate.

38.  Good communication is essential when transferring care to another person, speaking with and educating patients, interacting with families and other visitors.

39.  When giving report or transferring care, think SBAR: Situation, Background, Assessment, Recommendation.

40.  Use open-ended questions to assess for abuse: When do you feel safe? When do you not feel safe?

Thank you clinical team at Lippincott NursingCenter.com for putting together such an awesome list.  Learn more tips here!

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