Do you feel overwhelmed by cross coverage at night? You need a framework to stay organized. Here are 5 tips to thrive in these high stress situations:The problem? You might be 1 person covering admits and floor patients you don't know.This is a high stress situation. A framework allows you to provide better care. Let's dig in Tip 1 Determine acuityDid 5 pages just come through at once?Get the info from ALL of them asap(& have a system... more on this later)Why?You might waste 5 minutes replacing electrolytes on the first 4 but that 5th patient is decompensating.Tip 2 Triage (Who needs YOU right NOW)That admit has an ER doctor. That floor patient does not.See the floor patient whose only coverage is YOU. Also, if a nurse is concerned, err on the side of seeing the patient yourself vs managing over the phone.Tip 3 Stabilize first.You may get overwhelmed & distracted with diagnosing a decompensating patient. But what they need most is stabilization. With experience, you'll learn to do these concurrently. Example:Someone in respiratory distress with dropping O2 sats...Can this be managed with an increase in supplemental oxygen or not?Do they need transfer to the ICU?Do they need to be intubated?Ask these questions first.Experience will help you determine sick vs not sick.When you have a lot of tabs open it runs slowly.Closing the tabs allows it to run faster. Having a system = less cognitive load = closing tabs = clear mindI'm a fan of pen and paper 👇
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(Test)A framework for busy cross coverage.
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Do you feel overwhelmed by cross coverage at night? You need a framework to stay organized. Here are 5 tips to thrive in these high stress situations:The problem? You might be 1 person covering admits and floor patients you don't know.This is a high stress situation. A framework allows you to provide better care. Let's dig in Tip 1 Determine acuityDid 5 pages just come through at once?Get the info from ALL of them asap(& have a system... more on this later)Why?You might waste 5 minutes replacing electrolytes on the first 4 but that 5th patient is decompensating.Tip 2 Triage (Who needs YOU right NOW)That admit has an ER doctor. That floor patient does not.See the floor patient whose only coverage is YOU. Also, if a nurse is concerned, err on the side of seeing the patient yourself vs managing over the phone.Tip 3 Stabilize first.You may get overwhelmed & distracted with diagnosing a decompensating patient. But what they need most is stabilization. With experience, you'll learn to do these concurrently. Example:Someone in respiratory distress with dropping O2 sats...Can this be managed with an increase in supplemental oxygen or not?Do they need transfer to the ICU?Do they need to be intubated?Ask these questions first.Experience will help you determine sick vs not sick.When you have a lot of tabs open it runs slowly.Closing the tabs allows it to run faster. Having a system = less cognitive load = closing tabs = clear mindI'm a fan of pen and paper 👇