When I first became a hospital nurse, my preceptor gave me one of her flow sheets. It was a printed sheet. I didn’t like it. I tried another one. I didn’t like it. I tried formatting a sheet of my own. I didn’t like it. After about a month, I decided to go back to the drawing board.
I took a couple weeks worth of flow sheets and I dissected the information. I quickly realized that making a custom sheet allowed me to have the maximum amount of free space possible. That allowed me to scribble in notes for all the new events during the day making my computerized shift note a breeze to write (even if I didn’t have time to get to it during the shift).
From left to right, I have three columns; Patient information, nurse to nurse report and/or nursing tasks, and active information. Normally the above image would contain info on up to five different patients, but the first row contains generally where I put my information.
The second row down I attempt to neatly fill in what the information looks like in real life with a fake patient and doctor name.
The third row is what it actually looks like with my chicken scratch and nursing short hand. You’ll notice the amount of free space that opens up once you get a handle on exactly what information is pertinent to the type of nursing you do.
That big open space in the third column is where I put changes to patient care, new MD orders, upcoming exams, notes from PT/Social workers/Family/etc. It also contains the times I need to give medication on the far right. I will also put any actions I need to complete during a shift, like irrigating/flushing an NG tube, then I will check off the box once completed (not everything we do has a computerized task).
I make little notations next to medication administration times. Anything that involves blood sugar or insulin checks will be circled. Antibiotics will have an ‘A’ next to the time. Nebulizers will get a ‘N’ so I can call respiratory to bring treatment early if needed.
This is only one example of one fake patient. Every different type of diagnosis has its own related subtleties (hence why a pre-formatted sheet never worked). Try making your own custom flow sheet and see how it turns out. The beauty is that you can adjust, add, or remove whatever you needs to be on it.
Sure, going custom is like wearing someone else’s underwear at first, but after a while…it’s yours!