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Plan Chaos

Ace a busy Emergency Department or ANY Evening shift

For All shift workers out there !





Let’s just assume all emergency shifts are going to be super busy so to how plan an Emergency Weekend Evening Shift when staffing are less, resources are scarce and patients are more and more sick....Lately I have been doing a lot of self changes in lifestyle and this practice of mine is worth a look


Before an evening shift

  1. I make sure I have a good night sleep at least 8hours prior to day of my evening shift

  2. On the morning I will go for a brisk walk listening to gentle relaxing music to set my mood or take kids out with me

  3. Later if family is home I spend some time with them play, read whatever

  4. I come home have a shower early - I like hot shower and having a hot shower before drive to work can mellow me down a little

  5. PRIORITY Fix up my lunch for shift ( I will have 2 pieces of fruit + Some lean meat + brewed coffee + a snack)

  6. No screen time I have noticed not having any screen time no emails, WhatsApp Facebook or anything

  7. Power nap for 1 hour - this is very important for me as I have 1hour commute each way and then 10 hour solid work so I want to be fully charged

  8. Whilst driving, I am avoiding to listen to distressing news, crazy emergency pod cast which will set my anxiety up


At the Evening shift

  1. Check all staff here

  2. Take a handover

  3. Sit down with your team beginning of shift and lay a plan

  4. Go through screen and get all the investigations / X-rays bloods etc requested

  5. Delegate simple enough stuff like minor cuts and sprains to NPs (that’s what they are good at)

  6. Take your intern with COW and get an examining area and start seeing patient one by one (click patient off from screen)

  7. Get them analgesia, keep all required stuff there like plaster trolley, IVC and sutures new your bay

  8. Get your intern keep typing notes and requesting investigations whilst assessing the patients

  9. Check up on rest of your team nursing and medical …check if they need discussing any patient early on

  10. If you need to use resuscitation bay for procedural sedation let you nurse in-charge know and work with here who can be stepped out of resuscitation area to facilitate your procedural sedation

  11. If patient need speciality team r.v that is causing delay ….Call the speciality doctor yourself ..tell them courteously about wait and you needing to juggle space here and then TELL patient about this delay


Breaks

DON'T EVER DELAY YOUR BREAK ..there is never an ideal time.

Preset alarm for your breaks and take them

Preset your 2 x 10 mins 1 x 20mins break through 10hour shift

Have a regular glass of water drink in each of your breaks

First break snack -10mins I start shift at 1400 so that be at 1700

Second break dinner lean meat and fruit and coffee (that be mid shift) - 20mins - 1930HRS

THIRD BREAK DRINK OF WATER AND PEICE OF fruit -10mins - 2130 hrs

Finally, ending your Evening shift

  1. End of your shift at midnight

  2. 1hour before handover at 2300 ( so at 2200) go through board and make sure nothing delayed

  3. 30mins prepare for a hand over (2230)

  4. Finish at time 0000

  5. Before you drive back make sure- give yourself 10mins to unwind - have some water - close your eyes and relax and reflect

  6. Finish and drive back home - listen to active music or an interesting pod cast like a crime mystery that will keep your attention engaged (NOT Emergency)

  7. Come home shower and have some milk and hit the sack !


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