How to Organize the Nurse’s Morning Routine

Alternate Title: Sticky Notes: Organizing the Nurse’s Morning Routine since 1980


Well, I can’t speak for sure that nurses flocked to the shelves of office supply stores in 1980 to grab stacks of the newly-released Post-it notes from 3M, but I also can’t imagine that it took long for healthcare workers to realize their worth. The gold standard (or in most cases, Canary Yellow) for quick jotting and note-leaving, I owe a great deal of my success through career and educational pursuits to the 9 square inches of self-adhesive genius that is the sticky note.

Every nurse has his or her own method for organizing the day, keeping track of the hundreds of snippets of information encountered, and passing along this info to dozens of specialists, technicians, case managers, and family members. For me, my system is built around the (you guessed it) sticky note. If you or your fellow nurses (or nursing students!) are struggling to find a method of organization you really like, I encourage you to give this a shot as I dive into the super-specific way I use sticky notes to stay on track.


The Med-Cart Sticky Note


The unit where I work is equipped with med-carts which we as nurses can stock with medications for each patient along with supplies, flushes, IV tubing, etc. My first sticky note of the day is made as I prepare my med cart after leaving morning report. I access the EMR and look over the medications due for each patient and make a list for whatever I will need. I can then bring this sticky note with me into the med room to make ONE SINGLE TRIP, efficiently preparing my cart for the shift.


The Med Pass Sticky Note


The next note I always create is done during my morning med pass and assessments of my patients. All nurses are a bit different in their morning routines but I like to think of myself as a lean, mean morning machine. I walk in, scribble my name on the whiteboard, state who I am and what I’m about to do. “I’m Dave, I’ll be your nurse today. Can you tell me your name and DOB? Great. I’ll scan your wristband, give you the medications you have due this morning, and give you a quick check-up.” I’m out the door to scan meds before the patient has a chance to ask about a ginger ale or complain about the bed being lumpy.


I scan and administer the medications I already organized with the help of sticky note #1, then use my hands-on assessment time to check on the patient’s needs. I am quick, not because I don’t care about my patients, but actually the opposite.


I care so much about my patients, that I want to ensure they all receive meds and proper assessments on time. I care so much that I want to avail myself to them in the event of a true emergency. I care so much that I want to be free to help other nurses who may have fallen behind. It’s hard to do all of this when I’m in a room fluffing pillows or patiently waiting while an 80-year-old patient is trying to show me grandkid photos on her dang-flabbed smartphone.


That’s where the second sticky note comes in. Any concerns or issues the patient has, I write them down on the sticky note. I will refer to this note later after morning rounds are complete so I can delegate out to nursing assistants or call whoever I must to address the concern. It gets done, trust me, but while I am rounding in the morning I am responsible for the well-being of people I haven’t even met yet. Therefore, the extra creamer for your coffee may have to wait sir...I must be moving on.


The Add-On Sticky Note


After rounds in the morning and my patients’ immediate needs have been met, it is usually time to document. While not incredibly time-sensitive, there are assessments that should be in the system on the EMR if a patient is unstable, traveling off the floor, or being evaluated for an infection in a timely manner. I generally grab my second cup of coffee for the day, tell my unit coordinator in which nursing station I will be hiding, and begin charting. As I log in, the resulting new orders from the physician’s rounding will inevitably light up my screen, negating whatever satisfaction I had when I believed my work for the morning was complete.


Lab values are now in, and 12A needs a transfusion. 7B will need his magnesium supplemented for a value of 1.6 and 19A told the doctor (not me, of course) that overnight she felt dizzy going to the bathroom so now there’s a stat EKG and orthostatic vital signs ordered.


The choice is mine, should these tasks live scattered throughout the EMR software? Or perhaps I should use my powerful brain to store them? I could always ditch my coffee and documentation to get them done right away, but I could spend the rest of my shift “chasing clocks” and never getting everything done. Unless they are critical, those new add-on tasks make up my next sticky note. Write ‘em, prioritize ‘em, and forget ‘em until AM documentation is done.


The Buffalo Chicken Soup Sticky Note


For me, it’s generally between 1 and 2 pm that I get to stop and take a lunch break. But on that one magical day every two months or so, our cafeteria takes what would be run-of-the-mill cream of potato soup and they had chicken, Franks, and blue cheese crumbles. This heaven in a bowl (usually a paper cup with matching lid) sells out quick, so for me to get my share I will be writing my lunch break sticky note a bit early.


I’ll be asking another nurse to cover my team while I take lunch, so I write a brief synopsis on each patient. This is short, quick, and small enough to fit on a sticky note. For each patient, it will be a primary diagnosis, ambulation status, and what she may potentially need during the 30 minutes I’m off the unit. I usually ask for this sticky note back when I return to I can hand it over to the nighttime charge nurse as a little heads up about my patients.


Final Thoughts and Final Sticky Notes


By the end of shift, I’ll have notes on my cart asking me to call a patient’s sister when he’s out of the recovery room, the phone number for an infusion company setting a patient up for at-home antibiotics, and maybe even a brief timeline of events when a patient reported sudden chest pain and I will be writing the formal progress note later. However you organize yourself, it is important that you develop a system that is simple and works for you. Find purpose in getting organized, budget your time, and keep yourself available as much as possible for the emergencies or other special circumstances when your presence will be critical.


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