brains.nursemind.comNurseMind's Brain Museum

Every nurse knows what we mean by brain . You're not a nurse? It's explained here . Remarkable ingenuity goes into creating nursing brains. In them, we capture an important aspect of our work: the things we want to be sure not to forget. We use a variety of tools to create these brains: Excel, Word, text editors -- whatever application programs we know best. For consistency, all are presented here in PDF format. Collecting brains is more than just an amusing exercise. It reveals much about the thought processes underlying the complex profession of nursing. From the choices we make about the reminders we find helpful, you can see our perceptions of the cognitive burdens of our work. Studying these brains reveals many of our workflow challenges. When we find it necessary to write things down, we are in effect documenting workflow glitches. These insights gave us the design concepts used in our NurseMind app , the first in a growing family from Nurse Tech, Inc. THANK YOU to all the generous and brilliant nurses who shared their brains with us! General-purpose. By Elizabeth Eckard (thank you!), a med/surg nurse on the Neuro/Ortho Floor at Hershey Medical Center. One patient Many nursing assessments. General-purpose. Day shift. By a nurse who floats among med-surg, telemetry, ortho, etc. One patient Labs Med-surg basics Tasks with timings One patient Labs 5 patients Some hospital-specific data-collection Several nursing assessments 1 patient, med-surg Page 1 of 2-page brain SBAR format Detailed task timeline Labs Page 2 of above Very technical Some hospital-specific protocols 1 patient Lots of details for nursing assessment Med-surg, with details about long-LOS patients Details about wounds Regular vital signs recording Nosocomial infection notations PCS pump notations Nice graphic for wound mapping Detailed notation of pain meds timings SBAR format 4 patients Very basic med-surg For RN-to-RN handoff (SBAR) 5 patients A conceptual checklist (remember to consider these things about your patients...) rather than specific tasks Another handoff (SBAR) tool -- more general and complete. 1 patient Includes fields for planned procedures. Lots of interesting things to see in this brain! It is made by printing from the EMR's Patient Census. High-acuity unit -- patients have demanding diseases and many co-morbidities. The patient:nurse staffing ratio is 3:1. The right-hand column is from the backside of the sheet; the nurse folded the page over and lined up the rows for notating vital signs for later transcription to the EMR. Note the consistent sequence: temp, HR, BP, RR, SpO2. Notations in red are also for eventual charting. They are crossed out when charted. Lab values of concern (e.g. K+) are hand-notated. Relevant medical history (Hx) is hand-notated. Though the hospital has an electronic MAR system, some medications to be administered (observe that they are checked-off) are hand-notated. Med-surg basics Tasks with timings 3 patients Labs SBAR Checklist for an outpatient surgical unit (Weatherford Regional Hospital, OK) Not a brain but a good checklist with a nursing application A memory aid combined with a data-collection function. Some parts are to be completed while interviewing the patient. Post-op assessments Pre- and post-op Aldrete score Unlike brains that are discarded after the shift, this one is to be made part of the patient's chart. 2 patients Labs Colors 4 patients Basic nursing assessments Nice format for vitals Specifically for use in a maternity (L&D) unit For use by nursing faculty and students No HIPAA data is collected Interesting hand-written notes go beyond the form's fields Not so much a memory aid (the primary function of a brain) as a record of student clinical experience (note-taking) But see the hand-written checkboxes for meds (reminders) Color variations have no significance here By Laurie Rosa, MS, RN 3 patients, med-surg Very basic Labs Hourly tasks Classic organization: rows for patients, columns for hours of the day Annotated Nurse uses colored pens to denote, e.g. IV meds in red Front and back By Sharon McLane, RN, PhD PICU-specific Labeled "Worksheet" but carried in RN's pocket like a brain No patient data Hourly interventions Mainly to make sure nothing is forgotten during shift change Structured note-taking for nursing student 6 patients Just the med-surg basics Originally created with Excel Structured note-taking for nursing student 4 patients Basics + task times Post-procedure assessment Originally created with Excel 2 patients/page Basic info + vitals Head-to-toe assessment checklist for MDs Helpful for RNs, too Beautiful graphics Glasgow scale and many more By Mary C. Vrtis, PhD, RN Student nurse-oriented Lots of reminders of what to assess In Italian From a respiratory disease unit Mostly TB and pneumonia cases Frequent decubitus ulcers "Religion" is an important field in a Catholic country 1 patient Lots of labs Lots of nursing assessments Hour-by-hour to-dos A nursing student's checklist For head-to-toe assessment Checklist on the left side, room for notes on the right By Dan Keller, MS, RN Nursing assessment checklist For the patient chart Also a memory aid for the nurse to make thorough assessments Schmid (falls) and Braden (skin) scales Hospital-created, not nurse-created From the Univ. of Virginia web site Handoff Of Care (HOC) Like SBAR (Situation, Background, Asssessment, Recommendation) Patient Care Plan, informally known as Daily Doc Sheet Not really a brain but an efficient way to update the Kardex (a valuable nursing tool refined over decades but alas obsoleted by EMRs) Courtesy of Val Flood, RN (ret.) An Emergency Department RN's brain (thank you, S.W.!) The names are fake -- no HIPAA violations! She has invented her own notational conventions: she circles the room number, underlines the MD's name, and draws a box for each task she might otherwise forget to do and later checks it off when it's done. Thus, her brain is a highly personalized cognitive support checklist device. It omits explicitly listing the tasks for which she doesn't need reminding and is thus designed for her own style of practice. Another nurse would do it differently. A "quickref" brain Phone numbers on a Post-It On the back of a badge Not condoned but very common A trauma surgery RN's brain (thank you, B. H.-L.!) Two patients Room for lots of detail You wouldn't use all the fields for every patient, of course; just the ones of concern in each instance. Emphasis on peri-op An inpatient psych unit RN's brain (thanks again, B. H.-L.!) Two patients Room for lots of detail You wouldn't use all the fields for every patient, of course; just the ones of concern in each instance. Emphasis on psych assessments A well thought-out brain from Ashleigh Weeda, RN. One patient Helpful for handoff Complex patients Nurse_Brain_Sheet_12_Hour_Day_Night_Rotation Thank you ScrubsMag.com for this one Nurse_Brain_Sheet_Binder_Insert_with_Dividers Thank you ScrubsMag.com for this one Nurse_Brain_Sheet_Binder_Insert_with_MARS Thank you ScrubsMag.com for this one Nurse_Brain_Sheet_Half_Size Thank you ScrubsMag.com for this one Nurse_Brain_Sheet_ICU Thank you ScrubsMag.com for this one Nurse_Brain_Sheet_New_Shift_Report Thank you ScrubsMag.com for this one Nurse_Brain_Sheet_Telemetry_Unit_SBAR Thank you ScrubsMag.com for this one Nurse_Brain_Sheet_with_Shift_Hours-1 Thank you ScrubsMag.com for this one Nurse_Brain_Sheet_with_Shift_Hours Thank you ScrubsMag.com for this one Nurse_MedSurg_Brain_Sheet_Notecards Thank you ScrubsMag.com for this one The basics for elder care (acute) Thank you Roz for this one For one patient with numerous co-morbidities (complex). Up to three IVs. Practical -- though "BS" (blood sugar) is not generally considered a vital sign, it is grouped with them because it is collected at the same time. WNL ranges for lab values are handily listed alongside the blanks. Discharge plan ("DC PLAN") is shown right at the top. Good strategy -- ke...