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By Danielle LeVeck, DNP, ACNPC-AG, CNS, RN, CCRN @nurseabnormalities

Early in my career as an ICU nurse, I was advantageous abundant to accept a adviser who helped me advance a solid morning accepted I accept agitated anytime since. Because my acquaintance is primarily Cardiac ICU, this accepted mirrors what I do in that breadth of practice, however, it can be tailored to accommodated the needs of any ICU patient. 

While the afterward account may attending like a lot, awaiting any instabilities or interruptions with the patient, it can be completed aural 30-90 account (depending on acquaintance level) for anniversary accommodating afterwards a few months of experience. 



Of note, this accepted is completed accompanying with a absolute arch to toe assessment. The accomplish for a arch to toe appraisal are not included in this post. The purpose of this is to absorb genitalia of a morning accepted that are generally missed, but back completed, can accomplish your day abundant smoother. 

This is how I do it but, accomplish abiding to chase your hospital’s agreement or antecedent training. 



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The afterward comprises the 20 basic accomplish that accept formed for my claimed accepted as an ICU nurse. 

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1) Upon accession to the assemblage and afterwards accepting your assignment, breeze accomplished both patient’s apartment and glance at the patients and monitors. Accomplish abiding annihilation needs your actual attention, and if the patients are restrained, accomplish abiding the restraints are angry properly.

2) Take bedside address – it is evidence-based convenance to accept address at the bedside. Encourage your aeon to partake in bedside address as well.

3) Do a quick analysis of orders, medications, and the morning chest X-ray. Also, trend pertinent labs. Looking at the trend of labs is actual important. For instance, you can agenda if a claret is bottomward or a white claret corpuscle calculation is trending up. Whereas, if you aloof attending at the morning set of labs, you will not apperceive if your patient’s action is deepening or improving. 

4) Go into the allowance of the best analytical accommodating first.

5) Analysis dribble concentrations, affirm the weight programmed into the IV pump matches the patient. Affirm beverage rates, and accommodating name on IV bags.

6) Analysis adviser anxiety parameters. Anxiety ambit should be accommodating specific. For example, if your accommodating lives with a affection amount of 50, you will appetite to set the aerial anxiety about 70 and low anxiety about 45. But if your accommodating has a affection amount of 70, the ambit ability be set 50-100. 

7) Analysis the IV admission on patient. Even all borderline IVs and axial admission with a accustomed acrid even to ensure able functioning. I consistently accomplish a agenda of the functionality of my admission and think, “if my accommodating were to code, area could I advance cipher drugs?” 

8) Analysis for an attainable ambu bag in case of emergency, trach food and obturator if warranted, and ensure one assimilation accoutrement is set up and functioning. 

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9) Analysis ET tube size, length, and aperture settings, including aiguille pressure.

10) Analysis settings on any accessory and admittance sites: CRRT, IABP, LVAD, ECMO, PA cath etc. Level, zero, and even all tranducers, agenda waveforms.

11) Agenda the agriculture tube breadth and securement, analysis residuals and adjustment if applicative (tube abased and per hospital policy.)

12) Agenda the date on axial band bathrobe and all dressings. Change per hospital protocol. 

13) Complete urinary catheter affliction and accomplish abiding there are no abased loops or kinks in tubing.

14) Accomplish abiding all chest tubes, cords, IV tubing, drains are operating appropriately (either absorbed to assimilation or not per order, canisters aren’t full, tubing isn’t beneath patient, etc.)

15) Agenda the patient’s skin, decidedly the cheers of heels and abaft the ears. Prop heels on pillows, change draw area and chucks pad, agenda sacral arena for breakdown, about-face patient.

16) TALK to the accommodating and advance a plan for the day, additionally let them apperceive what you are accomplishing during your morning accepted and why. The ICU strips so abundant ascendancy abroad from patients. By giving them the befalling to advance a plan, you are accouterment bigger patient-centered care.

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17) Accomplish abiding the patient’s alarm ablaze is in abode and the TV is on their called channel. You can additionally put on music for your vented patients.

18) Complete the CAM-ICU aberration calibration or aberration calibration per your hospital protocol. 

19) Throw abroad old supplies, Cavi clean surfaces, move any chairs or tables out of the way that ability be blocking a aisle to the accommodating or abashing room.

20) Repeat with abutting patient. 

What is your morning accepted for your specialty? As an ICU assistant would you add annihilation to the aloft list? Share your tips in the comments to advice added nurses get an organized alpha to their day. 

Danielle LeVeck, DNP, ACNPC-AG, CNS, RN, CCRN is an ICU Assistant Practitioner, blogger, writer, and amusing media influencer, who strives to empower and affect nurses from all backgrounds, to partake in approved self-care and multidisciplinary teamwork, for the account of accouterment optimal accommodating care. Chase her on Instagram and Facebook for her latest. 

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