Table of Contents
What is a Nurse Brain Sheet?
A nurse brain sheet (also called a "nursing report sheet" or simply "brain") is a reference tool nurses use to organize and track important patient information during their shift. It's your command center for managing multiple patients safely and efficiently.
The brain sheet is typically filled out during change-of-shift report when the outgoing nurse hands off their patients. Throughout the shift, you update it with new vitals, medication times, lab results, and changes in patient status. At the end of your shift, you use it to give a comprehensive report to the oncoming nurse.
A good brain sheet is key to patient safety and effective communication. When you have 4-6 patients on a busy Med Surg floor, it's impossible to remember every detail about each patient. Your brain sheet keeps everything organized so you can prioritize care, catch changes early, and give thorough handoffs.
Stay Organized
Track all patient info in one place without relying on memory
Better Handoffs
Give thorough, structured reports to oncoming nurses
Patient Safety
Catch changes early and never miss critical tasks
Essential Elements of a Brain Sheet
1Patient Identification
- • Room number
- • Patient name and age
- • Attending physician
- • Admission date and diagnosis
- • Code status (Full Code, DNR, etc.)
- • Allergies
2Baseline Status
- • Vital signs (baseline and trends)
- • Diet and activity level
- • Fall risk / isolation precautions
- • IV access and fluids
- • Intake/output requirements
- • Pain assessment
3Medications & Treatments
- • Scheduled medications with times
- • PRN medications given
- • IV drips and rates
- • Wound care / dressing changes
- • Respiratory treatments
- • Procedures scheduled
4Labs & Assessments
- • Recent/pending lab results
- • Assessment findings by system
- • Changes from prior shift
- • Things to monitor
- • Consults pending
- • Discharge planning notes
Med Surg Brain Sheet Template
Med Surg nurses typically have 4-6 patients, so brain sheets need to be compact while still containing essential information. Most Med Surg nurses prefer 4-6 patients per page with organized sections for quick reference.
Med Surg Brain Sheet (4 Patients/Page)
Dx: _____________
Code: ___________
Allergies: ________
Diet: ___________
Activity: _________
Fall Risk: [ ]Yes [ ]No
IV: _____________ Fluids: ____________
Meds:
Notes/Labs: _______________________
Dx: _____________
Code: ___________
Allergies: ________
Diet: ___________
Activity: _________
Fall Risk: [ ]Yes [ ]No
IV: _____________ Fluids: ____________
Meds:
Notes/Labs: _______________________
Dx: _____________
Code: ___________
Allergies: ________
Diet: ___________
Activity: _________
Fall Risk: [ ]Yes [ ]No
IV: _____________ Fluids: ____________
Meds:
Notes/Labs: _______________________
Dx: _____________
Code: ___________
Allergies: ________
Diet: ___________
Activity: _________
Fall Risk: [ ]Yes [ ]No
IV: _____________ Fluids: ____________
Meds:
Notes/Labs: _______________________
Med Surg Pro Tips
- Color-code by urgency: red for critical labs, yellow for pending items
- Circle medication times when given, cross out when charted
- Keep a "To-Do" section on the back for tasks throughout the shift
- Use abbreviations consistently (see our medical abbreviations guide)
ICU Brain Sheet Template
ICU nurses typically have 1-2 patients but need to know everything about them. ICU brain sheets are more detailed with sections for hemodynamics, ventilator settings, drip titrations, and hourly assessments. Most ICU nurses use a full page per patient.
ICU Brain Sheet (1 Patient/Page)
Room: _______________
Name: ______________
Age: ___ Wt: ___kg
Dx: ________________
MD: _______________
Code: ______________
Allergies: __________
PMH: ______________
Day #: _____________
HEMODYNAMICS
HR: ___ RR: ___ T: ___
BP: ___/___ MAP: ___
SpO2: ___% FiO2: ___
CVP: ___ PAP: ___/___
CO: ___ CI: ___
SVR: ___ PVR: ___
VENTILATOR
Mode: ____________
Rate: ___ Vt: ___
FiO2: ___% PEEP: ___
PS: ___ PIP: ___
ABG: pH___ CO2___ O2___
ETT Size: ___ @ ___cm
DRIPS / IV MEDICATIONS
1. __________ @ ___mcg/kg/min
2. __________ @ ___mcg/kg/min
3. __________ @ ___units/hr
4. __________ @ ___mL/hr
5. __________ @ _________
6. __________ @ _________
LINES & TUBES
A-line: [ ] R [ ] L
Central: ________
PIV: __________
Foley: [ ] Yes
NG/OG: [ ] LCS
Chest tube: [ ]
Drain: ________
Other: ________
HOURLY ASSESSMENT
| Time | 0700 | 0800 | 0900 | 1000 | 1100 | 1200 |
|---|---|---|---|---|---|---|
| BP/MAP | ||||||
| HR | ||||||
| RR/SpO2 | ||||||
| Neuro | ||||||
| I/O |
ICU Critical Reminders
- • Always verify drip concentrations at shift change
- • Document line insertion dates for infection control
- • Note ventilator weaning parameters and goals
- • Track sedation and pain scores hourly
- • Record family contact info and visiting schedule
SBAR Format Templates
SBAR (Situation, Background, Assessment, Recommendation) is a standardized communication framework that improves patient safety during handoffs. Many brain sheets are organized using SBAR format for more structured reporting.
Situation
What's happening right now?
- • Patient name, room, and your name
- • Current chief complaint or concern
- • Why you're calling or handing off
Background
What's the clinical context?
- • Admitting diagnosis and date
- • Relevant medical/surgical history
- • Key events this shift
Assessment
What do you think is going on?
- • Current vital signs and status
- • Assessment findings by system
- • Your clinical impression
Recommendation
What needs to happen?
- • Pending tasks and orders
- • Things to monitor/watch for
- • Expected plan for the shift
Specialty-Specific Templates
Telemetry / Cardiac Step-Down
Telemetry brain sheets need dedicated space for cardiac monitoring, rhythm strips, and cardiac medications with drip rate titrations.
Cardiac Specific
- • Rhythm & rate
- • Telemetry events
- • Troponins (serial)
- • BNP level
Medications
- • Anticoagulation
- • Beta blockers
- • ACE/ARBs
- • Antiarrhythmics
Monitor
- • Chest pain
- • SOB/dyspnea
- • Edema
- • Daily weights
Emergency Department
ED brain sheets need rapid documentation with space for multiple patients who may come and go throughout the shift. Focus on chief complaint, time-sensitive interventions, and disposition.
ED Specific
- • Chief complaint
- • Triage acuity level
- • Arrival time
- • ESI score
Time-Sensitive
- • Door-to-needle
- • Sepsis protocol
- • Stroke alert
- • STEMI times
Disposition
- • Admit / DC
- • Bed request time
- • Pending consults
- • Transport status
Labor & Delivery / OB
L&D brain sheets track two patients at once (mom and baby) with obstetric-specific parameters like fetal heart tones, contractions, and cervical checks.
Maternal
- • G/P/A status
- • Gestational age
- • GBS status
- • Blood type/Rh
Labor Progress
- • Cervical exam
- • Contraction pattern
- • ROM time
- • Epidural status
Fetal
- • FHR baseline
- • Variability
- • Accels/decels
- • Station
Pediatrics
Pediatric brain sheets include weight-based dosing calculations, developmental considerations, and family-centered care elements.
Peds Specific
- • Weight in kg
- • Age-appropriate vitals
- • Growth percentiles
- • Immunization status
Medications
- • Weight-based doses
- • Max dose limits
- • Preparation form
- • Administration route
Family
- • Parent/guardian
- • Contact info
- • Comfort items
- • Developmental level
Organization Tips for Nurses
Best Practices
- 1.Fill out your brain during report—don't wait until later
- 2.Use the same template consistently so it becomes automatic
- 3.Update in real-time: new vitals, meds given, labs resulted
- 4.Double-sided sheets: patient info on front, hourly tasks on back
- 5.Keep a master task list for the whole shift
- 6.Review your brain before giving report—fill in any gaps
Customization Tips
- 1.Add sections specific to your unit's common diagnoses
- 2.Include your facility's required documentation times
- 3.Create a checkbox system for routine assessments
- 4.Add space for CNA delegation and communication
- 5.Include contact numbers for frequent consults
- 6.Try different layouts until you find what works for you
Paper vs. Digital Brain Sheets
Paper Advantages
- • Quick to reference without logging in
- • Works when computers are down
- • Easy to jot quick notes
- • Private—no one can see over your shoulder
Digital Advantages
- • Auto-populates from EHR
- • Easier to read (no handwriting issues)
- • Can be backed up
- • Searchable and sortable
Frequently Asked Questions
What is a nurse brain sheet?
A nurse brain sheet (also called a nursing report sheet or "brain") is a reference tool nurses use to organize and track important patient information during their shift. It's typically filled out during change-of-shift report and updated throughout the day. The brain sheet helps nurses prioritize care, remember critical details, and give effective handoff reports.
What should be included on a nurse brain sheet?
A nurse brain sheet should include: patient demographics (name, age, room, physician), diagnosis and medical history, vital signs, allergies, code status, diet, activity level, IV access and fluids, medications (with times), labs and pending results, treatments and procedures, assessment notes by system, and tasks/to-dos. ICU sheets typically include more detailed hemodynamic and ventilator parameters.
How many patients should be on one brain sheet?
It depends on your unit and patient acuity. Med Surg nurses often use sheets with 4-6 patients per page due to higher ratios. Telemetry nurses may use 3-4 patients per page. ICU nurses typically use a full page per patient due to the complexity of critical care. Choose a format that gives you enough space without carrying extra pages.
What is the SBAR format for nurse reports?
SBAR stands for Situation, Background, Assessment, and Recommendation. It's a standardized communication framework used for shift handoffs and physician communication. Situation: current patient status. Background: relevant history and context. Assessment: your clinical findings. Recommendation: what needs to happen next. Many brain sheets are organized using SBAR format.
Should I use a digital or paper brain sheet?
Both have advantages. Paper brain sheets are quick to reference, don't require logging in, and work when computers are down. Digital sheets can auto-populate from the EHR, are easier to read, and can be backed up. Many nurses prefer paper during the shift for quick notes and privacy, then use digital tools for documentation. Choose what works best for your workflow.
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