Your shift notes should reflect the support you have provided your client.
Read the fact sheet ‘Writing Shift Notes’ on the https://zestcare.net.au/team-resources/ page.
Remember: other Support Workers can see your notes.
Shift notes should include:
- Activities: What did you both do during the shift?
- Observations: How was the client and their environment presenting? (Mood, clean clothing, smells, facial expressions, information the client shared etc.)
- Planning: What to plan ahead for your next shift. (Shopping list, appointments, community access ideas, etc.)
- Transport notes: Details of client transport, to and from, kilometres travelled.
- Goals: How are you and the client working together to achieve their goals?
They should be written in an objective perspective. Objective writing is based on facts and observations. It is a description of what happened.
Objective writing is not influenced by personal feelings or opinions.
Example of Objective shift notes:
At 3.30 pm Marcella returned from a walk to Albert Street Park and she was holding her right arm against her body. I noticed that she had a graze and bruise on her right arm. Marcella said a dog had jumped on her when she was sitting on the grass at the park. She said she had been frightened and that her arm was sore.
Example of Subjective shift notes:
Marcella must have bumped into something when she went on a walk to Albert Street Park, as she has grazed skin and a bruise on her arm. She was holding her arm and looked unhappy.
