agency Nurses, How do you do it??

If you are working in LTC make sure the Narc count is right.

Hi I currently work for an agency and what I usually request is a quick tour of the unit, so I know where things are. Who is on any peg feeds, urostomy, colostomy, foley, crush meds, thickened liquids and diabetics. Make sure the narc count is correct when I get the keys, because if not you know you own it then. Hope this helps.

I just quit an agency job because I could not deal with it. Yeah, the pay of $35 an hour was great ($10 more than a regular LTC care in my area), but after 10.5 hours with no break at all (I know it is the law, and of course, the agency totally offers it, I did not feel like I could take one!), giving morphine doses to a HOSPICE patient with tons of family in the room, having LTC residents say they should have been in bed 2 hours ago instead of waiting for their HS pills, and having to process a new admit (really? couldn't someone else have asked him the same questions? Does it have to be an RN? Some of it, yes, but not everything!) - I wasn't willing to risk my nursing license and my future nursing goals for working a temporary, part-time agency job in LTC. I am on my way to being a midwife (what I have always wanted!) and am not going to lose the opportunity to a stupid med error in LTC. But, while I was there, what I really wanted to know was how their took their meds (whole, with sauce, crushed in sauce, etc.), who needs accu checks before dinner and insulin, and what strange personality quirks to look out for (i.e.: who want their HS meds by 7pm, who gets a cocktail each evening and how to prepare it, and who will refuse everything no matter what I try?). Good luck to you. I think LTC, and especially agency work, is harder than ICU and hospital units!

In report, as agency new on the scene, I care to know a brief but relative history if there has been change of condition in patient.
Who is diabetic, and pills crush or whole. New admits, recent falls, isolation's for_________, any GT's, ABO's currently being administered for________.

its OK to hear "OK, no changes" if all is OK and none of above.

out of report...

where things are located ( med room, supplies, drug overflow, etc)

yes, always narc count on with nothing funny going on.

Added note: I guess its like, if you know how to drive and drive on freeways regularly, then travel to an different town on a different freeway...you can still get around with a general sense of how things are .... but its always good to know where the exit is. :-}

And thank you for your concern and questions...it really is about the patients well being...nurses that care are awesome!