[Schmoo1022]

Hello,
We have a small facility, (33 beds) with 3 aids. Patient care isn't being finished until lunchtime. What can we do to make a.m. care go more smoothly? Any ideas or thoughts would be greatly appreciated!!
By the way, out of the 33 patients, 24 are complete care, 6 are assist, and the rest are independ.

[carebearRN08]

Ok so reading your post, I see the problem. 3 aides with 24 total care pts = 8 total cares per aide? Not even counting the others, that is enough to keep ANYone busy til lunch, even with 0 interruptions, which I doubt your aides have. I worked as an aide through nursing school and often had loads like this. The way to make it go smoother is to just gather your supplies, go in there and do your job, the help of a nurse would help. You probably won't get all 8 done by lunchtime, which I think is okay, unless there is some reason why it can't be done a little later. Another thing that really really helps is if the night shift could pick up on some of the baths, even one or two per assignment really helps. Communicate with your night shift and see if they can pull off a bath, say, during a midnight BM clean up; if you're already there wiping a bottom, it doesn't hurt to give the rest of the body a clean up. I'm not sure how busy your unit is on nights but at my old job they could get most of the baths done on nights.

I hope I'm not sounding pessimistic by saying that with that many patients and that few aides, getting things done by lunchtime sounds about right.... I'm curious to hear what other say though.

[phriedomRN]

Originally Posted by carebearRN08

I hope I'm not sounding pessimistic by saying that with that many patients and that few aides, getting things done by lunchtime sounds about right.... I'm curious to hear what other say though.

Nope, that's about right. I worked LTC for 3 years and we'd carry between 8-12 patients depending on staffing. We'd each have 3 or 4 total cares and we STILL didn't get everything done till right before lunch trays were coming out

[vivibonita]

I must agree with the last two posters... When I was in nursing school I felt really bad for the aides, but they would tell me that after getting the AM care done they were free to help with other things. It doesn't matter how organized or how prepared you are to give the AM care, there's always that patient that needs the extra attention, and will make the others wait a little longer for their care and the aides for their lunch.

It would be nice that everynow and then the nurses could help at least with one pt.

Peace

[bethin]

Sounds about right. In between answering call lights, running things to the lab, answering phones, nurses talking to me about pt's status, getting 10 baths done before lunch is a miracle.

The only solution I see is if the nurses aren't too busy that they could do one of their pt's baths or help with a complete freeing up another aide.

[bethin]

On the bright side, at least it's being done!

[Schmoo1022]

Wow! Thanks for the replies! We have a really great group of CNA's and I am sick of the administrator telling them that everyone needs to be dressed and in the dining room by 11:30am. I try to help the aids with the patients that need the bedpan and such, but I am not sure about the other nurses. Management really takes into consideration all the distractions

[CapeCodMermaid]

Originally Posted by Schmoo1022

Wow! Thanks for the replies! We have a really great group of CNA's and I am sick of the administrator telling them that everyone needs to be dressed and in the dining room by 11:30am. I try to help the aids with the patients that need the bedpan and such, but I am not sure about the other nurses. Management really takes into consideration all the distractions

I'm guessing your administrator isn't going to be at the forefront of culture change in LTC! If you do the math....8 patients in 240 minutes=30 minutes per patient. Surely it doesn't take them a full half hour to bath and dress every resident. I have a few staff people who take a 1 hour job and stretch it into 3 hours. I think your situation is doable, but I don't think y'all should be relying on the nurse to do care....a 33 patient med and treatment load is probably enough.

[st4wb3rr33sh0rtc4k3]

How bout getting the early risers, up during third shift? That seemed to help out the day shift, with getting them up and ready to go.

I don't know if the nurses can help, most third shift nurses, get up to 60 patients. And the day shift has a heavy morning medication pass, with up to 30. Don't know what everyone else patient ratios were.

Sometimes there are good days and bad. During nights I was sometimes able to help make the beds and do mouthcare.

[IowaKaren]

3rd shift doing baths and getting people up? I guess that depends on the 3rd shift hours. We are 10p-6:30a and no-one has to be gotten up before 6 AM unless they want to, same with a bath or shower. On my floor, there are a few that want a whirlpool bath that they never seem to get during the day because of time constraints so they'll ask to have one before 6 AM, same with getting up but otherwise, no-one is gotten up before 6 AM unless they want to. Goodness, what is residents rights good for if you have to have a bath in the middle of the night?