Help? Need cheatt sheet while doing precepting in nursing home

I think clipboards are incredible assets! Each patient has a 8x10 sheet of paper. If ya wanna get fancy, use post it flags on the ends. Start with either organizing them allphabetically, or by room #. Start by seeing if there's a med nurse, or will each student be responsible for their own patient's meds. FIRST and FOREMOST....look through the chart (or med book) and see which patients have finger sticks and insulin in a.m. I am not sure if you would have IV meds--scheduled antibiotics first thing in the morning--be on the lookout for these things, and they are your priority. Find out in what time frame meds need to be given. Make sure that you check bp's and pulses on patients before you give applicable bp meds. If you don't know a drug LOOK IT UP!! Don't just guess. Make your CNA know that she is a huge important part of your team, cause he/she is, and is an invaluable imformation gatherer for you in your assessment. (ie: "Is the patient acting differently than baseline? If so, please let me know this". Make sure that you know your 5 rights of med administration. Make use of the patient chart, and carry your drug book. Think about some different nursing diagnosis, mix it up a bit--ie: Spiritual Distress, ineffective coping, etc Good luck, and let us know how it goes for you. Deep cleansing breath......

I allways ask for the assignment sheet{ It's a paper with the names of all your residents & room numbers}. I look at my MAR and highlight Pt with 11am finger stick with GREEN. Pt with afternoon meds with Blue. Pt with wound care or procedure with RED. On that paper I'll write any thing I want on the back use signs or abreviation in case you leave it any where{ I Use my first languge, good luck understanding if you find it!!!}. Organization is the key find away you will feel comfort with and good luck. Some times I use my blackberry to remind me of things { just make sure to put the phone off }. good luck

I am a new RN grad and this week with be my 4th week orienting at a nursing home. I have between 18-20 resdients to take care of. Here is the catch they are residents not patients, this is their home now so taking care of them is different. I don't do full assessments on everybody, its impossible in the short amount of time you have. Get a good idea of there health history, if you see CHF, Pneumonia, or any heart related conditions and they are on beta blockers or something like lasix, take a peak at their lower extremities and listen to lungs. With all residents on O2 you need a fox and lung sounds. Residents that are in ok health you dont need to do the whole assessment with them unless something seems different about them,( you will get that information in report). As far as cheat sheet i recommend getting theire report sheet, you wanna limit it two one or 2 pages. mine is one paper divided into 20 boxes with names and room numbers. The MAR on my med cart is big with everyones own section tabed with room numbers on it and there picture and how they take there meds. You will get a feel for your residents and which ones want there meds right away and wich wait until later. If you are working evenings its always right after supper because the majority of the residents go to bed around 7pm. If their Trazadone is scheduled for 10p and they are in bed at 7pm it makes no sense so you gotta use your judgment, give it early. On top of meds you will have treatments, such as dressing changes, lotions etc. that needs to fit in usually after meds are done. You will be fine takes some getting used to i highly highly suggest a pen that as multi color choices on it. ( LIFESAVER) dont get to crazy with your cheat sheets you wont have time to flip back and forth if you have one sheet per person and that is also a good way to make a mistake when you are running around. GOOODLUCK!!! let me know if you have any other questions!! I am happy to help!!

There are really great things to find on this website. if you do a search from the toolbar on the homepage, cheat sheets for nh or something like that, you will find tons of stuff that other ppl have shared. you can print them right off, or save to your computer and change around. good luck!
-H-RN

Not to change the direction of this thread but one poster said something about using your judgement and giving a 10 pm med at 7. You are not supposed to use your judgement for this. If the med is scheduled for 10 you can ONLY give it between 9 and 11. If the resident is always in bed at 7, have the doc change the time.

You are so right!!

1. Come to work early
2. Before you clock in get a resident census sheet
3. Do rounds. Look at every resident on the census sheet. Make sure they are stable.
4. Find out who is a full code who is a no code. Mark it down on the census sheet. If someone is not breathing you have no time to hunt down a chart and figure this out.
5. Know where the suction machine with tubing attached ready to go, ambu bag and CPR boards are located. An emergency is no time to be looking for these items.
6. Know what residents need to get their blood sugar tested and at what time. If the order reads 30 minutes before meals. Know what time the meal is served and mark this down.
7. Know what residents recieve enteral feedings. Always a good idea to have the tube feeding formula at the bedside so it can be adminstered if an alarm goes off indicating the bag is empty.
8. Know what time the residents tube feeding pumps will be turned on and off.
9. Know what residents recieve their medications before meals, and after meals.
This will save you alot of time and should get your day off to a good start.
After you clock in:
1. Get report on the residents. Do walking rounds. Do narcotic count.
2. Give report to the nursing assistants
3. Start your med pass.
4. Do treatments when the meal carts are put away
5. Do weekly progress notes
6. Do the daily charting

Hope this helps.

Ohhh yes yes..!!!!!! i just re read what I posted! It really sounds like I am saying use your judgement and go ahead and give it. No ! You NEEED to call the doc for a new order. (I figured that was a given) I am sorry that sounded horrible. And i would not do that. I need to proof read ! sheeesh I sound like an idiot! ha!