Wow how do you find the time? I have been on Nights for 8 years now and we are just as busy as the day and evening shift tell me please what I am doing wrong. Typical night in my facility with 75-82 residents split between 2 nurses. Come on shift at Ten take report. Count three med carts for your three halls. Make out your V/S list for the residents in follow up including your Medicare patients Last shift I had 8 on Medicare + 10 on medical follow-up (falls,antibiotics,readmits, new admits, etc, etc). Lets get around and see those 18 folks before it gets to late. Make your notes to chart from as you go along. You also have 3-4 patients on Bi-Pap that need assist with their head gear and all the humidifiers on the BI-Pap machine need distilled water.Your still on the first hall of 3 you have at least 3 people see you pass by and want prns for this or that if its a pain med all the back to the unit to that cart where all the pain meds are. add your pain meds to the to do list you are making you will need that later for the charting you have to do in triplicate on pain meds. The phone rings at the desk you wait on the 4th ring you make a run to get the phone. Good Morning Its a great day at Happy Acres. The required way to answer our phones my direction of the corporate gods in New Jersey are down south in Oklahoma but don't get caught answering the wrong way or hour head will be chopped off. Can speak to my mom one of the CNAS Or the other nurse on the other side of the building cant use the intercom at night so go get them. Now back to hall one and finish there. Start hall 2 if your lucky 30 to 45 mins same with hall 3. Back to the unit. I have the unit , locked /dementia unit with 13 of the sweetest little ladies in the world but they can get on a roll even on the night shift. By now its after midnight closer to 1 a.m..
Get ready to do all your required paper work . Book 1 The Pain Book enter all the prns you gave on the 3 halls on the pain sheet be sure those are signed for in the narcotic book and charted in the nurses notes in the chart told you it was in triplicate. Book 2 The Behavior Book one page for each Psych med or sleep aid each pt is on typically 90-100 pages to initial in 3-4 places. This book also contains the Resp sheets for HHNs, Bi-paps, O2 , and inhalers. The diabetic sheets are here as well make out the FSBS list for your finger sticks later 18 right now. The Day nurse will give the insulin after six closer to breakfast. Book 3 the treatment book for your 3 halls 40-45 pages to sign no real TXs but all things you initial for not covered in the other 3 books. Don't forget the MARS for three halls. Lunch break 30 min that you punch out for but keep working. if you stop and do nothing for 30 min you are 30 min behind the rest of the shift. Now there is those 18 charts to start on 8 are Medicare so start the new MCR for the next 24 hours don't forget your required shift entry on the back of each sheet. Its 4:30 now time for last big push before shift change. Set your pills for morning med pass yes i said pre set there is no other way to get done on time there are 30 people with 6 a.m. meds ( synthroid, protonix, pepcid, various ac meds)depending on the day of the week. Now if you have had no falls or mishaps requiring the 10 page incident report, no one to send out , or no admissions to finish from 2-10 shift you might get done. Is this typical of all places? How can I do all those extras you do.