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| |  Question for those who work the 11pm-7am shift
This will be my first time working an 11-7 shift (i usually work 3-11). i know there are certain things i need to do during this shift that i need to ask about... like switching out the syringes for the gtubes, and checking the accucheck machines, etc etc etc.... my question, though, is about medications.
if everyone has meds due at 6:30am... and many of them have blood sugar checks at 6:30am... how do you get it all done?!?! i have 60 patients tonight. i'm working on my own, have only worked with these patients once before (and it was split in half the first time around), and i'm just wondering how to make it through this shift. how early can i start giving them their meds and insulin?!?! any input would be greatly appreciated... i think i'm gonna have a breakdown from the thought of having 60 somewhat-new patients all on my own. i also know that about 20 of them require accuchecks... help please? thanks.
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Jul 25, 2009, 11:03 PM
 Re: Question for those who work the 11pm-7am shift
I work a 7pm to 7am shift and my patient load is usually about 3-6 patients. In our facility we usually have an hour window, 30 min before a med is due and 30 min after a med is due. So, we can give it early if it is convienient and safe. We also give the 7am meds for day shift and day shift gives our 7pm meds. (it's just about impossible to give meds during report unless you get there early). Now with insulin, if it is a sliding scale to go with morning accuchecks I will give it. If it is Regular insulin, aka fast acting, and it says give before breakfast, I will let day shift give it. I am not around to know what time the patient is eating and I will not be responsible for their glucose bottoming out for the day shift nurse. But that is my facility. Talk to your house sup or your charge nurse. Hope this helped.
| | No. 2 |
Jul 25, 2009, 11:23 PM
 Re: Question for those who work the 11pm-7am shift
erm, pardon my ignorance (i work in critical care so my patient load is 1-3) but where do you work that you are responsible for 60 patients? I didn't even know that was possible - how do you provide nursing care for 60 patients in 8 hours?
sincerely,
confused nurse  | | No. 3 |
Jul 26, 2009, 12:06 AM
Re: Question for those who work the 11pm-7am shift Originally Posted by NewestRN_OnTheBlock  This will be my first time working an 11-7 shift (i usually work 3-11). i know there are certain things i need to do during this shift that i need to ask about... like switching out the syringes for the gtubes, and checking the accucheck machines, etc etc etc.... my question, though, is about medications.
if everyone has meds due at 6:30am... and many of them have blood sugar checks at 6:30am... how do you get it all done?!?! i have 60 patients tonight. i'm working on my own, have only worked with these patients once before (and it was split in half the first time around), and i'm just wondering how to make it through this shift. how early can i start giving them their meds and insulin?!?! any input would be greatly appreciated... i think i'm gonna have a breakdown from the thought of having 60 somewhat-new patients all on my own. i also know that about 20 of them require accuchecks... help please? thanks.
this is not a doable assignment....that said....if you have the blister cards of meds, organize them per mar, insulins can not be given early...meds no earlier than an hour before scheduled....accuchecks shouldnt be done early either, however....., dont expect to be out before 830 or so....good luck
| | No. 4 |
Jul 26, 2009, 12:29 AM
Re: Question for those who work the 11pm-7am shift Originally Posted by jlb_rn erm, pardon my ignorance (i work in critical care so my patient load is 1-3) but where do you work that you are responsible for 60 patients? I didn't even know that was possible - how do you provide nursing care for 60 patients in 8 hours?
sincerely,
confused nurse
\
for starters,LTC is not critical care, but 60 is a heavy load,
I was once pressured by my DON to be the only nurse for 90 pts!!! (with only 3 CNA's with me) I left that job.
However, I agree depending on the degree of care the patients need, 60 can be a lot and you have to be organized. You do have that one hour window obviously and sometimes you are late- someone falls and needs immediate care etc.
If you are late for a BS and the pt already ate- I just tell the doctor that the blood sugar was not fasting...
| | No. 5 |
Jul 26, 2009, 05:06 AM
Re: Question for those who work the 11pm-7am shift
60 patients?!?!?!  itd seem to me youd have to start passing meds when ur shift started to be done by 630 in the morning!
| | No. 6 |
Jul 26, 2009, 10:05 AM
Updated
Jul 26, 2009 at 10:10 AM by kythe
Re: Question for those who work the 11pm-7am shift
Personally, I would not work a shift where I was required to do a med pass for 60 patients that included 20 finger sticks. I know that doesn't really help you though, especially as a new grad where you may not have many work opportunities.
I've worked in LTC for over 2 years now. Most of my experience is agency, so I go back and forth between a few facilities. I have worked plenty of night shifts, but have not personally had more than about 35-40 pts on a unit. Even this can make for a very stressful shift if you are not used to the patients and there are a lot of finger sticks. It is also unsafe because you cannot do it all without making med errors of some sort.
You may ask some of your co-workers how they deal with it. I have even asked aides I am assigned to how they typically see nurses doing the med pass. What you are likely to find is that as many meds as possible are pre-poured during the night, and also that the med pass may start as early as 4 am even if they are not ordered until 6 or 7.
| | No. 7 |
Jul 26, 2009, 11:54 AM
Re: Question for those who work the 11pm-7am shift Originally Posted by kythe Personally, I would not work a shift where I was required to do a med pass for 60 patients that included 20 finger sticks. I know that doesn't really help you though, especially as a new grad where you may not have many work opportunities.
I've worked in LTC for over 2 years now. Most of my experience is agency, so I go back and forth between a few facilities. I have worked plenty of night shifts, but have not personally had more than about 35-40 pts on a unit. Even this can make for a very stressful shift if you are not used to the patients and there are a lot of finger sticks. It is also unsafe because you cannot do it all without making med errors of some sort.
You may ask some of your co-workers how they deal with it. I have even asked aides I am assigned to how they typically see nurses doing the med pass. What you are likely to find is that as many meds as possible are pre-poured during the night, and also that the med pass may start as early as 4 am even if they are not ordered until 6 or 7.
this is true, but illeagal....seen it done and done the pre pour....limitedly but some.....
| | No. 8 |
Jul 26, 2009, 12:34 PM
Re: Question for those who work the 11pm-7am shift Originally Posted by kythe
You may ask some of your co-workers how they deal with it. I have even asked aides I am assigned to how they typically see nurses doing the med pass. What you are likely to find is that as many meds as possible are pre-poured during the night, and also that the med pass may start as early as 4 am even if they are not ordered until 6 or 7.
Yup, this is how people manage 60 patients. The facility would rather look the other way than make a more reasonable assignment.
Most of the PO meds will be prilosec and synthroid.
I used to work in a facility that has a 60:1 ratio on 11-7. All the nurses prepoured and started their med pass at 4.
| | No. 9 |
Jul 26, 2009, 01:32 PM
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