Questions????

Specialties Geriatric

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Hi Everyone, I am a new grad., just passed the boards and I am now working at a nursing home. Is it common for most nurses 1st and 2nd shift to have 20 residents to give meds to, plus treatments, orders from doctors, having to check labs, answer the phone, order meds that have run out, dealing with residents families, do progress notes on most of the residents and only have you and another nurse on the floor, besides the CNA's? Just curious, new to the field and geriatrics. Thank you for your replies.

Specializes in LTC, Hospital, Staff Development.

I am not going to tell you how good you have it. It will only serve to make you possibly feel more insecure. The beauty of LTC is that within a month or two, as long as you work the same shift with the same patients, the medications really don't change often. If a medication changes for a particular resident, since you are already taking the orders off, you will know if there is a change for your resident. After a month or two you will have memorized most of the medications your residents are taking. You will also know where to find medications in the cart, right away. However, you still need to observe the Rights of Medication Administration, but it will go very quickly for you, I promise. Same with treatments. You will become very familiar with the treatments and will be able to do most of them by memory, unless the order changed. Charting does not need to be a book on each patient. If the patient is not a Medicare patient, most LTC's only have you chart by exception or if the resident is on alert. Please don't be hard on yourself. It takes a while to know your resident, your resident's meds and their treatments. But when you got it down, YOU HAVE GOT IT DOWN, and maybe have some down time to spend with your residents.

Hang in there, baby!

Specializes in ICU, PICC Nurse, Nursing Supervisor.

Trust me when I say you have a good deal...

Hi Everyone, I am a new grad., just passed the boards and I am now working at a nursing home. Is it common for most nurses 1st and 2nd shift to have 20 residents to give meds to, plus treatments, orders from doctors, having to check labs, answer the phone, order meds that have run out, dealing with residents families, do progress notes on most of the residents and only have you and another nurse on the floor, besides the CNA's? Just curious, new to the field and geriatrics. Thank you for your replies.

I have 33 rsds. I stay busy and I do all the things in your list. It is very hard and I never sit down except to do my charting at the end of the 2nd shift.

HI, i have worked in LTC on occasion and have found it very difficult nursing. If one thing goes wrong (pt seizure ) it could throw your whole day off. The amount of medicines for each pt can be overwhelming. I also was doing treatments and charting and everyother thing that came my way. I admire nurses who work this specialty.

So you don't do meds, you don't do treatments, you don't do summaries and you don't check orders. What do you do???

As a nurse manager, I am asking the same question!!!:no: :no:

What you described IS common where I work. Yes it is alot, and yes it can get overwhelming. Give yourself time to get use to your job, their routine and oriented to the facility. In time you should be able to organize and utilize your time wisely on most but not all days. Remember, need help there, just ask someone for help. I do hope you have other employees that are willing to help you.

Specializes in ICU, PICC Nurse, Nursing Supervisor.

I work agency in a facility that has med nurses and a treatment nurse. I have something like 20-25 patient..all diabetic and all medicare. Some have Gtubes whcih I have to do. But I still think having a med nurse and tx nurse is a extreme luxury.... and how does one not have to check end of month orders....

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So you don't do meds, you don't do treatments, you don't do summaries and you don't check orders. What do you do???

This is very commen, its very overwhelming at first but, you'll get used to it. My first job was at a nursing home on third shift. When I first started I was having a hard time getting everything done. I wrote down everything I did on my shift and scheduled a time for it. Things like: when I was going to chart, start my med pass, do treatments, draw labs and even when I was going to take my lunch break. Like, 2am: draw labs, 245am: start charting, 4am: take break, 430am: get things ready for med pass, 5am: start med pass. After a while it just became my routine and I didn't have to write it down anymore. Of course, you really can't stick to the schedule because you never really know whats going to happen. But, it really helped me manage my time wisely.

Specializes in Geriatrics.

In the facility where I currently work, the nurses on 1st and 2nd shift have 28/25 residents. Night shift has 55 and 50 on the front and back halls respectively. I started out working second shift on a hall with 28 residents. It is certainly a challenge when you have so much to do, however, just remember to take your time and it'll work out. It took me about 3 months to get my own routine down pat: learning the residents likes/dislikes with how they take their meds, learning the doctors, families and co-workers. Once you get your own routine and "system of operating" it'll be a breeze. But, to answer your questions, no it isn't uncommon at all to have that many and even more patients. I did the same thing that "lindseylpn" did when I first started and made a list of all the things I had to get accomplished and then a time frame for getting them completed. I found that it also helped to make my list on a check off format, so I could check things off as I got them done. That also gave me a sense of seeing at the end of the shift all that I did do, so I didn't feel like I had not done something. I know that you have enough (and then some) of paperwork to do, but that is probably the most important thing that I did to help me get going and get into a routine. Also, it helps if you can jot down notes on your residents for yourself, such as who likes crush meds, who needs applesauce or pudding, who gets thickened liquids...etc. It takes time, but you can do it and will probably really enjoy it. Just be sure that when things seem overwhelming (as they can) take a moment to breathe and relax yourself.

Your situation is great! Where I work we have 38 residents to a side. 2 sides on 1st and 2nd shift= 2 nurses each shift. 1 nurse midnight shift. Each nurse does orders, glucs, treatments, meds, charting, answers phones, labs, IV's, Feeding tubes, ordering supplies/meds, dealing with families and plus we also dispatch the local ambulance company.

I have 33 and I work gladly take your 20! That would be heaven!

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