What time does your LTC facililty start getting residents up?

At the LTC at which I worked, the policy stated that residents were supposed to be able to sleep as long as they liked, but the facility was having major problems with that culture change. If the noc CNAs didn't get "enough" residents up before day shift arrived, the day shift screamed at them and complained to the DON. The DON had her own issues with the culture change and she often sided with the day CNAs, causing most of the noc CNA staff to leave over a period of about eight months.

If culture change (e.g., letting residents choose their own bedtimes and wake times) everyone, from the DON to every CNA, has to be on board. Otherwise, there are too many conflicts between those who are trying to honor residents' rights and those who are still so task-oriented that they make sure things are done, on their schedule, not on the residents'.

I remember one woman who liked to be up around 4:30 AM. That was her habit, that was her choice. Another did not want to be disturbed before 10 AM. Again, her habit and her choice. Sadly, those who could not articulate a choice were gotten up as per the CNA's discretion, which meant that if a crabby day shift CNA was coming on, more residents would be up for the day than usual, whether they wanted to be or not.

Where I work, the CNA's start about 5am. There are a few people (1 is a man with a horrible skin condition with horrible odor and other is an enteral feeding resident that lays in bed most of the day anyway) that go to the shower, and this really is the best time to take them. The other resdents that get showers take them after breakfast. Our faciltiy gets about 10 residents up starting at 0500, mainly because these are the ones that HAVE to be up to eat breakfast (can't be fed in the bed, won't eat well). It also helps decrease the load for the 7A nurses.

But, I have noticed that some of our night nurses will start at 0400 passing out 0630 scheduled medication. I think that is ridiculous!!! The nurse should be able to complete the med pass in 45 minutes (TOPS!!); therefore, shouldn't start until 0530 or 0600. When I work nights, I start the medpass at 0530 and complete it with no problem - and mind you, I don't work nights except every once in awhile (if somebody calls out)>

I agree with getting the residents up early (BUT NOT 0400) so they can be sitting up for breakfast. This helps with their eating and decreases the weight loss issues.

As far as a CNA or nurse spraying a resident in the face with water---------She should have been fired on the spot!!! I have absolutely NO TOLERANCE for the mistreatment of our elderly - and this includes the tone of people's voices.

Best of luck to you.
You may be one nurse, but you can set an example and YOU CAN MAKE A DIFFERENCE.

ABOVE ALL, REMEMBER----WE ARE OUR PATIENTS NUMBER ONE ADVOCATE!!!

at our facility night shift will begin to get them up at around 6am. Most of the time residents are dressed and left in bed until the am crew gets there, so they'll sleep at least until 8am. It takes a little of the load off the day shift, especially since they never know how much staff they'll have to get through the day.

The place I work they get up generally when they want to. However, is it common to have a lot of the treatments, like patches, dressing changes pt/inrs, ect done on the 10p-6a shift? It seems like we wake our residents up a awful lot, but it is to spread out the work load.

You're right; it does spread out the workload, but who wants to be awakened at 3 AM for a dressing change or pain patch? Also, with the medication patches, I'd be concerned about applying them at that time of noc because you want to get it done quickly---and there's a much greater risk of not removing the old patch, hence giving the resident an overdose of medication.

IMHO, on that facility's practice. The facility should hire a treatment nurse if there are so many treatments that the day and evening shifts can't do them.

I am not a nurse but a CNA. We start get our residents up at 6:00 when our shift begins. Breakfast is served at 8:00.

We start about 5..but then they have breakfast from 7:30-9:30 now..and we have some residents that get up on their own at 3..*shrug* But I agree...get the h e double hockey sticks out of there...weird place.

One of the groups from my nursing class did their clinicals at an Eden facility. Their med passes are set up differently... meds are BID (or TID or whatever) and you just start whenever they wake up and go from there. It all sounds like a nice idea. I interviewed at that facility before I accepted my current position but I didn't think I could be so fly-by-the-seat-of-my-pants.

Most of my residents wouldn't be able to self medicate safely. It would take more time and energy for us to chase them around and remind them than it would to go the med pass ourselves.