3-11 LTC LPNs... what is your typical

Hi, there! I'm actually making the switch from evening shift to NOCs (night shift) out of my desire to escape the whiny, needy, terribly unrealistic family members that seem to plague LTCFs in my area.

Right now, I'm working the 2-10pm shift at a small, hole-in-the-wall nursing home. My patient load consists of 30 fairly low-acuity residents.

2pm: Change-of-shift report from the offgoing nurse
3pm: Skin assessments, medicare charting, summaries
4pm: Obtain blood glucose readings; pass medications
5pm: Continuing to pass medications
6pm: Treatments, wound care, topicals
7pm: Start the night time medication pass
8pm: Obtain HS blood glucose readings; med pass
9pm: Antibiotic charting, prepare change-of-shift report
10pm: Give report to the oncoming nurse

I am actually trying to get on the 3-11 shift. I currently work 11-7, and while it certainly has it's adavantages, I really, REALLY miss sleeping at night. Ultra-needy families are a concern, though. I have heard of some down-right SILLY requests. For example: We had 2 ladies in a room, and the one by the window would get really mad and pout if we didn't talk to her BEFORE the lady by the door. Evidently she complained to her daughter who then wrote the DON, administrator, and everyone up and down the latter DEMANDING that her mother be addressed FIRST IRREGARDLESS OF THE OTHER WOMANS' NEEDS. I did not work at my facility at the time. This is a story that was passed on to me. But, geesh! Anyway, I have a question regarding 2nds: Is it "normal" or "common" for 2nds to stay until 2-3 a.m. frequently? I can rarely get my shift started on time d/t the fact that 2nds has their charts spread out all over the nurses station, and I have to work around them. I typically don't get report until closer to 2400, and I have meds that go out then. Also, the narc books are rarely reconciled until I'm standing there waiting to get my midnight meds out. I like them all fine, but it would be nice to be able to sit at the nurses station getting my evening started as opposed to running back and forth from the common area getting my tx books and what not. I can't remember when they have left by 11. If that's a "norm" for working 2nds, I might just stay where I am.

The answer to your question depends on what type of floor you're working. If you are working on a skilled medicare hall or rehab unit, then staying until 2am is a very real possibility. At my facility, 90 percent of the admissions arrive on the 2nd shift. Each admission is time-consuming because I must write the initial nurses note, assemble the chart, complete the initial assessments, verify physician orders, write the temporary MARs, order the meds from the pharmacy, and deal with the onslaught of questions from the family members of the newly arrived patient. I must do all of this in addition to passing meds to the other residents, getting my treatments done, charting on everyone, and fulfilling silly visitor requests for coffee and 'courtesy phones.'

Thanks! I do work on the skilled unit at our facility. The problem is, supervisors are always "getting onto" our 2nd shift nurses for staying late, even if they've had 2 or sometimes 3 admits in the evening. I have worked a couple of 2nds there, but they were abnormally (as I was told) "slow" for that day. What I don't understand is 1st shift is scheduled 2 "medication aides" who pass all of the meds so the nurses are freed up. However, 2nds rarely if ever are scheduled "med aides", and therefore have to do all of their own med passes, assessments, admits, tx, finger sticks, charting, etc. I just wasn't sure if 2nds was just "slow", or if they truly are just inundated with a ridiculous amount of work. I would like to go to 2nds so I can sleep like "normal" people, but now I don't know. I'm really new at this, and am not sure WHAT I can or can not handle at this time. I'm freaked! My supervisor just informed me she has "put me in" or 2nds, so I guess I'll at least try. On the bright side, overtime pay will be nice...

I would like to tell you this is not how it is!, but most times it is. As a nurse you may find you're staying over to finish paperwork and other documentation. But, I can tell you that you may not ever feel you can go home feeling you have finished everything! But you can document what you do and pass on the rest to the next shift! As our facilities change and they become more acute care centers and rehab, 3-11 and 11-7 will have to pick up more responsibilities. Our facility has given us more power to pass on the paper work and the responsibility to follow thru. Do they like it? NO! 11-7 has always been a quite shift. But, now it has become very active in light of our new unit.
So, you may need to pass on what you cannot finish, as any 24-7 unit should LOL