I work on a subacute/rehab unit at a large nursing home, and I earn approximately $4.00 less per hour than the RNs that work alongside me. I am in Texas, which is a state that has one of the widest LVN scopes of practice in the nation. I am permitted to do everything the RN does with the exception of pronouncement of death, and pushing certain drugs (Vitamin K, ProcAlamine, Potassium, just to name a few). I do IVPB, IV push, initial assessments, and so forth.
Anyway, here is how I organize for the day. I work 16 hour shifts, from 6am to 10pm. Typically, I have about 15 patients to care for. At the beginning of the shift, I'll go through the MARs and TARs with a fine tooth comb and, as I go, I will jot down the things that must be done in my notebook. My notebook is how I organize the rest of the day, and I usually won't forget to do anything. Here is how Sunday's notebook page looked (names have been changed due to HIPAA):
DIABETICS, FINGERSTICKS: Agnes (BID), Agatha (AC & HS), Bill (AC & HS), Wendy (AC & HS), Rex (BID), Jack (BID), Esther (AC & HS), Margie (0600, 1200, 1800, 2400)
NEBULIZERS: Margie, Esther, Bill, Jack, Jane
WOUND TREATMENTS: Jane, Bill, John, Jack, Lillian, Rose, Lucille
IV THERAPY: Wendy (Vancomycin), Laura (Flagyl), Rex (ProcAlamine)
COUMADINS: Agnes, Agatha, John, Lucille
INJECTIONS: Agnes (lovenox), Jane (arixtra), Rex (heparin), Bill (70/30 insulin), Esther (lantus), Mary (vitamin B12 shot)
ANTIBIOTICS: Wendy (wound), Laura (C-diff), Rex (pneumonia), Agatha (MRSA)
1200, 1300, 1400 meds: Margie, June, Rose, John, Jane, Jack
1600, 1700, 1800 meds: Rose, John, Rex, Lucille, Lillian, Laura
REMINDERS: assessments due on Agatha, Jill, and Louise; restock the cart; fill all holes in the MAR; follow up on Jane's recent fall, fax all labs to Dr. Smith before I leave, order a CBC on Rex...