If you are working extended care cases, for say, an eight hour shift, when you have down time between med administration times or other care, you can do what the family allows, such as watching TV or reading. Before you engage yourself in these activities, you should always make certain there is nothing to be done for the patient, including tidying the area, cleaning equipment, etc. Vents, trachs, GTs are typical for home care clients. Basically you give routine care to include med administration, and personal ADL care. Whereas in the facility you would have a CNA to do incontinent care and daily bathing, you do these tasks during your shift, as well as strictly licensed nurse functions. You are also going to monitor for change in condition and will be required to take appropriate action. Pretty straightforward.