I work 12-hour night shifts at a freestanding rehab hospital. Fortunately, the CNAs still do finger stick blood sugars and vital signs, which is a huge help to the nurses. Depending on staffing, I get anywhere from 7 to 9 patients on a fully staffed night, or 10 to 12 patients on a night with short staffing.
I arrive at my regularly scheduled time, receive report, count the Pyxis, pull my meds, and hurry up and pass them while doing my first round. As I'm passing the meds I'll do a quick assessment, change any dressings, do any treatments, etc.
An overly talkative or chatty patient can throw a wrench into the routine, but overall this seems to work for me. We do hourly rounds during the night, so I'll round on even hours and the CNA will round on odd hours. If the patient is asleep we do not wake them up unless there's a specific reason to do so.
I usually start charting between 11pm and 1am, as we still use paper charting. I also try to do my 24 hour chart checks at this time.
I still need a smooth routine for passing meds, assessing, treatments of 10 patients in a 2 hour window.
If I have 10 to 12 patients, my med pass and assessments usually do not get done inside a 2-hour time frame. I'll start at about 7:15pm and not be done until 10:30 or 11:00. It takes even longer if my group of patients is overly needy or very chatty.