I work on an IRF that averages 8 patients to 10 patients. My co-workers and I generally find it very difficult to get everything done that's expected of us. Obviously there are the usual things that are consistant from unit to unit: VS, meds, assessments, admissions, discharges, etc. In addition to those things we have unit specific documentation to complete: FIM scores, narrative shift summaries, updating pt treatment plans (in addition to medical care plans), making narrative notes daily re: morning stand-up meeting, weekly progress notes, etc. And, or course, we're getting patients up, bathed, and dressed. We're to get the patients to the dining room for three meals a day, we do BP checks during tilt table exercise, occasional wheelchair follows when PT is ambulating a pt; take off orders and enter them into the computer when there's no secretary, manage medical issues, talk to doctors....etc, etc, etc.
I'm sure all of you do these exact same things. My question is: How do you get it all done?
We work through breaks, rarely if ever get lunches, and still leave past the end of our shift. We feel as if we have very little interaction with our patients and we're frustrated by all the repetitive documentation that takes up that time. I feel as if we are staffed fairly well--typically 2 nurses, usually RNs, and an aide for 8 to 10 patients--but we can't seem to be the nurses we want to be to our patients. Obviously it's easier with a lower census or patients with fewer medical issues, but that doesn't happen often. We get no help from our manager when we're swamped and only have a secretary for part of the day so we answer the phones, do the orders, etc. And we aren't a group of people who have time management issues so we're not sure what to do.
How involved are your managers? How much, if any, therapy involvement is there in getting pts to and from the dining room? Does night shift get anyone up or does day shift do all the patients therapy doesn't get up? Any and all help is greatly appreciated!!!!!