Advice and tips needed- New to LTC & mid-night shift

[GirlnextdoorRN]

hello fellow nurses,

i am so elated that i got the rn job offer to a new facility and next week be starting the orientation. i am new to ltc and be working 11-7 shift. .....definitely, i will have lots of coffee or tea.

please give me some tips, advice and all your knowledge - greatly appreciated :thankya: :redpinkhe. i'm getting a bit nervous and been browsing about meds, treatments and some nursing procedures....... thanks.

[gentlegiver, ASN, LPN, RN]

On the 11-7 shift, the first thing I did after report, go thru your MAR, flag all meds due during your shift, (I always put the 0000-0300 med page sticking out the top & the 0301 - 0700 to the bottom). Saves time and allows you to see any changes that may have been made. Also find out if there are any specimens that need collecting during your shift, UA & BM specimens can be collected when the CNA's do thier rounds, (why keep waking up people when you don't need to & they need to rest?). Do the same for your TAR, you never know when they schedule a treatment on your shift, better to find out at start shift than end shift.

If your CNA's can, let them apply creams, if not ask them to let you know when they will be working on a pt, this is also a good time to do any VS you may need. Most faculities have a 0000 med pass then again at 0600, I always started my Med Pass at about 04:30, pts are starting to wake up (due to most going to bed at 19:00 or right after supper) I usually do straight caths first, then Nebs, then meds, if a BS is required I do them last and save thier meds to be given when I do the BS. Get to know your pts, some will refuse meds if offered before 0530, some would rather get thier meds when the CNA's come in for rounds so they can go back to sleep.

I start charting after 0300, if I still need to enter BS or VS I flag the chart so I remember which ones I have to go back to. If anything should happen (a fall, or other emergent situation) you can always chart on that pt again.

After my 0000 med pass I restock the cart, empty water from the pitchers & fill with ice which I then put into the freezer, this way I don't have to run around at next pass to get it done. By following this schedule I was rarely late for clocking out. If possible (if you have time) maybe do a treatment (or 2)for the 7-3 shift if you know of any that need to be completed before the pts get OOB, the day shift will LOVE you for the help! Good Luck & God Bless!

[Forever Sunshine, ASN, RN]

On the 11-7 shift, the first thing I did after report, go thru your MAR, flag all meds due during your shift, (I always put the 0000-0300 med page sticking out the top & the 0301 - 0700 to the bottom). Saves time and allows you to see any changes that may have been made. Also find out if there are any specimens that need collecting during your shift, UA & BM specimens can be collected when the CNA's do thier rounds, (why keep waking up people when you don't need to & they need to rest?). Do the same for your TAR, you never know when they schedule a treatment on your shift, better to find out at start shift than end shift.

If your CNA's can, let them apply creams, if not ask them to let you know when they will be working on a pt, this is also a good time to do any VS you may need. Most faculities have a 0000 med pass then again at 0600, I always started my Med Pass at about 04:30, pts are starting to wake up (due to most going to bed at 19:00 or right after supper) I usually do straight caths first, then Nebs, then meds, if a BS is required I do them last and save thier meds to be given when I do the BS. Get to know your pts, some will refuse meds if offered before 0530, some would rather get thier meds when the CNA's come in for rounds so they can go back to sleep.

I start charting after 0300, if I still need to enter BS or VS I flag the chart so I remember which ones I have to go back to. If anything should happen (a fall, or other emergent situation) you can always chart on that pt again.

After my 0000 med pass I restock the cart, empty water from the pitchers & fill with ice which I then put into the freezer, this way I don't have to run around at next pass to get it done. By following this schedule I was rarely late for clocking out. If possible (if you have time) maybe do a treatment (or 2)for the 7-3 shift if you know of any that need to be completed before the pts get OOB, the day shift will LOVE you for the help! Good Luck & God Bless!

Thats usually my night. Although I've been starting at 4:15. We have had some new admits who added on more to the 6am med pass. . I finish about 6:15, 6:30.

[giulistudentnurse]

Thank you all for your advice. I am newly hired RN graduate in LTC. Tomorrow is my first day orientation and I will be working 11p-730a. I am excited and a bit nervous.