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can any LVN describe a NOC shift?

Posted

Like what you do when you first get in, daily duties. stuff I can expect, nurse patient ratio in a LTC?

I was thinking about picking up a FT NOC shift job at a LTC and work 70-80 hours a week since im still young.

BrandonLPN, LPN

Has 5 years experience.

Well, if you plan on working 80 hours a week, some of those shifts aren't going to be NOC, unless you know how to be two places at once. :)

On 3rds in LTC, the ratios will be higher. The ranges will vary wildly depending on acuity and staffing policies. I've seen it range anywhere from 30:1 to 80:1. Where I work leans toward 50:1 most nights, 80:1-ish on a short staffed night. My residents are lower acuity than most. IV therapy is rare at my facility, and our residents are long-term as opposed to rehab or sub-acute.

When you first arrive, you'll receive report and count narcotics with the previous shifts. If possible, walk around and lay eyes on every resident..... or at least on every resident that had "something going on" vis-a-vis the report you received. Give report to your CNAs. Personally, I recommend getting your own vitals when working in LTC.

Duties can focus on paper work.... 24 hour chart checks, monthly summaries, med re-orders, making sure stuff like glucometer testing and PT/INR lists are current. Monthly MAR reconciliation.

There's usually a small midnight med pass and a larger 0600 one. PRN pain meds through the night.

Lots of various little things like changing O2 tubing, tube feed syringes, auditing CNA flow sheets, census flow sheets..... really a lot of various flow sheets and audits that will vary by facility.

Ideally, treatments, showers and wound care should not be scheduled on nights if possible, in order to allow patients to sleep. But, it has been my experience that 3rd shift gets some of it scheduled on their shift in order to "keep it fair".

A good 3rd shift LPN rounds along with the CNAs every now and then in order to help out, foster team work, and to keep familiar with skin conditions and to be observant of changes in condition the aides might miss. And, with that said, all good nurses listen carefully when a CNA tells them someone doesn't seem right.

That's some of your routine, expected stuff. There's also, of course, the unexpected. Falls. Acute changes in condition that require you to page the doctor for orders or trips to the ED.

Hope that helps. Good luck to you.

CMLPN08

Has 5 years experience.

My night shift consists of counting meds coming on shift for two carts plus the narc drawer in med room. Also doing night census count, Medicare charting on select patients, treatments which are mainly supportive devices. Administering medications. Documenting vitals, making out daily condition sheets, collecting any urine for am labs. Checking fridge temps. And monitoring cnas and assigning them assignments.

I worked LTC before and did NOC fulltime. By 9:00am I am already knocked out. LTC is hard, but i think it also depends on the facility. I do 12hrs shift 3x a week. I took care of 45+ residents and I am the only nurse on the floor in charge of 2 halls. Once I'm done with one hall, I go to the next. Of course there will be interruptions. I also did wound treatments, prepare lab forms, check meds delivered by pharmacy,helped other staff and charting. Like alot of charting!

I work in a critical access hospital on the medical surgical floor. I come in at 1830, review orders, labs, radiology reports, and medications. I check the med fridge and count narcotics with day shift nurse. Get report, get my assignment from RN charge nurse and then hit the floor. I check vitals on all patients on the floor, we average about 10. During vitals I perform assigned assessments, assess IVs, toileting/bathing if needed. Next I move on to med pass and finish up night time ADLs. Most of the time however, New admits are thrown in the mix as well as recovering surgery patients. Once all patient care and orders completed, I chart. Of course, ill be answering call bells, checking vitals q4h or more often if ordered/needed. I'm responsible for checking the crash cart and quality controllers on blood sugar machine. At the end of shift I'm getting people out of bed for breakfast if needed. Assisting with ADLs, finalizing I and Os, checking blood sugars, daily weights, ambulating, toileting, giving AM meds and whatever else needs to be completed before day shift hit the floor. It's always an RN and me the LVN. We work as a team. Some nights are wonderful, others are complete hell.