Do you have a routine with your patients/residents?

tishirajan · Jun 19, 2009

It all depends on the shift you're working.

Mornings: Get report, get residents ready for BF, get supplies ready for showers, showered the easiest residents first, washed up residents who didn't get showers that day and dressed them, make rounds, get residents ready for lunch, get residents who take a nap down for their naps, make another round and answer call lights as needed. ( I always get all my supplies that I need for the residents and have them on hand...saves a ton of time or you end up running back and forth to the linen closest. Have at least 3 or 4 towels and 3 washcloths and any special soaps or shampoos the residents may have for their own personal use.)

Second shift: Get report, make rounds, get residents up from naps, get residents ready for dinner, get residents ready for bed for those who like to turn in early, answer call lights and make round, get the rest ready for bed. (While residents are eating dinner and I'm not called to do feedings, I go ahead and lay out their nightgowns and PJs and get their sheets turned back. I also have a few washcloths on hand so they can wash their faces with a warm cloth before bed.) I continue making rounds until end of shift after I do all my notes.

3rd Shift: Get report, make rounds and change anyone who needs it. Answer any lights that need answering and help out if anyone needs help with a resident. Make rounds every 2hrs, finish up any notes. Get a few earlier risers up for the next shift.

Everyone gets their own routine down. You'll get yours down in a week or two and you'll do fine. Congratulations on your job!! I wish you the best of luck. Just remember to hang in there when the going gets tough. You can do it! :yeah:

I hope this helped.

Tish~

fuzzywuzzy, CNA · Jun 19, 2009

Ask the other CNAs what order they'd recommend, then write the times on your rounds sheet or make a list for your pocket. After you do the same assignment once or twice you figure it out what order to fix up the residents in (unless you work a rehab hall and the patients change a lot, but usually in that case they're all alert and you can just ask them what they want).

I work 3-11 and I'm pretty good at hauling ass and getting my assignments done, but still being thorough. Usually, depending on what assignment I have, I'm able to do all my HS care, all my rounds, and then go help coworkers finish their stuff.

When we get to work we do our first rounds- getting people up from naps and toileting them. We also squeeze in our walks as we go along, and we take down all the beds. As I take down beds I like to lay everything out for the resident... gown, slippers, lotion, washcloths, powder, mouthcare supplies,brief, etc. I throw it all in their basin and stick it wherever they normally get ready for bed- either bathroom or bedroom.

No one else does this, but my personal trick is to stagger my rounds and toilet/change a bunch of my people at 5, right before supper trays come up. That way I don't have to worry about them at 6 o'clock when I'm busy doing HS care. The other CNAs wonder why I'm doing any of my 6 o'clock rounds at 5, but hey, we came in and started changing people at 3, so it's been 2 hours already. Even if it's just 2 or 3 residents that I do rounds for on the odd-numbered hours, it takes a load off my mind.

After supper when it's time to start washing people up I make certain ones my priority. Like if I know someone is incontinent all the time, I figure I have to take them to the bathroom and change them anyway, so I better just wash them up whether they're going to bed or not. Or on some assignments you have people who don't stop bugging you to put them to bed so obviously you do them first.

We wash a lot of people on the toilet, but if you have a 2-assist it can sometimes be too much of a hassle to get help getting them onto the commode or toilet, then again into bed, so if they don't mind, I skip the toilet part and just offer them the bedpan instead. That way I only have to get help with one transfer. And one some nights if you have a lot of 2-assists I get them all in bed right away, then go back and wash them later, especially if they're incontinent. I just have someone help me put them all in and we pull down their pants if they're wet and throw the covers over them and say I'll be back. Then you don't need to wait for help every time you need to wash someone- AND none of them are sitting in a wet brief. Sometimes you can work it out so you and another girl each help each other throw someone in bed, then you each wash one person and agree to meet in another room when you're done and do the same thing.

We're not supposed to, but I put briefs on a ton of people when I put them to bed and take it off before the next shift comes in. It saves me from having to do a zillion linen changes. There have been times when I haven't briefed anyone, and my 8 o'clock rounds take FOREVER, and I'm behind the rest of the night, and there are no linens left by the time 3rd shift comes in.

I like to have everyone in bed between 8 and 830. Then I do a round (this goes by quickly if everyone is briefed!). Then I do paperwork and/or help other people with their rounds and HS care, and I try to gather up whatever supplies I noticed were missing from the rooms. At 10, I do my last rounds, make sure all alarms are definitely turned on, etc.

I have a mouthcare routine too. A lot of the other CNAs don't even bother with it, so I make sure to do it. If someone can brush their own teeth I'll wash them, then set them up with a toothbrush while I wash their roommate. Then I put them into bed, set up the roommate, and go off and do someone else while they brush. There are others that I offer the toothbrush to before I wash them up. It's easy to overlook mouthcare in the people who want to go to bed really early because you don't have time to sit there and wait for them to brush, so if they can't do it themselves (or have dentures), I wait until my last rounds to do it.

mncna08 · Jun 19, 2009

I think it depends where you work. You will get down your residents routine, Your time managment will come with it. Since everyone is different you really have to go by that, I know at work who needs to get ready for bed first etc and i go around that. Its just a matter of time. good luck with the new job!!!

Dorali, BSN, LPN, RN · Jun 19, 2009

Thanks so much! I'm nervous about being put on my own my first day, but I'm sure it will be fine.

Tish-that was an awesome breakdown of the shifts. You reminded me of a few tricks I learned during clinicals. You were very helpful! Thank you!

Fuzzywuzzy- I've read several of your posts and you always seem to have good advice. I appreciate the time you put into your post.

Mncna-Time management is what it comes down to most of the time. I used to wait tables way back when, and you have to figure out the best way to get stuff done. I just hope I pick things up quickly. Thanks for your advice!

Dondie

tishirajan · Jun 20, 2009

I'm glad it was of help to you. If you have anymore questions don't hesitate to post them. Keep us informed on how it's going too! Best of luck to you, you're going to do great!