Quote from Ginnym1981
New grad here. Just received a job offer for my first job! (YAY!)
I am now a charge nurse at a rehab/long term care facility.
I'm working evenings (2-10:30) and there will be one other nurse on the floor with me. They average 50 patients (63 beds total).
The nurses are responsible for passing meds and doing treatments.
They still do paper charting still.
I know I will eventually get my own routine and everyone is different but I'd love to hear some tips on how you stay organized and prioritize your care, when do you write your notes etc.
Oh and are you responsible for writing nurses notes on ALL of your pts everyday or just if something is out of the norm?
I write everything down and check it off as I go,I developed a work sheet for my own use years ago. I document by exception -except for med a residents, they must be documented on Q shift (at least) I also keep a small note book with frequently used and any new policies and procedures written down for quick reference. I always assess any unstable residents (people who are on shift report) and flush any feeding tubes at the start of the shift and get a nurse's note in early on those folks. Make sure you know who is on Coumadin,has a sx disorder,is IDDM,is a full code. Most units have lists behind the desk with this info.If not,make one for yourself.
Gather your supplies,stock your med cart prior to your med pass.I also look over the treatments I'll need to do and sometimes carry some of that with me (especially the skin creams)so the cna's can call me during care and they don't have to wait (it's an infection control issue,we are not supposed to carry that stuff in our med carts and I'm NOT telling you to do it ) but I would NEVER get done if I didn't carry some skin prep,skin protectant and such in my pockets or in a drawer in the med cart (just make sure you remove it before the end of the shift)
If you have skin checks,weights,behavior documentation to do make sure you lay the notebooks on your desk so you don't forget them (write it down-check it off)
Carry some fiber bars,bags of nuts,yogurt-things you can eat fast. It will take you a few shifts to learn the residents likes and dislikes,the routine of the shift and get through the med pass.Don't expect to fly through it initially.Take your time,it does not matter if it takes you 3 hours-accuracy is more important then time.Don't let yourself feel rushed or overwhelmed.
Don't be surprised if the demented residents give you trouble with their meds,you aren't a familiar face.Don't be surprised if the A/O residents give you trouble with their meds--they need to learn to trust you and they may question every pill.
It DOES get easier.