How to Handle New Admissions?

  1. Hello,

    Had to admit a new resident for the first time a couple of days ago and had 3 packages of paperwork to complete. My shift starts at 0800 and ends at 1830. I started the interview with the family at 1300 as the resident herself was going to arrive an hour later and had a dx of cognitive impairment. Wasn't finished until 4.

    How do you handle new admissions while also having to take care of the rest of your 23 residents?
  2. Visit Newgurl17 profile page

    About Newgurl17, CNA, LPN

    Joined: Mar '17; Posts: 126; Likes: 32

    7 Comments

  3. by   CoffeeRTC
    Honestly, 5 hours of paper work for one admit? That's extreme overkill? What assessments are included? Are you doing more than nursing assessments?
  4. by   Newgurl17
    i just did her vitals and pain assessment. the rest of the info I got from the daughter. Of course I spoke with the resident herself and did my head to toe. The company I'm working for created all this paperwork for the nurses to complete which was quite repetitive. I was told on the day of the admission that we would be getting a new admission so I felt like I wasn't prepared. The admission package wasn't even double sided. Collected health history, completed adl's, pain assessment, diet, falls risk assessment, braden scale. Ended up staying til 9pm because of everything I had to do on top of the admission.
  5. by   CoffeeRTC
    if we have a charge nurse aka the desk nurse, they complete the admission.
    Its hard to give a number on how long it takes to compleat a new admission. If I am working the cart and doing an admit, I will cluster things. We are all paper too, so transcribing orders can be time intensive if there are a ton. After getting meds verified, faxed and or called to the pharmacy I will concentrate on getting a quick history, do a quick head to toe assessment and have them sign the POLST, consent to treat, inventory and a few other forms.
  6. by   CapeCodMermaid
    We get admissions 24/7. Yesterday we had three planned and one surprise. It shouldn't take 4 hours to do an admit. We plan the best we can but if the hospital wants to send someone, we take them. I did all 4 sets of orders yesterday..I'm the DNS...can't leave my nurses with all the work. I did a 13.5 hour day but with team work it all got done
  7. by   Newgurl17
    Quote from CapeCodMermaid
    We get admissions 24/7. Yesterday we had three planned and one surprise. It shouldn't take 4 hours to do an admit. We plan the best we can but if the hospital wants to send someone, we take them. I did all 4 sets of orders yesterday..I'm the DNS...can't leave my nurses with all the work. I did a 13.5 hour day but with team work it all got done
    Unfortunately 4 hours is the new standard at this facility due to the new admission paperwork the the company created which is 100 pages long. The floor nurse has to go through ALL the paperwork, assess the resident, and put the adl's together. A lot of the paperwork is repetitive, and there are chechlists for checklists. Usually an extra nurse is called in for the four hours that the other nurse has to do the admit but this isn't always the case. So in total, there are 2 or 3 nurses working the floor. When I was admitting my resident, all my DON did was hand me MORE paperwork amd left on time for the evening.
  8. by   kbrn2002
    Sounds about right. We now have assessments on top of assessments. I am pretty sure some of those assess other assessments. An admission is at least a couple of hours of just paperwork and that's not including double checking admission orders, or on bad days doing admission orders.
  9. by   Here.I.Stand
    When I worked in an SNF, we had 24 hrs to complete the admission. Those reams of paperwork were maddening... especially the ones that in my opinion were more appropriate for PT to be assessing. And especially because the PT WOULD BE assessing mobility. The OT WOULD BE assessing ADLs. I mean as nurses we're constantly assessing... but such a detailed form seems redundant when the pt is getting evaluated by an expert in that area.

    But anyway, I would of course do a quick head-to-toe (sometimes with the exception of skin; no need to have them strip when they will need HS cares in a few hours) pain assessment and set of VS. I'd ask about things that will impact their care (do they follow a kosher diet? Any daily routine type requirements/requests e.g. HS shower vs a.m., night owl vs "morning person?" Pills one at a time or one big gulp or crushed in applesauce? Typical BR habits?) orient them to their new surroundings, answer any questions, do their med rec etc.

    Beyond that, I prioritized. Patient care is more important than paperwork... sorry, not sorry. And then, whatever didn't get done was deferred to the next shift. Nursing is 24 hrs a day after all

close