You have started on a great adventure---truly--I love LTC and I love nights. The ladies have given you some great advice. I firmly believe in the following:
*My CNA's are precious to me. I say mine, in the possessive, because they take care of me and I take care of them.
*The CNA's can you if there is a change in a patients condition fro the start. Do not feel intimidated to ask them. Let them know that although you are the nurse, you value them input and "assessment" of the patient. From the start it is imperative to let them know how valued they are. Work with the team aspect.
* I recently started at a new facility. I, too, got a list of the patients and made notes beside of it as I went. Who's meds were crushed, who was diabetic, who was A&Ox 4, fall risk, code vs. nocode, ets. It will take time to compily the list. But keep it with you on a clipboard as your Bible and add to it. After a few weeks you will not need it anymore.
*Get all your supplies together before med passes---stethoscope, flashlight or penlight--so you can see pts without turning on the light, tube feeding materials, etc.
*Use your report bboard or list of pts to make notes of what to f/u on for report and for charting.
*Know who your "acutes" are before you make rounds or the first med pass. That way you can look at them during that time and not have to make that long walk to their room again.
I I think I have rambled but if I can be of any more help let me know or email me.
Good luck!!!!You can make a big difference in the life of a lot of older people. Remember a lot of these people do not see their families everyday or weekly. My philosphoy(mispelled) is that they may not have had anyone try to make them smile, give them a hug or a reassuring hand on the shoulder. If you have love to give show some of it to them. They are the most neglected population of patients, as far as I am concerned---I mean emotionally.
sorry to ramble, I will get off of my soap bbox!!!