11-7 Getting Residents up.

military spouse · Oct 3, 2005

I worked in a deficiency-free SNF many years ago and all residents were up by 0700. This meant the night-shift was responsible for getting the vast majority of residents up and ready for the day. The CNAs on days were responsible for getting up a few and there was a list, but if you were full-time you already new who you needed to get up and ready. I believe nights began getting pts up around 0530. I did think it was sad that one needed to be actively dying to be "allowed" to stay in bed. Patients were also kept up during the day, except for one nap period. This of course met the careplan for allowing adequate socialization. I hope when I'm that old they just leave me in bed to watch TV.

SerenityGirl · Oct 3, 2005

I'm a CNA who works the 11-7 shift. At my facility each CNAis responsible for getting up six residents each. Sometimes this requires giving a resident a shower, or simply getting them up and dressed. There is a set list of residents who the night shift has to get up. But we have to do it all. We normally start getting our residents up at 5am.

Quickbeam, BSN, RN · Oct 3, 2005

I worked at a free standing rehab faiclity for many years as the night charge. This was the biggest battle we had. The expectation was that we'd have everyone up for days, ready for therapy. When we had a full house that meant starting at 5 am. It's just wrong. I refused to give insulin as the breakfast trays did not come until 7:45 am.

lovingtheunloved, ASN, RN · Oct 3, 2005

The only thing our night shift is required to do is have the residents clean and dry. However, when one considers that breakfast comes at 0715 and report gets finished around 0700, it's not really a practical solution. Fortunately, the night shift starts at 0500, (on the people who are usually crawling OOB at this time) and gets as many up as they can. Often, it's just about everyone. If a resident doesn't want to get up,, days gets them up. It works pretty well. Nights don't bathe them though. We have a shower team during the day that does the baths. Nights washes their faces, does peri care, oral care, and gets them dressed. Everyone's usually up and happy and swigging their morning coffee.

Lisa CCU RN, RN · Oct 3, 2005

The only thing our night shift is required to do is have the residents clean and dry. However, when one considers that breakfast comes at 0715 and report gets finished around 0700, it's not really a practical solution. Fortunately, the night shift starts at 0500, (on the people who are usually crawling OOB at this time) and gets as many up as they can. Often, it's just about everyone. If a resident doesn't want to get up,, days gets them up. It works pretty well. Nights don't bathe them though. We have a shower team during the day that does the baths. Nights washes their faces, does peri care, oral care, and gets them dressed. Everyone's usually up and happy and swigging their morning coffee.

I posted on another post that I have been in a facility that wanted at least 100 residents up at 700 am even if there were only 2 techs on that night. We also had to do the laundry for the 7-3 shift. We had to do it no matter what because if we didn.t 7-3 wiuld have no linen. this is absolute hell to do and I quit after 3 weeks. now it wasn't impossible with say 5 techs, but two was not happening. Isn't it illegal to get residents up at 4 am? That 's the only way I could get them all done by 7 am.

SouthernLPN2RN, MSN, RN, APRN, NP · Oct 3, 2005

I posted on another post that I have been in a facility that wanted at least 100 residents up at 700 am even if there were only 2 techs on that night. We also had to do the laundry for the 7-3 shift. We had to do it no matter what because if we didn.t 7-3 wiuld have no linen. this is absolute hell to do and I quit after 3 weeks. now it wasn't impossible with say 5 techs, but two was not happening. Isn't it illegal to get residents up at 4 am? That 's the only way I could get them all done by 7 am.

OUCH!! I don't blame you for not staying somewhere like that! I consider myself lucky that we have laundry, housekeeping, cafeteria and an onsite pharmacy. At one facility that I worked at as a CNA, one dayshift person would come in an hour early to help get residents up (they would work 6-2). I used to do that alot and enjoyed it very much. Of course, it was a private pay facility. That was sheer heaven compared to what I see now. We usually had 4 CNA's on dayshift with 22 residents. We didn't have to do laundry or anything like that.

JCLF3 · Oct 4, 2005

I've seen alot of postings on the duties of 11-7 shift including getting residents washed, dressed and oob for breakfast. Just curious on a few things.....is this a routine thing? Is this only for residents that are already awake and wanting this? What is your staffing ratio? How do you get around this with the state?
Do you notice any increase in behaviors, etc?
In my facility..48 beds on 11-7 nights has one nurse and 2CNAs. These numbers never change. On occasion they will get a few residents washed and dressed if they have early appts or dialysis or they are already awake and trying to get oop. In years past they tried having nights get 1-2 res up off of each assignment for days. Never really went over well. We noted lots more behaviors, skin issues, residents would sleep all day and more complaints. The state also frowned on this. Of course we still have a nice sized 6 or 7 a med pass that some nurses will start at 5 am! BTW, breakfast isn't until 7:30 or 8 am.

I have noticed some of the same problems at the facility that I work at. Especially the sleeping during the day, which in turn effects the amount of participation in their ADLs including meal time. Many of the residents who get up on 11-7 shift began sleeping during meals and requiring more encouragement which then effects their behavior by making them more agitated at staff. Part of the problem was due to the 11-7 CNAs getting their assigned residents up very early in the morning because they said that they didn't have time closer to shift change when they were doing their last turns and dries. And I mean very early, some were getting up at 2 or 3 in the morning, which I feel is way too early. To fix this we had to reduce the number of people they get up and require that the 11-7 nurse monitors closely that no one gets up before 6:00 unless requests. We've not had much of a problem with state on this issue since we monitor that they don't get up before 6 am, however we do have 3 CNAs to 42 residents with one nurse.

Sunshine Sweetheart · Oct 4, 2005

In my facility the day shift comes in at 6 and the night shift leaves at 7:30 so there is an overlap. The night shift has a list of residents that they are responsible to get up and day shift gets up the rest. Breakfast is at 8 but we are not allowed to get patients up before 6. If a patient wants to stay in bed then they have the option of doing so and getting a room tray. We have some patients who want to get up early and oyhers that don't. We try to get the early risers up first and the ones that like to sleep in last.

Monica RN,BSN · Oct 4, 2005

In my facility, 120 bed SNF.. I implemented a shower team that is comprised of 2 CNA's for each wing. They come in at 6am to help with the get ups and showers. They do all showers for 7-3 and 3 - 11.. what ever they cannot get to, they leave a list for 3-11 to finish for showers that day.

In Florida: a nurse cannot have over 40 patients on any shift.

a CNA cannot have over 20 on any shift.

state says no one can be up before 5 am, unless they specifically request to be.

Lisa CCU RN, RN · Oct 4, 2005

In my facility, 120 bed SNF.. I implemented a shower team that is comprised of 2 CNA's for each wing. They come in at 6am to help with the get ups and showers. They do all showers for 7-3 and 3 - 11.. what ever they cannot get to, they leave a list for 3-11 to finish for showers that day.
In Florida: a nurse cannot have over 40 patients on any shift.
a CNA cannot have over 20 on any shift.
state says no one can be up before 5 am, unless they specifically request to be.

Must be nice, I've had 22 patients at one facility and over 43 at another.

Monica RN,BSN · Oct 4, 2005

Must be nice, I've had 22 patients at one facility and over 43 at another.

In my facility I will only allow the nurses to have max 25 and CNA's to have max 10. I believe in extra staffing for resident's sake and safety.