11-7 Getting Residents up.

[CoffeeRTC]

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.

[lovingtheunloved, ASN, RN]

This is probably not going to sound real nice to some people reading this, but I'll say it anyway. About half the nursing homes I worked in had the night shift getting up patients before the day shift arrived. Now, this is just my own observation, but it seemed to me that the private paying patients were not patients that got this kind of treatment. Neither do the Medicare and rehab patients. They can get breakfast in bed or stay in their rooms. Some years ago I would see patients gotten up, wheeled to the dining room or in front of the nurses station and sit there slumped over and sleeping until they got breakfast. What kind of existance is that? At the home I currently work, the night shift has only a couple of patients they are assigned to get up in the morning. This list was supposedly carefully considered by the DON. They are patients who are heavy lifts or confused and beligerant. I believe the criteria for this was because they take time to get out of bed due to their conditions and behavior. Otherwise, as soon as the day shift CNAs come in they start getting their patients up.

Most of our CNAs don't have any idea which resident's are private pay. As a matter of fact, most of the nurses don't. We have more important things to do than run around trying to figure out what someone's paysource is.

[mandykal, ADN, RN]

Since we're in the subject of 11-7 get-ups, I thought I add my 2 cents.

I really hate the shift wars and battles. I get really annoid when 7-3 shift comes onto shift and first thing they ask "Who's up?" Doesn't people usually ask was concerns them the most? Gee! I think the more appropriate question should be "how was the night?" Give them a chance of asking that and they usually vent the unusual episodes eventually leading to information on "who's-up."

I've always knew that 7-3 is the hardest shift and I respect that b/c of ADL's. That's one of the reasons why I don't work 7-3. The pay is not worth the labor (CNA). Furthermore, I hate it when residents are forced to get up 7 days a week after 5:45 am. I think that nurses need to alternate because these elderly people are compromised of getting ill. They should be alert to the residents physical well-being daily.

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"No-one of us is as good as all of us. Only as a team can our jobs be easier, Clients are satisfied, and goals are met."

[sharlynn]

At my facility, the bath aide starts at 0500. Only residents who request to be up that early and dementia patients who are up already are gotten up by the 10-6 shift. If 6-2 has had a call-in, they will frequently dress residents not on the days bath list on their last rounds and leave them in bed to help out.

Sharlynn