Help with LTC nursing

AshiPanda · May 11, 2009

Maybe a lot of the problem is that you are a floater nurse? I find it really hard to get anything done when my patients would constantly be changing on me...

I asked another nurse about the med times thing, and she said unless it's heart medications or things of the sort, she gives them all at one time.

RN_MishMish · May 13, 2009

I agree. Stability, knowing your people and getting familiar with their needs and meds will be easier when you are work consistently with the same ressidents. As a floater is it so much more difficult to build up this knowledge because your residents change all the time. Talk to manegement and find out if they can place you on a certain pod rather than have you float at least for a few weeks. Time management takes a while to build up and a changing environment isn't very helpful. Best of luck! :redbeathe

RN_MishMish · May 13, 2009

"How do you get organized?"

Like mentioned in another post, knowing your residents, their meds, their needs is a great piece but even if you'll have to be a floater for a while, eventually you will develop YOUR system, and see what works and what doesn't(or what slows you down). My system:

After getting report I take 10 minutes to quickly go over the MAR and mark on my list of residents t("the brains")the times of meds of each. I'd also mark on there if I have dsg changes, orders to take care of, skin checks etc. This way I know what needs to be done and when. Than I'll gather my supplies, anything I will need handy on the cart - I'll have ready and available - dressings, syringes, lotions, enteral bags. Anything I know is needed and is not located on the cart - this way I'll save mayself a few trips when it is really busy. The next hour I'll do my rounds - initially visit with and assess the residents. This way everyone is accounted for in terms of what they need for the evening and I have gathered the info to start documentation. I'll try to do most treatments before the big evening med pass. sometimes it works, sometimes I have leftovers for HS but at least I get a head start.

And yet, every shift there is something else that takes a big chunk of your time - an admission, a dischargse, a set of new orders from the doc, a resident who is sicker than the usual. There is never a dull moment, as you know. you will eventually find what works the best for you. If management wants you to be successful they will help you find the conditions you grow best in. If this shift doesn't - by no means you are a bad or incapable nurse, you need to find your corner.... Hang it there, it's true what they say you know - it does get better. and if it doesn't after you've tried - it's ok to find something that works better for you :up:

Best of luck!

rn_nxt_dr · May 14, 2009

first, i suggest that you relax and read over briefly your patients'/clients' medications. have the latest drug guide book handy to check for adverse drug interactions if getting overwhelmed. there is nothing wrong with that because you are ensuring patient safety (the ultimate rule).

secondly, if you feel you are not so adept with medications, try reading pharmacology all over again to refresh and update your knowledge, we all need to do this from time to time because of constant clinical research results that may greatly affect clients.

thirdly, you are doing great! without fear we will not take that leap into the unknown. with fear we act more cautiously and with better perspective because we care about our clients. have faith that you are doing the right thing. :up: