How many residents do you care for Per Shift?

Specialties Geriatric

Published

I work 1400-2230 as an LPN (soon to be RN as soon as I take boards). I work in a LTC facility that has 68 beds that are always full. So, each night, on second shift there is always myself and 1 other nurse. We are constantly promised that we will "soon" get an OMT to help with med pass, but this never occurs. I am curious what other LTC 2nd shift (evening) nurses have to deal with?

My duties: I have 34 residents a night... all get pills at 1700, about 50% of these get pills again at 2000, and about 25% get pills at 2200. I have approximately 10 diabetics that need blood sugars/insulin at least once per shift, 3 wound dressings that take atleast 10 minutes each, I have 2 residents with G-tubes. Almost all my residents get atleast 5-10 different meds during our 1700 med pass. I have 10 residents with eye drops, 4 with weekly procrit injections, 1 with a colostomy that gets completely changed q3 days. This is in addition to the fact that our secretary leaves at 1500, so we answer phones, respond to faxes, get doctor orders, sign out meds from pharmacy, call family with labs/med change/condition changes, ect.

And then comes charting.... on average, of my 34 residents, at least 6-10 are skilled, so they require mandatory in-depth charting, usually 4-10 residents are "flagged" (i.e. monitor for mood changes d/t decreased antidepressant), and then any charting that comes from lab results, med changes, ect.

I'm just very interested in what other nurses responsibilities are, such as how many residents they are responsible for, ect. Even our first shift nurses (0600-1430) often get stuck with just 2 nurses and 1 OMT for all 68 residents. I'm very interested in what everyone else has to deal with!

I understand the rant, as I go through the same frustrations myself. Plus, I also have dining room duty to do. This takes about an hour, although rarely another nurse will split the time with me, but that hour takes a significant amount of time away from the numerous other duties I have to do.

In a way, I feel better that someone else feels like he forgot to to numerous things during the shift when he gets home. Also, I was told on orientation by nurses that, especially in LTC, taking shortcuts is Standard Operating Procedure, since that is the only way to get everything done in a timely fashion with so many residents and duties.

My Unit has 2 halls of 30 residents each, I work 3-11 have 30 residents to care for, 14 of which are finger sticks @ 4 and again a 9p. 8 get coumiden @6p. 3 of those 8 are also diabetics. Sowhen I start at 3 after doing all the counting, reporting, and getting my cart set up, I do all of my diabetics first giving them their 4,5& 6p meds along with the fingerstick and insulin ( saving my 3 coumiden diabetics for last) then I do my other 5 coumiden residents. Then I do the other 11 Res last, with the last 11, If I can I combine their 1&2 med pass together. This usually takes me until 7:15, then I chart, grab a snack and start my 2nd pass around 8:15. Again starting with my diabetics, and I usually only have about 5 others that get 9p meds.. I have 4 residents that have huge meds on both passes, so I will pull (not pop) their 2nd pass along with their 1st and set it in their drawer with the exception of narcotics. ( as each drawer is individual :) ) and that saves alot of time. I am usually finished by 10:30 giving me just enough time to document skin assessments and monthly assessments, before the other nurse is there and ready for report and counting.

I also work in LTC/Rehab. I work both 7-3 shift and 11-7 shift. For me, the morning shift is more stressful. I never knew the stress in LTC. I thought it was about the residents but, I don't think it is. I just pray and ask God for the strength to make it through. I love being a nurse, it's rewarding for me. All the extra is a bit much but, every job has that..Good luck and hang in there.

Specializes in MRDD, HOME HEALTH AND MOST RECENTLY MEDS.

Does anybody know if there are any traveling nurse jobs out there that hires nurses for travel assignments that are not in hospitals? Just curious, Thanks! Sorry if I posted this in the wrong place! I work Med-Surg, generally 6 is the most I have had in one night but generally it is 4-5 patients! we are also a ortho-pediatric floor!!

Thank you for this recent post. I am orienting to a facility where I will be in charge day shift, and am a little overwhelmed and haven't even been on the floor yet.

I am currently figuring out how to strategize with time management.

I have a 6-3 shift, care of 35 residents.

BG checks, doc orders, talking to families, med pass on 2 floors!

However, the staff seems to be very helpful and although busy, they seem to really care for patients and they

enjoy gettting the job done.

I'm a new grad who wants to know good habits from bad ones.

Any tips from seasoned LTC would be greatly appreciated!

I have 2 jobs at my facility one is charge nurse and the other is RN supervisor. Some days Im on the floor some days Im in charge. It is a very large facility and working on the floor is exhausting to say the least. I work the 2:30-11 shift. I am responsible for 2 units the independant living and the sub acute unit but on top of that for 4 hours I am to cover the unit across the building (there are 6 units in all) which has patiens with a higher acuity...It is tough. It takes all night to get blood sugars and meds passed add the paperwork and orders that leaves little time for treatments which are crucial to patient care. The other night I got 3 admitts I wanted to cry I am sad to say this but I am ready to just work as the supervisor because that is more my speed writing orders calling doctors hanging IV's monitoring the patients on vitals....we have a couple of nurses who are super fast at the med pass but I have come to the conclusion that they must just punch pills and hand them out and sign the mar later there is no way that they can actually pull meds according to the mar at that speed. I love my job though and I love my patients I just want them to have the best care possible I feel like I should do more but I just dont have the time.

Specializes in psychiatric, UR analyst, fraud, DME,MedB.

OH my ...it looks like my choice of working into an elderly home is questionable, considering all that I have heard . Noted one thing that is so dominant in this area.....insufficient RN 's or insufficient staff for that matter. Why is this? Why is LTC/rehab so minimally staffed? and I agree , this is not about the elderly patients, just another business that puts profit #1 in the list . How about the residents? Truly what is the "ideal" staffing considering the multiple problems our elderly have? How about a medication aid, so the rn can get on w/ the assessments and treatments, doctors call. How about admission ??? this seems to be the least likely welcome assignments?:confused:

OH my ...it looks like my choice of working into an elderly home is questionable, considering all that I have heard . Noted one thing that is so dominant in this area.....insufficient RN 's or insufficient staff for that matter. Why is this? Why is LTC/rehab so minimally staffed? and I agree , this is not about the elderly patients, just another business that puts profit #1 in the list . How about the residents? Truly what is the "ideal" staffing considering the multiple problems our elderly have? How about a medication aid, so the rn can get on w/ the assessments and treatments, doctors call. How about admission ??? this seems to be the least likely welcome assignments?:confused:

The base reimbursement rate for a resident in my facilty is $168 a day. What profit?

Specializes in psychiatric, UR analyst, fraud, DME,MedB.
The base reimbursement rate for a resident in my facilty is $168 a day. What profit?

168.00 a day , including meals and meds? I can see this as an assisted living price...........I think we need vivalaviejas to input some stuff here. She works in LTC ...............

168.00 a day , including meals and meds? I can see this as an assisted living price...........I think we need vivalaviejas to input some stuff here. She works in LTC ...............

That is the base rate for room and board and the most minimal level of assistance. That barely covers plant and equipment and heating the place.

34 actually isn't too bad.

I would look at the chedule and try to make ONE pass per resident if there are meds that can be combined without complications. Early pass is for those nodding off at dessert and sound asleep by 1900, the later pass for those who can stay awake until 2100. So 17 at 6, 17 at 8. Two hours for each, you should be done with meds by 2100 and you have time left for charting.

It can be done. But you MUST create two passes instead of three, and ONE PASS per resident, again, the only exception for meds that can't be combined.

Good luck.

See, my issue is that we can't do that at our facility.... Say I work 1400-2230. Our meds are labeled and scheduled as "1430" "1500" "1630" 1700" "2000" "2100" and "2200". You can only pass pills 1 hour before or after scheduled times. Then you run across patients who have pills all scheduled at 1700 but one pill is labeled as 1700, but is labeled as needing to be given 30 minutes after meals. Well, if the Res doesn't finish dinner until 1830, then i'm out of compliance. I've heard of other facilities not having specific times labeled on meds, because some facilities have a policy against administering meds while Residents are at dinner. I'm not clear on how this works but something needs to change at my facility because the only way for me to pass my meds "according to state standards" and "according to good-practice standards" would be for me to hand off cups of meds to any CNA working that also has their oral-med tech certification and get them to give them to the residents... which would of course **** off/delay my CNA's in their work.

Specializes in Geriatrics.

I work evenings every other weekend in an LTC with 154 beds. On my particular station I am in charge of as an RN, I care for 39 currently. About 8 of those are skilled/Medicare. I do my own vitals and assessments and the 1400 nebulizer treatments as soon as I take the floor. Then, I give report to my 4 CNA's and one CMT. Then I chart my assessments and hook up the only G tuber we have, her feeding starts at 1500. Then, next on my list is the 1600 nebulizers (2) then 3 accu checks and insulins around 1630. I give one narc at 1700, then feed 2 people during supper and chart dining room meal intakes. I then help clear the dining room and take my 30 min. supper break around 1830. Then as soon as I get back, I pass my hs narcs (about 12 of them), do another 4 nebulizer treatments, do my hs accu checks and insulins, chart on my MAR and do about 2 treatments (lotions/creams), also the hs G tuber meds. Night shift does all the dressing changes and we have a wound care nurse that does them during the day. Then I do any extra charting and make rounds to make sure my aides have everyone in their jammies, clean, dry, teeth brushed and dentures soaking...and I check to make sure the DUR is clean and snacks have been passed. Then the night shift nurse comes on at 2130 and we count narcs and have report then I go home at 2200.

I think I have it very easy compared to what else I've been reading here. I have worked prn for this place for almost 2 years now and love it, for the most part!

Blessings, Michelle

+ Add a Comment