How to organize my time as agency nurse in LTC facility?

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Hi,

For all of you experienced agency nurses, is there a specific way you organize(or try;-)your shift?i.e., look at the MAR, see if anyone needs their meds now, and vs you will need to get, any diabetics, wound care? etc? I now you have to hit the ground running...I just want to get into a rhythm and do the best job that I can! Any lists, any advice, any tips, and a breakdown of your shift would be great! Thank you so much:-)

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Hi,

For all of you experienced agency nurses, is there a specific way you organize(or try;-)your shift?i.e., look at the MAR, see if anyone needs their meds now, and vs you will need to get, any diabetics, wound care? etc? I now you have to hit the ground running...I just want to get into a rhythm and do the best job that I can! Any lists, any advice, any tips, and a breakdown of your shift would be great! Thank you so much:-)

I work in a long term care and a hospital setting. To answer this question, it truly depends on how many residents you are caring for in a shift. 2) What shift you are working because it seems like the day shift nurses always are getting slammed. But no matter what shift i work, I always flag my meds on my MAR, then i jump straight into wound care, and do my vital signs as i pass my meds. Then after my meds, before their food arrives, i try and finish my wound care treatments. Then I start charting. I usually try not to chart until at least my first half of my meds are done and my wound care is completed. Also when you flag your MAR, this is a great opportunity to see when antibiotics are due and if they need to be removed from a refrigerator or not.

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Specializes in LTC, Hospice, Tele, ICU.

When I worked LTC I always did meds first. Ask the floor staff, who know the residents well, if there is anybody in particular you should medicate first. Some of the residents have a fit if they get their meds 'late'. By the time my first med pass was done there might have been a little time before lunch so I'd try and get my accuchecks done, help with lunch, 2nd med pass and finally treatments. Oh yeah, and then charting before I left.

Sounds like alot but if you frequent some of the same facilities you can get to know the residents and get into a swing. Good luck. LTC can be enjoyable :)

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Thank you for your replies:-)

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Specializes in ED, Informatics, Clinical Analyst.

I like to get there at least a half an hour early so I can formulate a game plan by finding out who i'll be caring for, looking at the MAR, looking at treatments I have to give, and finding out what other care providers there will be working with you. For example, I've gone through the MAR and seen that I have to give a bunch of breathing treatment but then low and behold a respiratory therapist shows up does them all so I don't have to make time for that (the opposite could also be true).

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Specializes in Peds, developmental disability.
I work in a long term care and a hospital setting. To answer this question, it truly depends on how many residents you are caring for in a shift. 2) What shift you are working because it seems like the day shift nurses always are getting slammed.
But no matter what shift i work, I always flag my meds on my MAR, then i jump straight into wound care, and do my vital signs as i pass my meds.
[WIKI][WIKI][/WIKI][/WIKI]Then after my meds, before their food arrives, i try and finish my wound care treatments. Then I start charting. I usually try not to chart until at least my first half of my meds are done and my wound care is completed. Also when you flag your MAR, this is a great opportunity to see when antibiotics are due and if they need to be removed from a refrigerator or not.

Philly, what do you mean when you say that you flag your meds on the MAR? Tell me how you do that, please.

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to flag means,to have those particular pages of meds stick out of the binder, etc in some way. Does that help you?:-)

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I have been an agency nurse in the past X many years. I worked primarily 3-11 shift. Let me add a few good tips to what's already been suggested: carry a clipboard to keep your papers together. Take careful notes from report for pts. with problems and place little square blocks on your sheet for important checks (labs, antibiotics, pain issues, etc.), last FS results and which need 4PM FS, be sure that PTs are in for those on coumadin (sometimes labs are late, and you need to give MD call to get coumadin dose), after report gather CNAs together and give quick report so no surprises later (pts. out on MD appts, off floor for whatever reasons, those who need wts., etc., then obtain the 4PM FS and give covering doses, start 5PM meds, check diet slips for meals on meal truck, finish 5-6PM meds, supper break by 6:30PM, return and flag treatment book, do treatments which don't require bedbound, start 8PM-9PM meds, after finished then complete PM treatments, complete nursing notes and other documentation, give report to 11-7 nurse (and supervisor if required). Hope this helps. Don't forget to check those records flagged with MD orders if they sneak up to the floor while you are on the med cart---I know they are capable of this. ;)

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Specializes in Peds, developmental disability.

Juzme,

Yes I am aware of that type of flagging. But the 1700 meds, let's say, are not all on one page for that resident. They are on all the pages, except the PRN page, which is last. So seems like I would need to flag MOST of the pages.

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Specializes in Peds, developmental disability.

Thank you for your ideas. That last note was a very complete to-do list!

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Specializes in Geriatrics.

What state are you in, and what agency do you work for.

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