How do you provide 8 hours of care in 12.5 min

EmeraldCoastRX · Aug 17, 2013

Welcome to LTC. Technically no, there is not enough time, but you find it. Once you get a routine down, it won't be that overwhelming. Yes there will be days where the inevitable happens and your shift is thrown into a tail spin, but you adapt and continue on. Hopefully your new facility isn't a stickler about clocking out as soon as your shift ends. Soon you will have a PHD in time management. :)

bluegeegoo2, LPN · Aug 17, 2013

Yes, it's possible. I currently have 38 residents on 2-10 and do all meds, fingersticks, labs, charting, falls, incidents, admits, etc. We are still all paper as well. It's not easy by any means. My assessments happen as I run meds. I ask general questions such as "How are you feeling today Mrs. Jones?" on the A/O residents. Most are more than happy to tell you about any issues they've had so far. The disoriented ones, you just learn what's normal for them and look for s/sx that something is out of whack and address accordingly.

Time management and prioritization of issues are the 2 most important things to master in LTC, in my opinion. If you try to handle every little thing that comes up through your shift as it happens you'll never get done. Most things can wait until med pass is complete, even admits. I will go to the new resident's room, introduce myself, make sure they're as comfortable as possible, orient to their room, roommate, call-light, etc., then finish meds and work on the admission paperwork later.

LTC is as safe a nursing environment as you make it. Take care of the people first, and you'll be fine. I would much rather stand in front of my admin/DON/corporate and explain why I chose to take care of a resident over doing the paperwork as opposed to standing in front of the BON trying to explain why I chose to do the paperwork and neglect a needy resident.

PeacockMaiden · Aug 17, 2013

The real answer is that you don't/can't provide (good quality) care with the ridiculous patient ratios they give us and all the extra documentation, double charting, slow computer systems, broken printers, lack of supplies, etc.

Management will pretend that it is doable, but they know it really isn't, but they don't care as long as they keep getting their paychecks.

It's not about the patients, it's all about the money.

BrandonLPN, LPN · Aug 17, 2013

This will sound blasphemous, but your stable residents often won't really need anything more than a nurse to medicate them and do a quick "eyeball once-over" assessment.

In LTC, it's the CNAs who spend the most time providing care. They're the ones who'll put them to bed, take off their clothes, hold their head, tuck them in, turn off the lights and tiptoe out.

For many of my (relatively) healthy residents, I might spend well under 12.5 minutes with them per shift. They don't need 8 hours of care.

Lynn52 · Aug 18, 2013

Thanks, tonight was my third night of training and guess what...I think I like it :) . I'm scared and know I have a lot to learn but am slightly optimistic. The front hall of this facility has two wings pt loads of 23 - 29 with higher acuity pts but more organized and there is a second nurse handy to ask for direction if needed. I will ask to be assigned there and will also ask for additional training and we will see how it goes......I do think I will advocate for better nurse resident ratios in facilities like this....kind of a crime :) Thanks again!!!

chrisrn24 · Aug 18, 2013

This will sound blasphemous, but your stable residents often won't really need anything more than a nurse to medicate them and do a quick "eyeball once-over" assessment.
In LTC, it's the CNAs who spend the most time providing care. They're the ones who'll put them to bed, take off their clothes, hold their head, tuck them in, turn off the lights and tiptoe out.
For many of my (relatively) healthy residents, I might spend well under 12.5 minutes with them per shift. They don't need 8 hours of care.

Exactly.