LTC charting

kkluczynski · Jul 6, 2009

no computer charting at least not at my facility. everything hand written on nurses notes.

kythe, LPN · Jul 6, 2009

I've never worked in a hospital, so I can't compare the amount of charting. Most facilities I have been in still have paper charts.

What caught my attention is that you said you would love to "get to know" your patients. For me getting to know people in a LTC facility is often limited to, "Here's your pills. Bye". There are so many patients to be responsible for it isn't likely you will have much more communication with people than that unless you choose the facility very carefully based on staffing.

NC Girl BSN · Jul 6, 2009

When I worked LTC. We has a few people that was Medicare patients and we charted on them everynight. It was a brief nurse note that had to address a few key elements based on the patient. Then the MARS and TARS had to be signed. I&O's book on a few pt. MDS book on behaviors and care. It took me about an hr to chart everything. Sounds easy but when your on the cart for 5 hrs. Doing treatments and shin assessements for 1hr . Taking a short break, taking off Dr. orders. Time gets away from you fast.

southernbeegirl, BSN, RN · Jul 6, 2009

you chart WAY MORE in LTC than you do in acute care.

Sparrowhawk · Jul 6, 2009

I don't think it's AS much...and it's all on paper. As for getting to really KNOW your residents...you might with one or two you see a LOT..but...with 43-60 residents...it's hard if not impossible.

Auntiegrade_Amnesia · Jul 6, 2009

In my experience, it really depends on the facility as to the amount of charting they require. While all of them require the residents on Medicare to be charted on, you may run into a whack-job D.O.N every once in awhile who wants you to chart everytime they blink. As far as getting to know the residents, its really not possible anymore in LTC. Not like it was 20 years ago when I started. You simply don't have the time. Paperwork and passing meds have taken presidence over patient care.

NightNurseRN · Jul 6, 2009

That is so disappointing to hear there is no time to get to know the patients in LTC! I remember when I used to work as an aide, the nurses knew the patients sooo well, it was like we were all a family. This was 10 years ago, has it changed that much? This was a really small nursing home too, maybe that had something to do with it? I hate that passing meds and charting are taking over patient care as one said! This is just getting ridiculous.

kythe, LPN · Jul 6, 2009

That is so disappointing to hear there is no time to get to know the patients in LTC! I remember when I used to work as an aide, the nurses knew the patients sooo well, it was like we were all a family. This was 10 years ago, has it changed that much? This was a really small nursing home too, maybe that had something to do with it? I hate that passing meds and charting are taking over patient care as one said! This is just getting ridiculous.

It may not be so much that things change, but your perspective is different as an aide. Aides do a lot more hands-on work, such as toileting and bathing. This allows them to develop more of a relationship with the residents due to the time spent with them and the personal nature of that time.

I enjoyed working a couple of shifts (I work through an agency) as a wound care nurse in a sub acute unit. I had the opportunity to really talk to people and hear their stories while doing their wound dressings, conversations that would never have happened as the med pass nurse. It's nice because its not like just going down the assembly line. I've also worked in group homes for the developmentally disabled. There is a lot of charting there, but these can be very personal environments due to the low staff/patient ratio.

debelair · Jul 6, 2009

If you really want to spend time with the residents in a LTC facility, find a small one and work 3-11. There are fewer pills/treatments, very little PT/OT and only one meal. I worked 3-11 in a LTC facility for years and I had time to talk, cut nails, even play the piano for them on occasion. I will say, though, there were more behaviors to deal with because of sundowning.

CoffeeRTC, BSN, RN · Jul 7, 2009

I do 3-11 on weekends, it is a lot less of the rush around, but still....I have just as many pills as the day shift, yeah, only one meal, but more of the treatments and we get all the admits and readmits on that shift.

As far as the charting....probably more than acute care. Most places do not offer computerized charting or maybe only some parts are computerized.

Still...You do have more of an opportunity to get to know the pts since the stay is longer.

There is a LTC forum....head on over and join in!