LTC is Crazy.

Do you have a pt census sheet? I put several things on mine: med and treatment times, glucose checks. I also highlight residents to chart on and why. I add my PRN data during the shift as well as other notes. The sheet helps me know at a glance what needs doing on my big unit.

I also have worked with the doctor and/or facility policy to adjust med admin times and even medications to better suit some residents.

Check your med care and supply it BEFORE leaving the station.

Time care with your CNAs (e.g., a skin care treatment)...

Where I work we aren't supposed to work after the shift, so I hustle as fast as I can all shift long. --You will get alot faster as you get to know your residents.

No we don't have a patient census sheet. I was thinking about creating my own, because I really need to organize myself. I have a small child at home, so I can't afford nor do I want to stay several hours after my shift is done. Thanks for the advice.

As the prior poster said, get yourself organized with a census sheet to keep track so you don't have to run up and down to check also note any thing you want to chart or pass on to next shift, it will help when you do your report... it is a crazy environment at first but it will get better, just hang in there, if there is stuff left what about midnight shift helping.... it is a 24/7 operation. I'm not saying dump it on them but if you get left extra work, and have a little left ask MN to help out... if possible. Good luck, I worked LTC a lot and loved it...

My advice: make good friends with all the caregivers/cna's. They can make your life alot easier.

I agree with making friends with the CNA/CMA because they do help you out a lot when it comes to patient care.

Well I am working on a rough draft for my own census sheet, since the facility doesn't provide one.

What shift are you working?

Definitely do treatments when the CNA is putting a resident to bed or changing them. This is a quick way to get treatments done.

At first yes, you feel over overwhelmed. But you will learn to work quickly and zip through the medpass. You learn which residents are fingersticks, so you get those out of the way before dinner.

Speaking from many years' experience (26 years now as a nurse, 14 of which was in various LTCs), I say RUN to another position while you can. There is WAY TOO MUCH hinging on your license. It will suck all your energy and no matter what you do, you will ALWAYS end up leaving late(despite the cheat sheets that are supposed to "save time"). I got out of LTC 7 years ago and am so glad I did. Too many times I was doing CNA work as well as mine due to a shortage of staff. Best of luck to you.

Speaking from many years' experience (26 years now as a nurse, 14 of which was in various LTCs), I say RUN to another position while you can. There is WAY TOO MUCH hinging on your license. It will suck all your energy and no matter what you do, you will ALWAYS end up leaving late(despite the cheat sheets that are supposed to "save time"). I got out of LTC 7 years ago and am so glad I did. Too many times I was doing CNA work as well as mine due to a shortage of staff. Best of luck to you.

I've never made myself a cheat sheet. I don't have the time lol. I could get 5 fingersticks with coverage knocked out of the way in the time that it would take me to make a cheat sheet. Besides.. cheat sheets for LTC need like a poster board because theres so much.

I agree with making friends with the CNA/CMA because they do help you out a lot when it comes to patient care.

Well I am working on a rough draft for my own census sheet, since the facility doesn't provide one.

When I first started, and felt just like you, I bought a spiral bound index card notebook. I wrote all of my residents names on them and their treatments. I also had pages for unusual timed meds or treatments, pages for wound care. It saved me from having to go to several different books or MARS all the time. Also keep a list of who gets their blood glucose testing done in the AM and if they get coverage. Don't bother writing their coverage in their - use the MAR. That can change too often. Good luck!

Something like this...nothing fancy...list addl data in the extra white spaces (PRNs, supplemental drinks you must give, etc.)

PT/OT Patient 1a - 0800 1000 1200 .......- BG98, BG

ABT... Patient 1b - 0800 ........1200 1400

.........Patient 2a - 0800 1000 ........1400

.........Patient 2b - 0800 .........1200 .......-BG80, BG

I also have a list for I/O, vitals... I have several copies so it's ready (may need a little tweaking) per shift.

You should be able to make it up pretty quickly. Eventually, you won't need it anymore. I also include how the resident takes their meds (but after a couple weeks, I have that down pat and don't need to list it...it's nice to have all the data recorded so you can just give it to an oncoming nurse that doesn't know your unit)... I save cheat sheets for other units for when I have to pick them up, too. Changes happen, but it helps to have some info.

Hello

I was hired as a inexperienced nurse in a LTC facility and I am stressed to the max. The patient to nurse ratio is unreal. I am on orientation, and not once have a left on time. Thier is so much to do and so little time. I am so afraid that this job will consume my life once I finish orientation, because most of the tiime the nurses dont't leave til 1 or 2am in the morning. Just because they have to finish up work they didn't complete on the previous shift. It's unreal to me, and its def not safe. I am so stressed. I def don't want to quite but I just need some advice from someone working in LTC .

welcome to real nursing....once you get used to it, you will discover your own pace and get more comfortable.

good luck to you.

I had to laugh when I saw your post, you hit the nail on the head, IT'S CRAZY! I felt just like you when I started last April and most days I still think it's crazy, but I love it and it's do-able.

Once you learn the floor, (hopefully you will be able to stay on the same floor most of the time?) the med and treatment carts, and the residents, you will get faster. You'll find a routine like which residents have to have their meds first, who are the finger sticks, who you can give meds to at dinner, who goes to bed first and so on. You'll know which things have to get done fast and which can wait.

There are some days I leave late, as you stated, I get behind because of some problem and yes, I stay late to chart, but most nights I'm out by 11:30-12 midnight on the 3-11:15 shift.

It can be unsafe but hopefully you have great aides. The BEST thing you can do for yourself is get on the aides good side. While you are orienting, watch and learn. Offer to help the aides here and there, like help pass trays, put someone on the toilet real quick, ANSWER CALL BELLS, set a good example of teamwork. Then when YOU need help they will be right there for you.

Remember you will be the leader and no one wants to follow a leader who is mean, lazy or who doesn't set standards.

The doctors, supervisors, unit managers etc can be royal pains. You will have days where you get 'in trouble' get scolded, and just plain mess up. You will have the most amazing days where you feel you did a great job. The residents appreciate you so much, they will become like family because remember that to them YOU ARE family! Cherish their smiles and hugs.

One great thing is you will never be bored! The shift goes crazy fast and when you get in your car you will feel like you just got off a ride at the amusement park. It's crazy but some people love it. See how it goes. Oh and get great shoes! :)