Need time management tips (ALF 40 residents)

[tlc2u]

Hi, To All and Thank You!!! for any advice you are willing to share.

I am an LPN and have been working 5 months in an Assisted Living Facility.

Shift: 3-11

40 residents

1 nurse (me)

1 CNA

(does her job but when asked to do anything extra complains about how hard her job is so I don't ask her to do things to help me. I feel if she can do her job I should be able to do the rest like refill ice and water in the nurse pitchers on the med cart and run to the supply room to get med cups, water cups to restock the med cart.)

Listening to small talk when I go in a room to give meds takes up more time than I can afford to. Or if resident is lying in bed - waiting for them to sit up to take meds or waiting through the small talk to ensure the resident takes the meds (doesn't drop any and doesn't get choked on any larger pills.)

I need advice - How do you politely cut out the small talk - or do you? How do I let the residents know I just need to get my job done and don't have time to listen to the small talk. I don't want to be rude but honestly to finish my job I need to quickly give meds to my healthiest residents so I have some time for the needier ones.

Answering a few call bells

Answering phone calls

Troubleshooting little stuff, strange beeping in a room-dust in smoke detector, water won't turn on - not turning handle the right way, remote for TV not working, family says resident did not get shower check nurse note states resident was showered.

New admission from another floor - back and forth with other floor to ensure have all orders for new admit

Resident sick or fall - VS, fall assessment etc. Call family, call doc, write new orders, fax to pharmacy etc.

How do YOU get it all done and get out on time????

Any time management tips you can offer would be greatly appreciated!!!!!!:)

[NamasteNurse, BSN, RN]

you rarely get out on time, so just let go of that pipe-dream! (sorry, sad but true)

Stock your cart before you leave the med room. better yet, the nurse before you should be doing that and you do it for the oncoming nurse.

As to the small talk with the residents, it's hard to walk away. But you can just say something like, I have to get to the next pt can we talk later?

Time wise, I plan my day like this...(3-11 shift)

Insulins first. Then people with narcotics who need them early. I keep a portable phone on the med cart.

Then go through the rest of the pts, keeping notes on things that come up along the way such as held a bp med, Mrs. X's light needed fixing etc. Pass repairs on to the correct department later.

As problems come up, deal with them then and there. You usually have a two hour window for your meds, so you can catch up.

The only thing that you can do to save time is shorten the small talk so concentrate on that. Maybe during a meal you could circulate and chit chat then so the residents feel you had time for them? It does get easier, you will get better at it. I am still new as well, only 10 months in but you learn a lot every day

Good luck

[lilaclover]

It gets easier. I promise

I can't think of any specific tips to give you. It just takes practice. You will get into your own routine soon enough. Just try to stay organized and focused on what you need to do next.

[Jlpsigmon]

Hi dear. I read your post, and I can absolutely relate to the problems you are having. I used to deal with those same issues myself. I'm a MT Supervisor at an ALF with 150 residents. I have been working in healthcare since 2004. Started off as a CNA, and then later began working as a MT Supervisor. Time management is one of your most important assets as a Nurse/MT. And all of the little things you can do will really add up to save time on your med passes. 1st off, I agree with the above post. It is common courtesy for nurses to stock med carts for the oncoming shift. If you can get this practice started at your facility, by doing this for the shift after you and expecting the same in return, then you can eliminate the first few minutes of your shift being spent looking for supplies. 2nd, always remember that CNAs are a huge asset to you and the nurses job. Without them, you really couldn't do it. Delegate tasks that are within their job description to them, esp. tasks that will save you time, such as answering call bells, or phones if that is allowed at your facility. Having portable phones that you can carry on your med cart is nice though. Have CNAs give messages to residents that are requesting to see you if you cannot go to that room at the time, unless of course it is urgent that you do so. Let your aides fill water pitchers if they can, chit chat with residents when you do not have time to, direct visitors or families, do initial skin observations on residents, bring CNA documentation books to you when you need to review them at a certain moment (such as for the shower confirmation). Remember that in most facilities, CNAs can take vital signs, fill out Meal Roll Call Books, and can sit with a resident who is injured while you call EMS, complete paperwork, and make your notifications. Remember also to return the favors your CNAs are doing for you. When you have a moment that is not so hectic, one outside of your med pass and paperwork time, help a CNA finish one of her daily tasks. Fold a load of laundry, toliet or assist a resident to dress, answer a call bell or chit chat with a resident that is waiting for CNA care, give residents messages for your busy CNAS, set the dining room, etc. If you don't have time to do any of the above or if you just want to, then treat your CNA when you can. Most healthcare workers love a good snack or bottle of lotion. Another tip you may find useful... When issues come up during your med pass, such as maintenance issues, CNA issues, appointments residents mention, pharmacy issues, so on and so on, make notes on a sticky pad you keep on your med cart. Assure residents, families, whoever has brought the issue to your attention at the time, that you have made a note, and will handle the (non-imperative) problem as soon as your med pass is over, or will delegate the task to a person or department that can deal with it at that time. This will eliminate taking minutes off your med pass that are very valuable to you. Also, when an admission comes in on your shift, or esp during your med pass, make a quick initial visit with the resident and family. Gather important information that you must have immediately upon move in at that time, and then communicate that you will return for a more in depth visit, and to familiarize your resident with the staff and facility, after your pass is over. Quickly discern what you must do now for the move in process, do it, then set the rest of your tasks with that admission to the side for later, after your pass. Make sure that you return for that 2nd visit with your resident too. I agree with the tips from the other posts here. Prioritize your med pass. That will definitely help with your timing. Insulins asap, residents with narcs/PRNs who need them at a certain time, residents who need meds early and then residents who stay up late or won't mind taking them later. Also, using the "I would love to talk with you more about this, but I have to finish my med pass by ___ o'clock. Can we talk ____ (a designated later time)?" will be very helpful to you with your small talk problem. Just remember to go back and make your rounds with residents who want to talk with you. There's usually a few minutes each shift you can spend just for this. Lol. I also have to agree with the other response here that you will RARELY EVER get out on time. Staying late to finish up just comes with the territory here. So acceptance of that will be beneficial to reducing your stress about it. We all end up with this inevitable problem, so just know that it isn't that you're doing something wrong or aren't good at your job. It's all just part of nursing. Good luck to your dear. But I'm sure, like us all, you will find your own routine that works perfectly for you, in time. Take care.

[simplyme83]

Thank you I'm going through this now, and this is some very helpful info.. I'm a new grad just started my new job this wed on 7-3 but I will be working nights& weekends 12 hrs never trained on nights don't know all residents or diagnoses geesh..pulling my hair out already

[xoemmylouox, ASN, RN]

The sad thing is that you have 40 residents to care for. Time management is important, but what kind of care can 1 nurse and 1 cna really provide to 40 people?