New Grad in SNF

[rene2010]

I am a new grad that recently got hired at a SNF and want to know if this is normal. I had orientation last night for the 10pm to 6am shift. The nurse that was orienting me first got all the meds for the night, then about 11pm charted that every resident had 0 pain, was sleeping, 0 interventions, and that every resident voided 2 times for the shift. He then went to pass meds, which included a breathing treatment, which the order stated to check lung sounds before and after the treatment, which he didn't do and just charted "clear." He went to give a bp med, which said to hold if sbp

[Kittypower123, BSN, RN]

Do things right, there are ways to make things go faster, but recording meds given before they were is wrong, as is reporting there was no pain during the shift at the beginning of the night (in fact, I believe it is considered false documentation - someone correct me if I'm wrong). What if you mark that a patient has no pain then give Norco for pain? If state audits that MAR, they are going to wonder what is going on. Unfortunately, there are lots of patients and little staff (especially during the night), but we still have to do things as best we can.

Handwashing is non-negotiable (either with soap and water or alcohol based hand gel). Vital signs means ALL vital signs - including temp and respirations - none of it should be made up. If something is going on with the patient VS can be an important clue. As for not doing something because it's "the CNA's job" - it is everyone's responsibility to care the patients. I never ask the CNAs to do something I'm not willing to do myself (of course because of time constraints I frequently am unable to those tasks, but I'm willing to when I can and need to).

[CapeCodMermaid, RN]

OMG---this is NOT how things are usually done in a good facility. He sounds dangerous and he wouldn't work for me for more than 5 minutes.

You shouldn't have left 2 hours before the end of the shift.

Can you nicely let the DNS know what's going on?

[Aem1215]

This is not just you, and this is not how LTC usually is. Please do those patients a favor and approach the DON about this guy!