new job in a rehab nursing facility..tips anyone??

TheCommuter, BSN, RN · Jan 3, 2013

I will start off by mentioning that I am a very task-oriented person. After all, skilled rehab in a nursing home involves multiple tasks that must be completed.

I worked on a subacute/short-term rehab unit at a large nursing home/SNF several years ago, and here is how I used to organize for the day. I worked 16 hour weekend double shifts, from 6am to 10pm every Saturday and Sunday. I typically had about 15 patients to care for. At the beginning of the shift I would go through the MARs and TARs with a fine tooth comb, and as I go, I would jot down the things that needed to be done in my personal notebook.

My notebook was how I organized each shift, and I usually wouldn't forget to do anything. Here is how one of my really old notebook pages looked (names have been changed due to HIPAA):

9-23-2007

DIABETICS, FINGER STICKS: Agnes (BID), Catherine (AC & HS), Bill (AC & HS), Wilma (AC & HS), Rex (BID), Jack (BID), Edith (AC & HS), Margie (0600, 1200, 1800, 2400)

NEBULIZERS: Margie, Edith, Bill, Jack, Jane

WOUND TREATMENTS: Jane, Bill, John, Jack, Lillian, Rose, Lucille

IV THERAPY: Wilma (Vancomycin), Linda (Flagyl), Rex (ProcAlamine)

COUMADINS: Agnes, Catherine, John, Lucille

INJECTIONS: Agnes (lovenox), Jane (arixtra), Rex (heparin), Bill (70/30 insulin), Edith (lantus), Mary (vitamin B12 shot)

ANTIBIOTICS: Wilma (wound), Linda (C-diff), Rex (pneumonia), Catherine (MRSA)

1200, 1300, 1400 meds: Margie, June, Rose, John, Jane, Jack

1600, 1700, 1800 meds: Rose, John, Rex, Lucille, Lillian, Linda

REMINDERS: assessments due on Catherine, Jill, and Louise; restock the cart; fill all holes in the MAR; follow up on Jane's recent fall, fax all labs to Dr. Smith before I leave, order a CBC on Rex...

<3RehabRN · Jan 8, 2013

Organization and time management are must haves. 25 patients is quite a lot, My unit gives us no more than 8 pt.'s, but we do have acute pt.'s that take ample amounts of time. We also get 1 CNA. Everyone does things differently and I'm not sure how your facility divides responsibilities among shifts. I, myself, work 3-11 on my inpatient rehab unit. I love it. I would say the best advise I received was coming into work early, about 30 minutes is enough time to gather your assignment and kardexes and review pt dx, orders, etc. I figure out who needs to have a BM, who needs wound care, etc. This way I have tasks written down to complete and keeps me on track. Good luck!