Nursing home job

dcrrlb8185 · Sep 26, 2007

From my experience, punch in, get report, count narcotics, do some tx, med pass at 4:00pm, help with supper, do some charting, by that time many resident will be in bed, do some more tx, pass at 8:00, finish with tx, finish charting. Hopefully nothing crazy happen like a fall on floor in the interim. Good Luck!

TheCommuter, BSN, RN · Sep 26, 2007

I work on a subacute/rehab unit at a large nursing home/SNF, and here is how I organize for the day. I work 16 hour shifts, from 6am to 10pm. Typically, I have about 15 patients to care for. At the beginning of the shift, I'll go through the MARs and TARs with a fine tooth comb and, as I go, I will jot down the things that must be done in my notebook. My notebook is how I organize the rest of the day, and I usually won't forget to do anything. Here is how Sunday's notebook page looked (names have been changed due to HIPAA):

9-23-2007

DIABETICS, FINGERSTICKS: Agnes (BID), Agatha (AC & HS), Bill (AC & HS), Wendy (AC & HS), Rex (BID), Jack (BID), Esther (AC & HS), Margie (0600, 1200, 1800, 2400)

NEBULIZERS: Margie, Esther, Bill, Jack, Jane

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

IV THERAPY: Wendy (Vancomycin), Laura (Flagyl), Rex (ProcAlamine)

COUMADINS: Agnes, Agatha, John, Lucille

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

ANTIBIOTICS: Wendy (wound), Laura (C-diff), Rex (pneumonia), Agatha (MRSA)

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

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

REMINDERS: assessments due on Agatha, 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...

ex1140 · Sep 26, 2007

I hope your experience will be better than mine. My first gig was at a LTC/Rehab. There were 2 units LTC/Rehab and strictly Rehab, and they wanted me to be work both and the rehab floor was very stressful.

I had a lot of G-tubes, wound care, accu checks, labs, and the G-tube preps were tedious, and charting...and of course there were a lot of meds. Oh yeah...and if someone fell it threw everything off. There is a lot of paper work for falls. I would start passing very early around 4am in order to finish on time. I worked the LTC/Rehab unit most of the time and I worked nights. I had the floor all to myself most of the time a supervisor would show up around 3 am. However one night...oh boy!... I had 60 patients to deal with...the next morning the DON...saw me coming down the hall with my cart I was so exhausted she was afraid to say goodmorning...and the floor supervisor arrived at the same time...she replied "why didn't you call me" ...yeah right.

Needless to say, I don't work there anymore and I have a stigma where LTC is concerned, and I don't recommend them unless they are going to give no more than 10-15 patients because when you have 20 to 30 patients that is very stressful and anything will and can go wrong. I remember coming to work and finding patients in distress because the offgoing nurse was up to her neck in new admissions and didn't have a clue what one of her 30 patients needed attention.

Make sure it's a good LTC facility and as I stated I worked for a LTC/Rehab they are the worst...in my opinion. With LTC you see the same pts q day, but with Rehab they come and go and some should still be in the hospital they were releasing them way too soon. That's my opinion and experience, hopefully yours will be different. God bless you on your endeavors.