old nurse/new to nursing home work

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I have been an LPN for 23 years, but I just started working per diem in a nursing home. I have a couple questions. Since I work thru an agency, there really is not Orientation. So, I ask, what is the best way to manage my time? When do you start your "Treatments," dressing changes, etc. After I finish morning meds,etc, its lunch time, then everyone goes off to therapy, visitors,etc. Also, I cannot believe that the other LPNs are really doing their "Treatments" For instance, when I go to put Skin Prep on someone's heels, they act like they never heard of it before. Are people cheatin on their chartin?

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Specializes in LTC,Hospice/palliative care,acute care.
I have been an LPN for 23 years, but I just started working per diem in a nursing home. I have a couple questions. Since I work thru an agency, there really is not Orientation. So, I ask, what is the best way to manage my time? When do you start your "Treatments," dressing changes, etc. After I finish morning meds,etc, its lunch time, then everyone goes off to therapy, visitors,etc. Also, I cannot believe that the other LPNs are really doing their "Treatments" For instance, when I go to put Skin Prep on someone's heels, they act like they never heard of it before. Are people cheatin on their chartin?

I'm 7 to 3.I run with the treatments in the first hour-I do the skin assessments (we do ours on the resident's bath day and I do mine before they get out of bed ) I assess and get vital signs as I go and get any fingersticks I need.I do any treatments I can-I instruct the cna's to flag me for any dressings,topicals that need to be done after am care and I take that stuff with me while I do the med pass.If it's a fast treatment and I'm on time with meds I'll do it then.If it's a more complicated dressing or I'm running short on time the resident may have to wait until I'm done the med pass but I always try to call PT or whomever if they have an appointment and may be late..Our cna's are permitted to do some of the topicals and we'll give them a med cup with a few squirts of the treatment.We have to have our med round completed between 8 and 10-that leaves plenty of time for treatments before lunch.I can catch up fast after lunch if I have to- .Sometimes we've been skin prepping someone's heels because they were a little reddened and boggy 10 months prior-don't sweat that kind of thing.The cna's can tell you what's going on-make sure you see any new areas of concern and note it.I don't know about others-if I have not done it,I don't sign off on it.I can catch up fast after lunch if I have to-if the resident is unavailable then I'll document that.Good luck

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I have been an LPN for 23 years, but I just started working per diem in a nursing home. I have a couple questions. Since I work thru an agency, there really is not Orientation. So, I ask, what is the best way to manage my time? When do you start your "Treatments," dressing changes, etc. After I finish morning meds,etc, its lunch time, then everyone goes off to therapy, visitors,etc. Also, I cannot believe that the other LPNs are really doing their "Treatments" For instance, when I go to put Skin Prep on someone's heels, they act like they never heard of it before. Are people cheatin on their chartin?

Sure sounds like it to me!

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I will be honest....I can't be in 100 places at once and sometimes the skin prep or some minor thing isn't done. If it isn't done, I circle it.

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