N1colina

I really appreciate when they stick around also, but don't you have translator phones available for when they leave?

Oh I'm so sorry... I just realized you were a PCA, not a nurse... So disregard that advice! I'm sorry. I think what you have listed is reasonable of a what a PCA should ask. You would want to ask how often they need vitals checked too (Q4, Qshift)

Well, they should be telling you all of this. You shouldn't have to ask, unless they leave certain things out. Some give better report than others (obviously) but I think what you listed is great. You also want to know their orientation. We're they alert and oriented x 3 for them? And now you've picked them up and they're lethargic, and oriented to self only... Very important to know their baseline. V/S and I&O's you should be able to get from the computer, unless of course the previous shift didn't do them (happens on my floor at times). You also wanna know how they take their medicine. This is a big time saver and safety issue. Of course, sometimes they can't tell you, (because the patient was NPO for them or whatever) and you have to figure it out yourself, but it's a huge help to know the 92 year old stroke patient takes her pills crushed in applesauce before you go in the room so that you can prepare them in the med room, and bring applesauce and spoons with you ahead of time! It's so nice to know this ahead of time, and saves you a lot of time and hassle of trying to get those pills down!

That's what I'm saying! I've always had at least 20... That's why I'm wondering if SNF stood for something other than skilled nursing facility...

Does SNF stand for something other than skilled nursing facility? Or is that where you mean?

I live in NY (not NYC) and we have 4-5 on days, 5-6 on evenings, and 6-9 on nights (nights is always short)

Also- BIG deal on our floor- you want to check who is being discharged that day. There should be a list of people going. You want to make sure those patients are seen first, given all their meds, and whatever else that floor requires with their discharge planning. This is where delegation comes into play, as well. As the RN, you would communicate with your nursing assistant on who is being discharged, so that they know who to wash up/ get dressed first. As the student, you may be doing all of this yourself, depending on your instructor, how many patients you have, and what semester you are in.

You will definitely need some form of paperwork to get organized. Whether you use a clipboard, or just staple a few sheets of paper together. The instructors in our hospital (and I'm sure in most) are big on infection control, and HIPAA so you want to make sure you're not leaving your papers anywhere. A lot of the students like to keep them folded in their pocket (I know, one more thing for your pocket!) Other essentials for your pocket would be at least 2 pens, a few 3 ml NS flushes, a few red caps, tape, and alcohol swabs. I never go a day without stocking my pockets with any of these (unless I'm in charge). Then, you want to write down all of your med times (noting any critical meds that have to be given on time, such as antibiotics, Parkinson's meds, seizure meds, BP meds, etc.) Some meds are given multiple times a day, and giving them late would screw up the patient's whole schedule. Everyone has their own way of organizing and you will find yours. A good tip would be to watch others. Observe those that appear the most organized, calm, and collected. That's what I did. I looked at several of my orientor's sheets (with their permission) to get an idea of how I could organize my own. They will help you determine which things are crucial to write down for that specific floor (such as a Hct/Hbg level for a post-op, recent V/S, any drains, O2, diet, how they ambulate). Having organized sheets and writing everything down, I found to be the most helpful way to prioritize, and maintain good time management skills. This way you have a plan, you know what you have to do. Of course there will be the unknown, unexpected events that occur, but that's the fun part! And that's what helps you learn! Good luck!

Depends on the shift on our floor. Ideally, we will have 4-5 patients on days (6 is a REAL busy day), 5-6 on evenings, and 7-9 on nights (we are always short on nights)

Good for you! Obviously this person has never worked in LTC... And we'll just leave it at that :)

I stand corrected. I guess new research (new to me) shows that Tylenol can be nephrotoxic as well :/

Just want to point out that all that APAP would be tough on your liver but either way, it sounds like BS that they didn't send you home with any pain meds after breaking your legs... 1 Lortab while you were there?? I'm sorry that you encountered that kind of experience.

Hahaha that's great!