sub acute/snf describe your typical day

TheCommuter, BSN, RN · Mar 28, 2014

I am a very task-oriented person, and you will come to know that skilled rehab in a nursing home involves a bunch of 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...

readytobeanurse · Mar 28, 2014

thanks for responding. Did you do your assessments as you go. Im so used to doing my assessment on every patient then going to pass meds. What was your patient load?

TheCommuter, BSN, RN · Mar 28, 2014

Did you do your assessments as you go.

No, I saved my charting for the last hour of the shift. I never did true head-to-toe assessments unless I was admitting a patient because, as Sweet Brown would say, "Ain't nobody got time for that!"

I would only spend a couple of minutes on a focused assessment, pass the medication, change their dressings, and quickly move onto the next patient.

What was your patient load?

It was an average of 15 on day shift. During night shift I might have up to 35.

readytobeanurse · Apr 19, 2014

any other insight you can give on how to organize and time management? I have started. I have 16 patients. They use a computer system, I pretty much push a med cart around to each patient room. I do love the patients though. They are so sweet. But my last med pass took like over 2 hours. I guess with time I will get better.