Tell me about your LTC on 3rd shift

volcomcna · Nov 30, 2010

Wow... sounds like your facility is busy ! I hope you get paid well for what you do! I also work 11-7 but it is nothing compared to your work!

2300- Initial in the resident book who you will be taking care of for the night/ read daily log. Usually 2 CNAs on the floor 1 LVN and 1 other CNA that is a 24hr caregiver for one of the residents.

2330- Pass new water pitchers

2400- Start first rounds, Our census is 18-- 9 residents per CNA and have 2 Fall risk, 2 feeders, 2 screamers. Take vitals for our side which is usually 2-3 vitals per CNA.

0200- Check the bed wetters.

0300- 30 minute break

0400- Start 2nd rounds and get up 2 residents each CNA (3 if I have time)

0630- Record Bowel n bladder, write in the daily log, empty all trash, and relax til AM shift arrives.

On the other hand, some nights we have only 1 CNA, 1 LVN and 1 24hr caregiver so it will be a little different....

2300- Inital resident book for who you will be caring for.

2315- Pass new water pitchers

2330- Start 1st rounds. ( 18 residents )

0130- Read daily log

0300- 30 minute break

0330- Start 2nd rounds

0530- get up 2 residents

0630- Record Bowel n bladder, write in the daily log, empty all trash and relax til AM shift arrives

Just a quick schedule it's pretty easy, less staff but also less work .

volcomcna · Nov 30, 2010

Oh by the way the time frame is kinda messed up it doesn't take an hour to read the daily log or whatever. there is a lot of down time and we can be sitting for 2 hours straight. some nights we go without call lights. ( just to be clear) :)

fuzzywuzzy, CNA · Dec 1, 2010

You only do 2 rounds in 8 hours?

DreamyEyes · Dec 2, 2010

I work 3rd shift in assisted living, but we have a lot of residents who need complete care.

We usually have 3 aides and 2 nurses on during the night.

Here's a rundown of my night:

11:00- Start first rounds (usually have about 8 residents to toilet/change/reposition)...Get any vital signs that need to be done.

12:00-2:00- Start laundry for 1st shift, pass out linen, answer call lights. There is either a LOT of downtime during these hours, or it's crazy. It depends on the night.

2:00- Second rounds.

3:00-5:00- Take 1/2 hour break, answer call lights, etc.

5:00-7:00- Busiest time of the night. First we start our last rounds, then we usually get up 3 residents for 1st shift..sometimes more, and get them washed & dressed. Also, a lot of call lights are going off at this time. About a 1/2 hour before the shift is over, I fill out the ADL books and empty the trash.

Of course, things don't always go as planned.. especially on the dementia floor. Sometimes it's quiet, other times we are crazy busy. I think the worst time for me is 3a-5a, because it draaaags by very slowly. After working all 3 shifts, though, I love this shift and I'm most likely going to stay on nights when I become a nurse.

fuzzywuzzy, CNA · Dec 2, 2010

You only do 2 rounds in 8 hours?

I still can't believe this. You said you have nothing to do but sit for 2 hours straight... maybe you could, I don't know DO A ROUND during that time!

I work first shift and we barely have time for our mandated half-hour lunch. Then again we do 4 rounds (not TWO) on top of AM care, showers, 2 meals, 2 snacks, walks, vitals, waters, bedmaking, constantly getting people up and down from naps, transporting to dining room or activities, etc. When we do have 20 minutes of downtime at the end of the day we "relax till 2nd shift arrives" by trimming nails and giving extra fluids, not sitting around doing nothing. And we have 9 residents apiece too.

I am so disgusted right now.

yousoldtheworld · Dec 2, 2010

I work at a Children's Home for the profoundly developmentally disabled, so mine is a little different than "normal" LTCs. 3rd shift is 10 p.m. - 6 a.m.

Each 3rd shift aide has a wing to themselves. Each wing is a little different - one wing only has 12 residents, two wings have 16 residents each, and one wing has 19.

The residents are all total care, and only a handful can walk, stand, or bear weight due to their disabilities. This can make taking care of them much more challenging, but on the flipside, we don't have call lights (the residents would not be able to physically use them nor mentally understand them). About half of our 80 residents are tubefed, and 16 have trachs.

A typical night goes something like this:

10 p.m. - Get report. Check each room, put away any laundry that has come back, and get out clothing for the next day. I don't do a full bedcheck, since 2nd shift was supposed to do one before they left, but I do make sure no one left them in a mess, since we have a few girls who are famous for that.

11 p.m. - Clean 4 wheelchairs per night - spray down, dry, change seat covers, clean cushions, etc.

12 a.m. - First real bedcheck. Change and turn residents. Every resident is total care and incontinent, so the rounds take a while. 12 - 19 people to turn and change every 2 hours.

1 a.m. - Pack the residents' bags for school and/or workshop. About 3/4 of them go to workshop or school every weekday, sometimes more. Get out coats and shoes.

2 a.m.- Next bedcheck, change and reposition residents, followed by my lunch break.

3 a.m. - I start my charting, filling out everything that I can before the end of the shift. I also use this time to straighten out rooms and do any cleaning that needs it.

4 a.m. - Another bedcheck. This is when I doublecheck everything in the rooms to make sure it looks decent for dayshift.

5 a.m. - Depending on the wing you're on, the routine is different. Normally you have one resident to get up completely on weekdays- normally one who leaves for school at 7 a.m. This includes bathing them on their shower days, bed bath on the non shower days, getting them dressed, teeth brushed, and in their chairs. If I have the time (and one of the dayshift girls who isn't a total JERK comes in after me), I get up one or two extra kids.

Breakfast comes at 6 since most of them leave, so the majority of the kids get fed in bed. On each wing you have a few who are choking risks, so they have to be put in their chairs before breakfast. They don't have to be dressed, just up.

Finally, before I leave at 6, I do one last bedcheck to make sure everyone is dry for dayshift.

It's a lot more relaxed than most places, since we don't have call lights to run after, but every resident is incontinent and has to be turned, so sometimes rounds take a loooong time.

yousoldtheworld · Dec 2, 2010

I work at a veteran's home in KY. I work 11-730 (if I'm lucky...mandatory overtime). What is your routine? I read some 3rd shift comments where they don't expect 3rd shift to get everyone up. I want to see what it's like in your LTC.
About my unit: It's a total care unit with 53 residents. Two are tube feeders, 6 are independent and can walk around. About 20 are fall risks, about 14 of them are major fall risks that like to fall at night. We have quite a few people that scream all night long. One screamer will also smear poop all over his room, horde knives, or steal his room mates belongings. There are about 3 people that can be on the light all night. A good portion of my men will verbally abuse or physically abuse the aides.
11:00pm: Clock in, hit the floor. Start running the bath water. Get the first carelift up for the bath. After that bath is complete, we get our other bath in which is also a carelift. Typically we have three staff on our floor. Two do both baths and the other does vitals for both halls. Although since we all started to riot months ago, our units gotten second priority which means there is a higher chance of having four staff on the floor.
12:00: Do first round. If we are only 3, we all work together to change both halls. If we have four, we do our own halls. Usually we'll pass linens and pull clothes out at this time.
1230-200: Hopefully rounds don't last an hour and we can use this down time to do anything we need to do like change O2 tanks, wash chairs on Sunday, exchange urinals, change sharp containers, do lift checks, make sure there is disonfectant in the shower stalls, and make sure we get our breaks in. During down time we have to watch certain frequent fallers like hawks (the other day one fell/crawled across the room moments after we left).
200: Next round.
300-400: Lunch breaks. We're lucky cause most the nurses don't get a lunch break because of the charting
400-415: check the heavy wetters, empty caths. We don't want to wake everyone since we'll be getting most of them up in an hour
415-500:breaks, prep the hall for get ups
500: Get ups. We're required to get everyone up on each hall except for a few. Hall one has 15 get ups (was more before a recent string of deaths), a good portion of them are stand up or carelifts which require two people at all times (facility rule after a lift broke on a resident) while checking call lights for the down ones and changing the tube feeders (or anyone in isolation). Hall two has 26 get ups, 10 are carelifts. Hall two is also the hall with most of those fall risks.
Breakfast is at 7:30 for these residents. Since we made the hub bub about the inability to get up all these people with 3 or four people, on good days, we're given 5 staff, 3 of which go to hall 2. My unit is probably the hardest unit in the facility, physically and mentally. Sometimes it's hard to get everyone up even with 3 people because of someone fighting or falling.
If we were lucky and had five staff, all people should be up at 700-715. If not, many people are down at 730. They used to (or only one nurse would throw a hissy fit) require us to stay till everyone was up. Some mornings we only have 3 staff which means most an entire hall is down. Imagine being on that hall two by yourself with 4 of those fall risks trying to jump up while trying to dress people? It's awful. I can take a lot and one day like that almost made me crack. Now, the nurses have switched it to where hall two has to have two people on it in the mornings. Being on hall one with only two fall risks to worry about and just dress people is so nice.
?

Wow. I have to ask - what exactly does your day shift do? I've worked places where I had to get as many as 8 people up, and even that was a little ridiculous for the end of the night. I can't even imagine!

volcomcna · Dec 2, 2010

I still can't believe this. You said you have nothing to do but sit for 2 hours straight... maybe you could, I don't know DO A ROUND during that time!
I work first shift and we barely have time for our mandated half-hour lunch. Then again we do 4 rounds (not TWO) on top of AM care, showers, 2 meals, 2 snacks, walks, vitals, waters, bedmaking, constantly getting people up and down from naps, transporting to dining room or activities, etc. When we do have 20 minutes of downtime at the end of the day we "relax till 2nd shift arrives" by trimming nails and giving extra fluids, not sitting around doing nothing. And we have 9 residents apiece too.
I am so disgusted right now.

I understand that your shift is busy but who's stopping you from working NOC ? You chose that shift and i chose noc .well if you feel that you have so much to do, the hardest part about NOC is staying up, and that's why people don't work NOC unless they have to. I could easily have a good nights rest and go in doing AM shifts work! I've worked AM shift before and I know what it's like, there is little to no downtime and thats great that you spend your downtime clipping nails and encouraging fluids, did you want to be commended for being the best nurse assistant? I also mentioned w'e do 2 rounds and w'e check the heavy bed wetters, some dont need to be changed 3x a night, and those that do are being changed 3x!!! did you think of that?!

1) AM care is AM care too bad there isn't a NOC care huh?

2) Wouldn't you like to have a shower at 3am.. When it's time to sleep?

3) Sure I pass snacks too, these people aren't hungry they just wanna sleep!

4) Oh Ms. Orange look it's 3am let's go for a walk !

5) Vitals are done every shift

6) Waters are done every shift

7) bedmaking is AM shifts job ( people wake up and then they maje thier beds ) and if I'm happy I will do it for the 2 residents I have to get up.

Hate to say this but really quit your ********. Don't compare shifts, everyone knows NOC has a lot of downtime but these people are sleeping for Christ sake :mad: _|_

fuzzywuzzy, CNA · Dec 2, 2010

Looks like I hit a sensitive spot. I'm not jealous that you get to sit around all night- I like 1st shift just fine. I'm also not trying to say that you should have to drag people out of bed at 3am to walk them- that's ridiculous and you know it. I was making a point about how if I can manage to change and repo my 9 residents four times a shift on top of all that other stuff then so can you. There is no reason to leave people laying in one position on the bed, possibly wet, for 4 hours if you're not even busy. Look at the other 3rd shifters who posted in this thread. As soon as one round ends they have to start a new one rather than sit around for 2 hours doing nothing.

volcomcna · Dec 2, 2010

You didnt hit a soft spot, it irks me because i know i do a damn good job taking care of these residents, if i didnt my residents would have bed sores by now, and they dont. I do more than i have to, and my residents appreciate me, thats all that matters really. We also get spot checked randomly by the DON during the night. Those night shifters have 18 residents per Cna of course they have to start the next round right after. when I'm the only Cna on the floor I don't have any downtime either w'e are a small facility it only makes sense that there will be lots of Down time. I know it's possible to change and repo all night but Honestly some of these people can turn themselves and w'e do repo every 2 hours that can't turn themselves .

daimere · Dec 6, 2010

Our first shift helps get anyone else up that we couldn't get up. They help feed the residents and do shaves and a few baths. They'll put whatever residents that are careplanned for bed after meals maybe and change briefs once before lunch. Then they feed for lunch. After lunch, they clear the lunch room of the residence and do their book for 30 minutes.