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.
Most of us are just in charge of a hall. We don't split it up like "you're in charge of this group," "you are in charge of the other" because we couldn't really do our job due to the 2 assist rules. We work together throughout the night an in the morning. Most of the time we work together unless we've split up to assist one assists. We're like family at my unit.
That's so crazy to me - dayshift most places I've been is ridiculously busy, at least until lunchtime. Must be nice for them to not have to get many people up. The dayshift girls at my facility have 8-12 to get up each day, depending on staffing, and they're all total care and most have to be ready to go out by 9.
My dayshift is really busy. Most of what I remember from orientation was just walking/fast walking around. Although we have a large facility. Now they are thinking of experimenting with our unit by knocking two walls out which would give us four less beds on the unit. This would be a private dining room. I just hope that they do it on the harder hall. Team one already has an isolation room + two private rooms.
yousoldtheworld
1,196 Posts
That's so crazy to me - dayshift most places I've been is ridiculously busy, at least until lunchtime. Must be nice for them to not have to get many people up. The dayshift girls at my facility have 8-12 to get up each day, depending on staffing, and they're all total care and most have to be ready to go out by 9.