Time Management

[311ltc]

Work in an ALF. Recently one of the newer residents with alzheimer had a rapid progress with the disease. Requiring one on one :bugeyes:for around two weeks until medication adjustments have become moderately successful.

However this created overtime, espically on the evening shift. I have 33 residents to care for with one CNA, we also have to content with SNF residents that come over to the ALF unit (All residents are allowed to move freely throughout the facility). The ALF residents vary from AA+O X3 to various stages of dementia. This one particular resident is on the cusp of entering the severe stage of dementia. Add in a resident of 5+yrs that started sundowing about the same time and a resident with no short term memory who has a jealous streak that comes out when someone else requires attention from staff.

Of course administration is upset with the overtime, but for some reason can't or won't acknowledge that the overtime coincided with the above situations.

It's a struggle on a good day to complete everything and get out on time.

Does anyone have any acceptable shortcuts or tricks of the trade they can share?

I love my job and residents. I would really like to work with administration and hopefully they will be receptive to working with nursing and not just decide without input what we should be doing, especially since they don't work the floor.

Thanks!

[litbitblack, ASN, RN]

Sounds like some of these residents are not qualified for assisted living anymore and need to be eval for ltc

[makes needs known]

Go to your superviser, make her aware of what is going on, if she isn't already. Ask her to help you deal with behaviors or calling doctors to treat these residents before things get worse. Your superviser needs to help you. That is part of her job. Dementia residents and residents who have jealous/anger issues will probably get worse. you don't want injuries,too. Perhaps there is an infection that isn't getting treated. Perhaps pain is a problem. The more people who are involved the better the chances of management understanding. Of couse I'm sure this is a 24 hr facility, at the end of your shift, pass it all onto the next shift and leave.

[achot chavi]

The best way to prove that there is a problems is to keep a time diary one day where you write all that you did every quarter of every hour. Any client that needs more care- is not longer ALF- material- have evaluated.

I also advocate setting limits when you are pulled in many directions at once. Simply tell the client that you are busy with someone else and he has to wait- half the time they discover that they can solve their own problems...

If a client from a different unit is taking up your time and interfering with your ability to give YOUR patients proper care- simply call the unit and ask that they come take care of him or bring him back to their unit. Be kind but firm. Say it with a gentle smile and it will be accepted more. Remember the bottom line is that you are responsible for your 33 patients and if something happens while you're distracted- you could be sued!!!

Good Luck