What to expect on PM shift?

[SlaveHeart]

In my clinicals we were at a facility from 7-3 three days a week for a month so if I were to get an AM shift I would know how to handle it. However I have no clue what to expect on PM shift that starts at 2:30. I am assuming to start out with brief changes and toileting. Then what do you do before dinner starts? After dinner more toileting, teeth brushing/denture care and then getting residents changed for bed. Do you take vitals before bedtime? I really want to practice taking vitals and observe different heart and lung sounds.

What else do you do during PM shifts? How do you handle sundowning? What other surprises will I be un prepaired for only having AM experience? Also is eight to ten residents a heavy load or a normal number of residents? During clinical we were in teams of two taking care of two to three patients so handling eight by myself seems like a lot!

[tenn_bsnstudent]

We then smile happily and skip merrily down the hall arm in arm to punch out because our day is now done only to reach our cars and drive home sobbing realizing we will have to return and do it all again tommarow.

Hahahaha this part made my day! But it is so definitely true!

[Abigail612]

@ TurtleCat: yes we do there is a Residents telaphone which we have to answer and deliver to the residents and there is a nurses phone. Often times the nurse is busy doing something and because it is evening shift there is no else around to answer it. A lot of times if we get phone calls in the evenings it is from a concerned family member or physician and really can not be ignored so we as the CNAs have to answer it, put the person calling on hold, and page the nurse.

@ futureADN: lol sad but true! I just want to add that I really do like being a CNA its just that it can be hard both physically and mentally and if you can't find humor in it you will snap!

[mstearns09]

I work the 2 p.m. to 10 p.m. shift at my facility and while there is a perception that it is the "easier" shift, it, by no means, is always easy.

We actually report to the floor at 1:45 for shift report. This takes about 15 minutes as we're a small facility. After I get report, I double-check any residents who are in their recliners or beds just to make sure they are dry. Once I do that, I make sure I have all supplies on hand, i.e. briefs, pull-ups, wipes, denture tabs, etc. I also pull out pajamas at that time and store them along with incontinence needs in the top drawer of their dressers.

I then check oxygen concentrators to make sure they have water in them. By the time this is done, I usually check to see if there are 3-day vitals that need done, find out if the nurse needs any partial vitals and find out if there's anything that the CNA previous to me left out during report. I check for wash cloths in rooms and toilet anyone who needs toileting.

Depending on which hall I'm working, I start getting people up for dinner around 3:45 p.m. because on one particular hall, we have residents who start ringing their call lights constantly at about that time and because of some extensive assists that require more than 2 people. If we don't start then, we get nothing done but answer about 4 particular call lights. I also toilet people during this time and get them to the next activity until dinner time. From about 4:30 to 6, we're in and out of the dining room taking people in to eat, helping people eat, and taking people out of the dining room. Our first residents will request to be in bed around 6:45. Yes, I said 6:45! It makes getting people cleaned up and out of the dining room very difficult but these two particular ladies think we're just there for them and no one else. We have a few residents who take advantage of whomever is assigned to them as their aide for that shift. One particular resident will make me take her to the bathroom at least 10 times a shift because she likes me. It makes it very hard for me to care for the rest of my people.

From 6:45 to 7:30, call lights are going off all the time and we're doing our best to keep up on answering them, toileting people, getting them dressed for bed and in bed or in their recliners for a while. It will slow down for about an hour and then at 8:30, a whole new round of constant light ringers starts again. I try to get ice and water passed during this time and if I'm lucky, I'll get my full 30 minute lunch break at anywhere between 7:45 and 9. I usually don't have my last resident in bed until close to 9:30 if I'm working one particular hall. We do bed check at about 9:30 and then the next shift comes on the floor around 9:45. We give report and if I'm lucky, I'm clocking it out at 10.

There are other things we do in between all of this like answering the phone, helping nurses with treatments (this usually only consists of holding up a foot or abdomen fold), showers if needed, taking out the trash hoppers, the laundry hoppers, etc. It would go much more smoothly on our largest hall if everyone would work together but there are a couple of aides who think no one else can do the job right but them and they treat the rest of us like crap. It makes it hard to work together when people are like that. We also have to work short very frequently. We are at a point where we need 4 aides on one hall but they only assign 3 aides and it's starting to take it's toll on us and the nurses.

[SlaveHeart]

Thanks againg to everyone who has replied. I start a pm shift this Friday thru Monday! I had my second interview with the facility today where I did a lot of paperwork and watched videos and took a tour of the facility. Then they sent me to get a physical/TB/drug screen. When I got back they said I was scheduled and gave me my calander and uniforms! They allow any shoe color and even painted nails. I haven't painted my nails in ages and am kind of afraid to for infection reasons.

So this week and my second week will be 'orientation' and I will be shadowing/working with a CNA whose been there for a while. I am going to search all the threads on here on what to expect during orientaiton/training weeks. Or if anyone would care to share their experience with their training I'd appreciate it.

Thanks