What is a typical night shift for a LPN in LTC?

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This is my very first thread so we'll see how this goes!

First off, I am a planner. I really like to be prepared and ahead of the game. I just passed my NCLEX and believe I've found my first J-O-B:yeah: They said that I will only get 3 days of orientation...WHAT?? 3 DAYS?? Are you ******* kidding me? Just to prepare myself and have a clue of what to expect, can someone run me through a typical 11-7 shift hour by hour. I understand every facility is going to be different; however, I'm sure that most of you have a game plan down and some order to your maddness. So please share some of your routines... I'm so green, I've never even been a CNA, so anything will help. :confused:

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That's not an orientation, that's throwing you into the ring of fire.

You really can't give a list like that unless you've worked in the facility. Different things fall on night crew depending.

However, you'll be starting a med pass at 5 a.m. That I'm sure of.

Restocking the med cart, making sure meds have been ordered, reconciling changeover maybe.

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Thank you! Once I start I'm sure I'll have a better idea...I'm just so nervous. Knowing that I'll only have 3 days to orientate, I've been spending the past few days reading, skimming this site, and more reading, to brush up on things I'll need to know. The thing is.. I'm not sure what to expect period in a long term care facility!! aarrrgg:crying2:

oh well, after I start I'm sure I'll be back with many more questions. Thanks for your imput!

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A friend of mines just started as a RN at a long term care facility. She said when she 1st arrives she gets a report, count the nacrotics,check the crash cart, briefly do rounds to make sure the patients are breathing and then begin her glucose checks. After glucose checks, she pass meds and do wound assessment, dressing changes and then documentation. As a LPN im sure you will be doing something similair to that.

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Specializes in LTC, Home Health.

I would ask for a longer orientation. I have had ones that short but never in the beginning. Please speak up if you do not feel comfortable after the 3 nights. I think nights are a great shift for new grads.

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I know there aren't tons of jobs for new grads out there but that orientation is just awful. I was just orientating a new grad and she was with me for 3.5 weeks then was with a nurse on second shift for 1.5 weeks (second shift will be her permanent shift) before she was by herself. I think all new grads need a supportive orientation and they need to be set up for success.

Let's see, night shift...I'm a dayshifter but I used to pick up a lot of 2nd/3rd doubles. Your responsibilites will vary according to facility but this is what I was responsible for at the two facilities I worked night shift at:

11pm: get report from second shift, count narcs, set up your sheets (it's a good idea to flip through and flag midnight meds, note who your accuchecks will be in the AM, etc.) Give a quick report to the CNAs, make sure they know who the AM get ups are, who needs to be T and P all night, who is incontinent, etc (actually if they have been there awhile they may be able to give YOU a report, LOL.)

I like to do a quick round, see who is still awake, if anyone is in pain, that call bells are in reach, alarms are in position, etc.

I also check the tx cardex at this time so I know if I have any treatments to do (night shift is usually responsible for G-tube and S/P cath type dressing changes only, and maybe some creams for inct. patients).

12pm: Take care of any midnight meds

After that, there are multiple things to do. The exact timing will vary, but you will have to start your AM med pass by 5 am so keep that in mind.

Common night shift tasks:

-chart checks (at my facility have to pull each chart and make sure there are no new orders that were missed and that all orders in the chart were properly noted and double checked. If an order wasn't double-checked the night shift nurse should do that when doing chart checks)

-blood glucose monitor checks

-checking crash cart

-checking temp in the fridge in the kitchenette and the med room

-if it's toward the end of the month reconciling orders/MAR for monthly turnover

-if there are any discharges NOC nurse is responsible for filling out the W-10 and discharge med list

-if there are any MD appts. NOC nurse fills out W-10 (except for vitals and last med time...day shift does that part)

-typically work on stocking med and tx carts if they have time

Of course you also have to field requests for sleepers/pain pills, if anyone has an issue you have to determine if you need to call the doc in the middle of the night, frequently I was short CNAs so I would help them whenever I could too.

The med pass/accuchecks will make the morning from 5-7 fly by. Then you count, give report and you're done!

I'm sure I'm missing some stuff, but that is most of what I remember from my time on NOCs. It's generally a lot less busy in terms of family members and extra staff but if someone goes wrong there's often not a lot of support staff available to help out.

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Make sure you know from report who the unstable pts are, and what their code status is.

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