Write down notes as you round on your patients. You may forget key information by the time you can chart on your residents. Use breaks in medication pass to chart on patients. It is very challenging to remember the details after a long busy day. If you use any downtime to chart, you will have less charting to complete at the end of the shift.<\/p>\n\n\n\n

Respect your staff<\/h2>\n\n\n\n

Treating other staff members with respect usually will result in them treating you with the same respect. When times get tough, aides that you have treated well in the past will usually step up and help you when you need it.  <\/p>\n\n\n\n

If you have a CNA struggling to provide care for the residents and have some downtime, take a few minutes to help them. <\/p>\n\n\n\n

It will be hard not to take it out on the other staff when you’re having a hard day. Work with them, and don’t be afraid to say thank you.<\/p>\n\n\n\n

Hold other staff members accountable for their actions.<\/h2>\n\n\n\n

The best way to do this is to lead by example. Try to arrive early, so you have time to review charts and assignments. Others will notice if you’re an early bird. <\/p>\n\n\n\n

Sometimes you will run into situations where your staff is not working. You will see them talking on the phone, heading in certain rooms, or just not doing the assigned activities.<\/p>\n\n\n\n

It may be challenging, but you need to hold them accountable for their actions. <\/p>\n\n\n\n

Suppose they are not doing their job, which puts more responsibilities on your shoulders. Plus, the other CNAs may grow resentful. They have to pick up the other person slack. <\/p>\n\n\n\n

Make sure to voice the expectations of your staff at the beginning of the shift and take charge. However, make sure to be very thankful to the staff members. Do a good job and assist you during your shift. <\/p>\n\n\n\n

Ask lots of questions. <\/h2>\n\n\n\n

What are the first things you should do when you become a nurse in a nursing home? It would help if you tried to identify a mentor. Most experienced nurses will give advice when asked genuinely. Almost every nurse I’ve ever spoken with has some tip or trick up their sleeve to make their shift easier. <\/p>\n\n\n\n

The flip side is don’t ask too many questions during the report unless something is missing. The quicker you get through the report with the answers you need, The quicker you can get started with your shift. <\/p>\n\n\n\n

Listen to others<\/h2>\n\n\n\n

Don’t be afraid to ask questions from those that have been doing this for a long time. You’ll be amazed at how much you learn just by asking questions and, more importantly, listening to what they have to say. You have two ears, two eyes, and one mouth. Therefore you should be doing twice as much listening and observing.<\/p>\n\n\n\n

Don’t be afraid to ask your CNAs for advice and to let them know to tell you if your patients are not doing well. <\/p>\n\n\n\n

Take good notes when you are getting report. Then spend a few minutes seeing who had bowel movements, due for lab work, wound treatments, and more. Try to prioritize your most important activities, so they get completed.<\/p>\n\n\n\n

You can’t always get everything done.<\/h2>\n\n\n\n

  You will need to learn to prioritize what is most important to get through your day. Just like you were taught in nursing school, try to identify the ABCs of nursing:<\/p>\n\n\n\n

1. Airway <\/p>\n\n\n\n

2. Breathing <\/p>\n\n\n\n

3. Circulation. <\/p>\n\n\n\n

After you do that, it’s all about making sure people get what they need to survive. Make sure your residents are getting their medications. Then you can start to prioritize what is most important, wound treatments, blood sugar checks, vital signs, or all of the above. <\/p>\n\n\n\n

Most days, you should get through most of the duties that are required of you. However, on some shifts or days, you won’t be able to get to everything. Working in a nursing home as a 24-hour seven-day-a-week position. This means you may have to delegate some responsibilities to the oncoming nurse. <\/p>\n\n\n\n

Make sure that whatever you’re not able to get done in time is put in the 24-hour report so that the next shift can get to it in a timely fashion. <\/p>\n\n\n\n

If possible, get your blood pressures and blood sugars done first to administer the diabetic and hypertensive medications. Many of these meds will need to be administered after checking vitals. <\/p>\n\n\n\n

Come up with a system for pulling meds. Maybe start with narcotics so you can sign out, then pull OTC meds, then regular meds, and then administer. At this point, ask patients if they need any PRN medications with the following medication pass. <\/p>\n\n\n\n

Make sure you get a good report from the previous shift nurse. If they don’t answer the questions, make sure you ask the right ones. Try to figure out how your residents are doing and what has not been done in a prior shift.<\/p>\n\n\n\n

 Try to learn what your residents like and don’t like. You can improve the speed and efficiency of your med pass. Identify who your blood sugar checks are ahead of time so that when you’re doing your med pass, you can combine your activities. <\/p>\n\n\n\n

If you’re working on a skilled unit, sometimes getting the pdpm sheet to use as your guide can lead to improved trip documentation. Make notes while you’re passing your medications on the sheet so that your documentation matches your day.<\/p>\n\n\n\n

When you are in a hurry, you run the risk of making a medication error. We all want to finish our shift along with the assigned tasks, but not at the expense of patient harm. You need to pay attention to the finer details to avoid these errors.e<\/p>\n\n\n\n

Avoid medication errors by following the rule of the “five rights”: <\/p>\n\n\n\n