I recently got an opportunity to get oriented on the 11-7 shift at my facility. There's only one RN who's willing to cover other people's shifts, and she claims she's too old to work five days a week, so I figured I'd let her show me the ropes so I could help her cover the other night RN's vacations and leaves of absence.
For the first 5 hours or so, I felt more like a clerical worker than a nurse. Well, more so than usual anyway. We calibrated the glucometers, checked the emergency equipment, recorded the temperatures in the refrigerators, and then audited each of the residents charts to make sure the orders were noted in the treatment and medication kardexes.
This shift was on..what did they call it...flip night? A third RN got all of the new kardexes ready for the new month, which involved another painstaking layer of audits and double-checks. We spotted some anomalies in the orders and flagged them for the next shift to hash out with the house doctor and the pharmacy.
The med pass for 6AM looked daunting, but I didn't have many treatments to do (mostly lower extremity vascular assessments and pulse oximetry) and I had flagged all the MAR cards ahead of time, so I figured I could make short work of it. I medicated a couple of people for pain throughout the night, re-tucked-in one of our dementia patients a few times, and got ready to bang out the medications, which were all scheduled to be administered right before the end of my shift.
Once the residents all started waking up, of course, was when the problems started.
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