Creating a Shift Time Inventory

Creating a Shift Time Inventory

You are a 3 PM to 11 PM shift coordinator for a skilled nursing facility. You are the only RN on your unit this shift. All the other personnel assigned to work with you this evening are unlicensed. The unit census is 21. As the shift coordinator, your responsibility is to make shift assignments, provide needed patient treatments, administer IV medications, and coordinate the work of team members. This evening, you will need to administer treatments and/or medications to the following patients:

Room 101 A Gina Adams

88 years old. Senile dementia. Resident for 6 years. Confused-strikes out at staff. Soft wrist restraints bilaterally. Has small grade 2 pressure ulcer on coccyx, which requires evaluation and dressing change each shift.

Room 102 B Gus Taylor

64 years old. Diabetes. New resident. Bilateral AK amputee. Right amputation 2 weeks ago. Left amputation performed 8 years ago. Needs stump dressing on right amputation site this shift. Has developed MRSA in wound site. Wound isolation ordered. IV antibiotics due at 4:00 PM and 10:00 PM tonight. Blood glucose monitoring due at 4:30 PM and 9:00 PM with sliding-scale coverage.

Room 106 A Marvin Young

26 years old. Closed head injury 5 years ago. Resident since that time. Decerebrate posturing only. Does not follow commands. Percutaneous endoscopic gastrostomy (PEG) feeding tube site red and inflamed; medical doctor (MD) has not yet been notified. Needs feeding solution bag change this PM.

Room 107 A Sheila Abood

93 years old. Functional decline. Refusing to eat. Physician has written an order not to resuscitate in the event of cardiac or respiratory failure but wants an IV line begun this PM to minimize patient dehydration. Family will also be here this y and wants to talk about their mother’s status.

Room 109 C Tina Crowden

89 years old. Admit from local hospital, 2 weeks postop left hip replacement. Anticipated length of stay –2 weeks. Arrives by ambulance at 3:30 PM. Needs to have admission assessment and paperwork completed and care plan started.

Oral Medications Schedule

Room 101 A—4 PM, 8 PM

Room 101 B—4 PM, 8 PM

Room 102 A—5 PM, 9 PM

Room 103 B—4 PM, 10 PM

Room 104 C—5 PM, 6 PM, 9 PM

Room 106 B—6 PM, 9 PM

Room 108 C—9 PM

Room 109 C—5 PM, 6 PM, 8 PM, 9 PM

Create a time inventory from 3:00 PM to 11:30 PM using 1-hour blocks of time. Plan what activities you will do during each 1-hour block. Be sure that you start with the activities you have prioritized for the shift. Also, remember that you will be in shift report from 3:00 PM to 3:30 PM and from 11:00 PM to 11:30 PM and that you need to schedule a dinner break for yourself. Allow adequate time for planning and dealing with the unexpected. Compare the inventory that you created with other students in your class. Did you identify the same priorities? Were you more focused on professional, technical, or amenity care? Will your plan require multitasking? Was the time inventory that you created realistic? Is this a workload that you believe you could handle?