I started my career as an LPN.
I still remember the excitement of graduating and landing my first position in a nursing home. I proudly signed my name with “GPN” after it, and I couldn’t wait to transition that to “LPN.”
I smiled every time I wrote those letters after my name.
In that first job, I was the nurse responsible for a long-term care wing with 32 residents.
It was a lot of responsibility: medications, treatments, physician orders, charting, creating assignment sheets for nursing assistants, managing the dining room, delivering snacks, and so much more.
Honestly, I struggled at first to manage it all—I didn’t have the time management skills I needed, and that was a lesson they didn’t teach in nursing school.
So, I became intentional about learning how to manage my time and my residents effectively.
Here's how I developed my process for starting and managing my shifts:
Receive a detailed report from the off-going nurse to get updates on residents’ conditions.
Count narcotics to ensure accuracy and accountability. Never accept the keys if the count is off and follow up immediately to resolve any discrepancies
Create assignment sheets for the nursing assistants so everyone knew their tasks
Print out shower and skin check schedules and add them to the nursing assistants' assignment sheets.
Review the bowel protocol to track which residents needed assistance with elimination.
Review the MAR to identify which residents are diabetic.
Review treatment schedules and ensure all residents needing care were accounted for.
Prepare for Medicare documentation for residents requiring special charting.
Print out vital signs schedules to track who needed monitoring that day and add these to the nursing assistants' assignment sheets.
Print out weights and add them to the nursing assistants' assignment sheets.
Conduct rounds and assessments: Check in on each resident—this is very important, and many skip this step. You want to be sure that everyone is safe and stable at the start of your shift.
Give report to the nursing assistants, sharing what was needed for each resident.
Start the medication pass to ensure timely administration.
Complete treatments for any residents needing additional care.
Document everything: Accurate documentation is critical for continuity of care.
Communicate with physicians: Keep doctors updated on any significant changes in residents’ conditions, and advocate for your residents when necessary.
Keep family members informed: Call families to update them on their loved ones’ condition, ensuring they feel involved and informed.
Deliver snacks and document consumption, especially for residents with weight loss or diabetes.
Perform final rounds: Check on residents before the shift ends, addressing any concerns or changes in condition.
Receive reports from CNAs on any updates or changes before ending the shift.
Give report to the oncoming shift for smooth continuity.
As I grew into the role, I learned that rounding and conducting assessments were crucial to staying ahead of potential issues.
Not only does this ensure that every resident is safe, but it also helps you identify early warning signs that might prevent issues later in the day.
This simple step can save you from a crisis later on.
By staying in constant communication with my team, physicians, and family members, I was able to avoid crises before they started.
At first, this process felt overwhelming, but once I got it down, I mastered not only time management but also prioritization.
Anticipating the needs of my residents, communicating effectively with the team, and managing my tasks in a systematic way became the key to success.
Master these steps, and you’ll master your shift.
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