A Day in the Life of a Nurse in a Nursing Home/ Care Home

Notes:

• Most care homes are separated by floors which are managed by 1 or 2 nurses and a team of HCAs or carers

• Usual nurse to resident ratio = 1:18 but can be up to 1:25

• Difficult residents usually have a 1:1 HCA

• Nurse responsibilities are mainly:

  • Allocating and managing the HCAs

  • Administration of medications

  • Nursing referrals

  • Communication with the MDT such as the GP, TVNs, podiatrists, dietitian, etc.

  • Communication with the NOK (next-of-kin)

  • Monitoring of poorly residents

  • Receipt and auditing of monthly medications – medications come in monthly cycles

  • Destroy and/or return unused or excess medications

  • Wound care and dressing

  • Nursing documentation, care plans, risk assessments

• Observations are not usually done daily or BD.

• Before the pandemic, observations are:

  • weekly

  • for the resident of the day

  • for those that need monitoring or are poorly

Typical Schedule Long Day

07:30 – 08:00

· Quick check of the residents – if breathing and alive

· Handover from night nurse to day nurse

· Handover from day nurse to care staff

· Check the nurse’s diary for the day

- Resident’s appointments

- Next-of-kin visits

08:00 – 10:30

· Morning medications

10:30 – 12:00

· Chase medication orders

· Communication with GPs, other healthcare professionals

· Taking observations

· Check bedside or room folders if HCAs are completing the papers such as:

- Food and fluids

- Repositioning chart

- Hourly rounds

- Bowel charts

12:00 – 13:00

· Staff meeting

- Meeting with manager, head of departments and other nursing personnel

- Overview of the day

- Urgent concerns

- Any changes

13:00 – 14:00

· Lunch time medications

14:00 – 15:00

· Lunch break time varies but will always be a one-hour lunch break

15:00 – 17:30

· Wound care and dressings

· Continuation of nursing care and nursing documentation

· Nursing documentation such as:

- Completion of resident of the day care plan

· Taking observations

· Nursing referrals

17:30 – 18:30

· Tea-time medications

18:30 – 19:30

· Check bedside or room folders

· Updating the nurse’s diary

· Continuation of nursing documentation

· Controlled drugs check/audit

19:30 – 20:00

· Handover to incoming night nurse

Typical Schedule for Night

20:00 – 20:15

· Handover from night nurse to night HCAs

20:15 – 22:00

· Night medications

· PEG feeds as per dietician regime

22:00 – 24:00

· Helping HCAs as needed with:

- Resident’s personal care

- Repositioning

- Incontinence care

· Updating care plans as needed

00:00 – 02:00

· Break – can be a one-hour or a two-hour break for sleeping

02:00 – 05:00

· Helping HCAs as needed with:

- Resident’s personal care

- Repositioning

- Incontinence care

· Updating care plans as needed

05:00 – 06:30

· Before breakfast medications

06:30 – 07:30

· Controlled drug checks/ audits

· Check bedside or room folders if HCAs have completed the papers such as:

- Food and fluids

- Repositioning chart

- Hourly rounds

- Bowel charts

07:30 – 08:00

· Handover from night nurse to incoming day nurse