6:00 a.m.
INITIAL First Round
(First round is to check all Residents for major problems .. ie clean, change, reposition, etc.)
Begin to get residents up, dressed, groomed, make beds, give showers as time allows before breakfast. *Some nursing homes require all showers to be done prior to breakfast*

6:45 a.m.
Prepare and transport residents for breakfast (Overall heading to dining area, who must be lifted by 2 people = 10)
with assigned CNA's going to the dining room.
The Assigned CNA's on the hall, to pass trays to roombound residents.
Feed Roombound Residents on hall and then pass ice.

8:00-8:10 a.m.
FIRST BREAK
8:10-8:20 a.m.
SECOND BREAK

8:20 a.m.
SECOND round
This round consists of cleaning, changing and repositioning, etc. oral care, nail care, shaving (males) for all residents (not receiving showers)

Residents that are receiving showers, receive the oral care, nail care, shaving (males).

10:30 a.m.
FIRST LUNCH = CNA #1
11:00 a.m.
SECOND LUNCH = CNA #2

11:30 a.m.
Third Round
This round consists of cleaning, changing, repositioning, Prepare to transport residents to dining room for lunch. (same as above)

12:00 noon
Assigned CNA's to go to Dining Room
CNA's on hall pass trays and feed roombound residents.

1:00 p.m.
Fourth Round
This consists of putting residents back to bed, cleaning, changing undressing, repositioning.(Any residents that are bed bound)

1:00-1:10 p.m.
FIRST BREAK (if work is done and Charge Nurse approves.)
1:10-1:20 p.m.
SECOND BREAK (if work is done and Charge Nurse approves.)

1:30 p.m.
Last Round
This consists of clean, change, reposition, fill linens, take out trash, complete flow books, and other documentation.

**Other assigned duties, to be done during the course of this day are assigned vital signs (Anywhere from 5-20 Vitals may need to be done), taking residents to the bathroom as needed by the resident, passing snacks, feeding snacks to the resident who cannot do for themselves. Completing all showers for that shift. Completing all other resident, and Needs assigned by Charge Nurse.

This is just an idea of the schedule (based on performance seen at 6 am to 2 pm). Each nursing home or facility has a set of requirements they have.
Some homes, require as many residents as possible to be sent to the dining area. This generally could be by 8 a.m. and most showers and being dressed must be completed before they are sent to the dining area. Again, this depends on the rules and regulations of the nursing home, and how many residents you actually tend to.
There are some nursing homes, that allow the resident by their request to stay in the room for meals. There are other Facilities that want under any circumstances as many residents in dining as possible. This, is a hear nor there argument. If the resident refuses to go they have their reasons why they don't want to.

Resident Rights cannot be violated, if the Resident refuses to go the the Dining Area and the Nursing Facility tells you to bring them anyway, you must try to get someone, with superior authority to hear the resident refuse. Once this is done, documented the resident has the final say.

Please Refer to an article, written by Patti Green about HORIZONTAL VIOLENCE Horizontal Violence, is something that should not occur, but does occur.

The Focus of Horizontal Violence is for every Nursing assistant, Nurse, LVN, LPN, Med Aide, Restorative Assistant, ADON, DON, and down the line, to read and understand that an Inservice should be held regarding this Subject.

If you do read the Article called Horizontal Violence here or in the Journal for Nusing Assistants, Please, by all means suggest this topic to your Nursing Facility to be discussed at Length.
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