How many hours of care will you get in a nursing home?

You won’t get the hours promised

Direct and indirect care is more complex than you might think.    How many hours of nursing care will you really get?  I’m going to crack the door open a little bit by explaining subdivisions in care.  When you look at nursing time promised to your, it is divided into many groups.  The first subset is Direct vs Indirect care.   Direct care is the care that is “hands on” with the caregiver, in your room.  Indirect care is when staff are not in the room they’re not with you and they’re doing something else, but what they are doing pertains to you.

Direct Care:  This will show how many hours of nursing care you will receive before you subtract indirect care.

Taking vital signs:  includes blood pressure, pulse, temperature, respiration and oxygen saturation readings.

Taking your weight:  can either be done on a scale standing up, in a wheelchair where they wheel you on to a big scale, use a bed scale included in the bed or that can be attached to the bed.

Activities of daily living:  include brushing your teeth, taking you to the toilet, coming your hair, washing up, getting dressed, putting on shores and braces and make up.   These things take time and are included in the activities of daily living.

Changing the bed while you’re in it, because when you are in the bed they must do a special process to turn you over and over back-and-forth rearranging the linen underneath you.

Dressing a resident: takes time, choosing the outfit, getting the residents OK.  Assisting their arms and legs in them, getting them buttoned up zipped up and looking presentable.

Feeding a resident:   it may seem easy, just put the food down in front of them and let them eat them their own food. But not every resident can eat on their own.   There are different types of diet’s, and residents have different types of abilities to eat.  Some residents have difficulty swallowing so the staff provide one to one care hand feeding them their food.

Assisting with mobility: means walking and exercise.   A lot of times they just need staff to walk with them.   Then some people need a gait which wraps-around your waist giving staff a place to hang on to in case you get wobbly.  Many people need different types of things such as canes, walkers and holding on to a wheel chair. Mobility includes different types of footwear and braces needed for stability.

Emergency aid and support: is direct care involving many things such the initial assessment.   CPR or the chest compression and respiration.  The Heimlich procedure is included in the emergency and support which means anything take over for you while you are not able to do it yourself.

EKG’s is also direct care because staff are doing the tests.

Calorie count are done every shift.

Range of Motion is something staff does either passively, actively or with patient assist.  It means helping a limb to move or have motion.  If you don’t have motion you eventually stiffen and not be able to move at all.  Range of motion is very important

Repositioning and transferring:  With a gait belt or a mechanical lift which is used if a person cannot support their own weight and need to go from bed to another bed or to a chair or a shower chair.

Setting up equipment while you’re in the room is also direct care.

Assisting with incentive spirometer and cough deep breathing:  The Incentive spirometer will help strengthen your lungs.  Staff will teach and encourage to cough deep breath which clears the air ways.

Oral suction is direct care helping to remove mucus from the throat and upper chest area.  It will help you to breathe easy.

Setting up chest tubes:  preparing for placement or changing the canister.

Preparing fora sterile procedure:  creating a sterile field and supplying it with sterile supplies to do a sterile procedure.

IV care:  observing the site, changing the dressing flushing, flushing and medicine through the system.

Post mortem care is the care your body receives after you have died.


Indirect care:  This will show how much indirect nursing care you will receive.

Cleaning equipment: when you’re not in the room.

Room care:  don’t need to be in the room to have the room cleaned and the bed made or sweeping and mopping.

Taking Specimens to the lab

Making phone calls: calls made in your behalf to doctors, therapist, your family or any one of many people involved in your care.

Assembly of Orders:   After the doctor gives orders the processing of the order is not always easy.  It takes a bit of time to get that order all the way to completion.  It needs to be entered into the computer, and a decision made to which times of it’s a medicine is going to be given not to interfere with other medicines.   It’s may be a dressing or a special diet. Equipment may need to be ordered or arrangements for transportation.

Stocking supplies: Many supplies are used throughout the day in many different procedures which need to be ordered and put in the supply room.

Cleaning the nursing area:  a good clean nursing area helps the keep things organized and running properly otherwise papers may fall on top of other papers causing chaos causing things misplaced.

Cleaning patients after a procedure:  Doing the procedure is direct care, however cleaning up a patient and the supplies are considered indirect care.

Supplying the cart:   Besides the stock room we have many carts to stock and maintain such as the emergency cart, and Oxygen cart to name a few.

Obtaining and delivering blood products: is a very timely procedure.  First the order sent down to the lab, so the lab tech’s can order and check the product. Once verifies by them, a nurse will double check everything with the lab tech.  Then two nurses will double check the order and the product before bringing it into your room.  At that time, it will be double checked with two nurses again and vital signs taken.  It can be a very lengthy process.

Orienting ancillary staff:  or staff that comes in to fill in during a nursing shortage.   They need to be brought up to speed, given instruction and filled in on the operation of the unit.

Keeping logbooks up-to-date:   There are many logs to keep current, from how many staff are on each day on which units, refrigerator temperatures and tally of supplies.

These are the first two divisions of time, this will better show the hours of nursing care you will receive.   By looking at this you will see the time promised to your is effectively cut in half.  So, if you expected to receive 3 hours care, at this first juncture of division, you now know you will receive only 1 ½ hours care.  But stay with us and you will find that there will be many more divisions, and the time you expect to receive will become smaller and smaller.


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