Nursing in Practice spoke with Lilian Uchechukwu about a day caring for the residents at Stowlangtoft Hall in rural Suffolk
The nursing home is situated in a remote village where finding a place to rent is difficult. The care home owns a number of cottages which it rents on Airbnb, and I’ve been staying in one of these since I arrived from Nigeria eight months ago. I came here alone – my husband and my three kids are back there, but luckily I’m taking some holiday soon and I am looking forward to going home.
My work start time is 8am, but I get in at around 7:30am so we don’t have to rush the handover.
My first task is to see the night nurse and carers to ask how the shift went. I might have worked yesterday, but it’s still a new day and I don’t know what has happened in the night. From their answers, I’m able to plan my day.
The next job is to check the notice board for any new information. We get information from carers on the first to the last room in the home and what work has been done in the night. The carers are the ones closest to the residents, so it’s a great time to get to know them better.
The next task to think about is staff allocation. As the registered nurse on duty, I need to look not just at the capacity of the staff but also their strengths, so I can place them properly throughout the wings of the home.
When all the care staff have been assigned to their wing, we’ll begin the first medicine round of the day. A lot of the drugs are time restricted, so we have an alarm clock set to help us keep track of the timings.
Another consideration in the morning are the GP visits for that day. The residents are registered with different GPs so I check which GPs are coming in and which residents are on the list. We make a note in the diary of any issues or medicines that need checking.
The morning is also a time to chase medicines from the pharmacy to ensure we have everything we need.
Every day can be different and there are often unforeseen circumstances. For instance, somebody could have a fall, so it wouldn’t just be business as usual. You have to make sure that resident is safe and take all the necessary steps.
During the morning I also check in on other members of the team to see how they are getting on, and make sure the residents are comfortable and safe.
When the residents have had lunch, it’s a little less hectic, so we’ll try to get a few different jobs done. The main business of the day is wound dressing for residents who might have a cut or pressure sores. Many are on patch medications, so we change those too.
We also check the residents’ beds. Most have an air mattress, adjusted for their weight, so we go around to ensure they are inflated adequately. We wait until the domestic staff have finished, so there’s no chance anyone will mistakenly pull the plug on a mattress and deflate it.
Although I have an opportunity to take a break, it is often so hectic that I don’t have much time. Sometimes I have to encourage myself just to take a bathroom break.
Some days ago, I was on duty when a resident fell. I had to take vitals every 15 minutes until the arrival of the paramedic. I had to make phone calls to the family and to the GP and await responses. There are days like this when other things just have to take priority.
After the residents’ dinner, we begin to plan for the next day. I put as much as I can in the diary for the incoming nurse because that’s how we keep track of everything.
After dinner there are activities. You get to know people’s likes and dislikes. Some might want to go straight to bed, but on a nice evening some might say ‘I would like to sit out and watch the sunset’, so we’ll take them outside.
I am contracted for a 12-hour shift, so I am still working in the evening. I write reports to document changes in medications or issues that arose during the GP call. I’ll then write up the progress notes and handover notes.
My day finishes at 8pm, but it doesn’t take long to get to my cottage. If I’m in the next day I will quickly head to bed, but if I have the day off I can relax, pray and rest.
Profile: Lilian Uchechukwu
Location: Bury St Edmunds, Suffolk
Main areas of responsibility: To care for the residents and ensure their safety; make sure they receive their prescribed medication in a timely way; and oversee the team of carers so the home is run as smoothly and effectively as possible.