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Caitlyn, a seasoned licensed practical nurse (LPN), is providing care for 20 residents on a 3:00 PM to 11:00 PM shift in a long-term care facility. There are two licensed nurse assistants (NAs) working with her, one of whom has just recently completed orientation. A third NA, who normally floats between this unit and an adjacent one, called in sick, and the supervisor cannot replace her. The supervisor had promised to help but is kept busy on other units. Throughout the shift, the new NA has many questions. One of Caitlyn's patients is in respiratory distress and has a temperature of 101 degrees F. she contacts the doctor on call and receives, transcribes, and carries out orders for oxygen, antibiotics, and chest x-ray. Several family members have visited, and Caitlyn has answered their many questions and addressed their concerns. She has also made calls to the physician, pharmacy, and hospice to facilitate a new order for morphine for another patient. There are also quite a few bed alarms and call lights she has to respond to over the course of her shift. She doesn't take any rest or breaks but manages to grab a sandwich. By 10:45 PM, when the.
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