[nightmare]

I am in Scotland,IT so probably things are different. Our inspection teams will look for closed doors because of fire safety!( This is all because of a bad nursing home fire some years ago)I do agree with you that it goes against some of the residents wishes.A lot of them hate having the doors closed and will wedge them open! this is even worse if there is a fire!We do had door closers on some of the doors which are activated by the fire alarm but these are not on every door.

[withasmilelpn]

I spend a lot of time down my hall, helping meet my residents needs during my med pass, treatments, etc. With 2 CNAs to 30 patients, someone always needs something. It makes my med pass very long, so that I am never in compliance. I would say that I do generaly have very happy patients and family members though. But, as I never really sit down until my shift is over, I never get out on time-still have chartng to do. For hourly rounds to really work, and not make us break the other regs we must follow, we need to be staffed by acuity. An increase in falls on a unit should result in increased staff, or behaviors, IVs etc. Right now we have a patient getting IV push benadryl! We should not be doing this. LTC/Rehab is becoming increasingly complicated. (Of course, then insurance companies will start to demand that ALFs provide more assistance with less nursing, right?)

[facetiousgoddess]

count me in with Michelle126 and Withasmilelpn....I do what I think of as defacto hourly rounding....as I am always on my hallway, and can usually see into 3 rooms at any given time.

Acuity is truly an issue. Multiple IV's, tube feedings, trachs, fingersticks etc. Out of my 30 residents I had 12 on ABT's, not related to their admit dx, ended up doing head to toe assessments on 18 (because of comorbities) and more focused assessments on the rest. Was there till 2:30 am charting, taking off orders etc....

I love my job but it is really just getting to be to much...especially maintaining the standards we were taught.....

Tres

[gt4everpn]

I've said it before and I know I just might get blasted for saying it again but I dont know how or why some people enjoy geriatrics (ltc), I'm a new nurse and if not for the hospice and rehab unit my ltc has I would have learned nothing in the 8 months I've been working in ltc!!I try to gain as much knowledge as I can but my workload is so demanding learning isnt a priority! trying to figure out how to make them go or stop going is about all I've learned!! There is no support for nurses let alone new nurses! my workload increases everymonth from either management or the charge nurses with no pay increase! Families are out to get you and so is the state!, its sad, my facility has something called survey prep rounds where the ADNS goes to each floor and makes sure everything is squeeky clean just before the state rolls in! As soon as i get that RN license critical care here I come, atleast I know I'll learn something, anything!!