Re: ALC solo nurse starting on the bottom floor
I've done AL management for several years but it's always been a (more than) full time job. What is the capacity for the unit? Who administers meds? What kind of med management system is used? Med errors are the biggest problem in facilities with "med techs"--non-licensed aides who distribute meds. They mean well but just don't have the knowledge base or judgment to handle the job. They require CLOSE SUPERVISION. I use the facility's assessment tool as a guideline but make up my own, more detailed form. For placement, you want to ask questions that will cover social and medical history (it helps to know ahead of time if someone has hepatitis, won't accept a female caregiver for bathing, etc.), what assistance is required with ADL's (families often downplay this to try to get them in at a lower level of care; many need more care when they first arrive), skin issues, mobility and fall risk,, mental status exam (MMSE), etc. Residents should be re-assessed after any hospitalization or change in condition or at least annually. The more you can learn about that resident the better--and remember that
we should adjust to
their routine as much as possible, not the other way around. Put a new photo of the resident in the MARS, also helpful for in event of elopement. Ask what is the main reason for placement now--it could be wandering, incontinence, confusion, a fall, death of spouse, inappropriate behavior, etc.--so you can address that issue right away. Keep the family involved but direct most of your questions to the resident. I ask the family to always let the potential resident answer first, then add their comments. Teach the caregivers to always treat the residents with respect, preserve their dignity, be patient and make them smile. If I can help with more specific questions, let me know.
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