Dining Room Duties

Karou · Oct 25, 2015

When I works in LTC we had the exact same policy. Nurse had to monitor the dining room until every resident was finished eating. We weren't allowed to pass meds during this time. It was only a problem on the weekends, because during the weekdays the charge nurse or ADON would do the dining room. Weekends were minimally staffed and we didn't have anyone else to do it. It was chaotic and stressful. Their policy never changed, no matter how late med passes had to go to facilitate this dining room supervision.

NurseQT · Oct 25, 2015

I don't foresee the DON, ADON, or clinical manage supervising one of the dining rooms... It makes it all that more frustrating that the rehab/short term hall nurses aren't assigned to dining room duties. They have time to take breaks, have actual down time, and are the first to punch out. Yes, they do get busy but there's two of them on one hall. And why is it ok to leave the residents who stay on the hall for meals unsupervised by a licensed nurse but not in the dining room? Our dining rooms are at the end of one of the halls so it's only the other hall that's left unattended during meals. This is actually "my" hall, I currently have 3 at risk residents who remain in their rooms for meals. With the new policy there is only the CNAs on the hall at mealtimes, the nurse assigned to the hall will be on the other side of the building...

kbrn2002, ADN, RN · Oct 26, 2015

If it's any consolation that was tried at our facility and given up on after a fairly short period of time as it left the med pass too disrupted. There are plenty of CNA's in the dining room assisting with feeding and they can get help pretty quickly if a nurse is needed.

Eleven011 · Oct 26, 2015

The last 2 nursing homes I worked at the policy was that "someone", either nurse or CNA needed to be in the dining room until the last person finished. That made it much easier for us to leave and finish med passes.

BuckyBadgerRN, ASN, RN · Oct 26, 2015

I've worked in two LTC facilities, different procedures in both.

#1: There were two "wings" and a main DR. The nurse from the "long-term" care wing would stay in DR from first bite to last bite. If anyone ate on her unit, they were supervised by CNA's. The other wing was considered rehab but there were long-termers there too. LOTS of people on that wing chose to eat in their rooms (as in, perfectly able to eat in the main DR, they REFUSED to and wanted room service), clearly some were unable to join their peers. Some people would eat in the smaller day rooms on each wing, but honestly, probably a full 50% did not have a nurses eyes on them while they ate. The nurse in the DR would pass as many of her meds as possible while she was stationed out there. I never worked during a mealtime there, so I really don't know how smoothly that system ran.

#2: I do an every third weekend charge at a different facility now, so I am there for Bfast and Lunch on the days I work. Once in a while I'll pick up to work the floor as well. There are two wings, both are a mix of long-term and rehab. (There is also a smaller dementia unit, meals are delivered there and always staffed by a nurse and a CNA at meals). The floor nurse on the wings are in the DR for most of the meal, passing meds as much as possible. Once the CNA's are sitting to help with the feeders, the nurse will catch the residents who are eating in their rooms, the CNA's and kitchen staff are trained for choking and someone will run for the nurse immediately if anything happens. Again, not everyone is being monitored during meals d/t those who eat in their rooms

NurseQT · Oct 28, 2015

Monday went ok but there were no MDs rounding and no care conferences. And one of the two nurses working on the rehab wing usually works on the LTC wings so she came down to help at lunch time since she knows what it's like. It's still taking a lot of time away from med passes tho. Tomorrow will be the ultimate test, one of our providers will be coming in for rounds. He typically sees a lot of patients and writes a lot of orders while he's there. The floor nurses have to check their own orders and the oncoming shift usually throws a fit if any orders are left for them to check. I'm praying that I'm working with the nurses who are willing to help out when it's needed, because that definitely helps.

CoffeeRTC, BSN, RN · Oct 28, 2015

Why do they want a nurse in the dining room? Is it to observe meal pass and feeding? Is is to make sure the meal documentation is accurate? Is it to have a nurse there incase of an ememergency?

This seems to go back and forth at my facility. Point is, all staff should be CPR certified and that includes how to deal with choking.

NurseQT · Nov 6, 2015

Agreed Michelle!! We have not been given much direction in this... We don't know if we're expected to assist with passing trays (which would be hard if we're passing meds) or are we just supervising? Do we stay down there until the last person is done eating of until the last person leaves each of the DRs. What's the protocol if we're needed on the wing for whatever reason. Lunch has been the worst. We don't have big noon med passes, mine usually takes 20 min tops. They serve lunch starting right before noon there are typically a people still eating at 1! So we basically stand there twiddling our thumbs for least an hour! Once I can finally leave the DR it's after 1 and I have less then and hour and a half to finish up my charting, check any orders, and enter my VS in the computer. I go from standing there doing nothing (which I hate) to rushing around like I'm on speed (which I hate too!) by the time PMs comes in I'm tired and feeling like I may have missed something.

I don't like it..

CapeCodMermaid, RN · Nov 8, 2015

Most facilities swear there is a reg stating a nurse must be in the dining room. I have NEVER been able to find such a reg. I took the nurses out of the main dining room....it was 2-3 hours at breakfast and several at lunch and dinner. No ill effects---no one choked. There were nurses in the rooms where most of the residents needed to be fed and in the 'social dining room' where there was supposed to be a 1:8 ratio for supervison. And yes, Virginia, there are DON's who man the dining room on a regular basis.

Karou · Nov 11, 2015

Most facilities swear there is a reg stating a nurse must be in the dining room. I have NEVER been able to find such a reg. I took the nurses out of the main dining room....it was 2-3 hours at breakfast and several at lunch and dinner. No ill effects---no one choked. There were nurses in the rooms where most of the residents needed to be fed and in the 'social dining room' where there was supposed to be a 1:8 ratio for supervison. And yes, Virginia, there are DON's who man the dining room on a regular basis.

It's interesting how anytime an unpopular policy (unofficial or official) gets started in LTC, administrators are quick to bounce back with, "State requires it!". Everything unpopular gets blamed on state.