Is there a flow sheet for nurses in LTC?

travel50 · Feb 7, 2009

At our nursing home, we have check off sheets only for the skilled residents, but I still expect narrative notes on them. However, it is like I said in reply to a similar post, you are overworked and understaffed, and you cannot perform miracles under such conditions. My facility is well staffed. Besides the floor nurses, we have a treatment nurse who takes care of many things. My floor nurses do not have more than 8-10 to chart on for any shift, unless there is a problem. When we are short staffed due to illness, weather, etc., my entire administrative staff goes out to help. That is to include myself (DON). Yes, I have more paperwork to do than I'll ever get done, but if my floor nurses are so overwhelmed that they quit, then I'll really be in a pickle. It is in my best interest (and more importantly, the residents') to keep their level of stress to the lowest possible.

barefootlady, ADN, RN · Feb 7, 2009

travel50,

thanks for the quick reply. I take it your answer is no flow sheet that you are aware of in your vacinity. The kind words are appreciated, I have just about made up my mind to start a search elsewhere for employment. I was given a schedule change without my knowledge or input too. I just happened to look into the schedule book for a nurse who called to check and see that I am scheduled for a quick return next week. Yes, after a 12 hour night shift, with only 1 other nurse for 60+ residents, I am expected to come out and fill in on the evening shift. Seems the supervisor has something important to do. It also seems that this supervisor talked to every other nurse at the facility and told them I was going to work for her, too bad she did not bother to ask me.

I think the nurse who called for the schedule check was really only calling me to give me the heads up on this situation. She has done this one other time when there was a mixup regarding my time. Needless to say, I will not be working the evening shift that day, they can stay over (the DON) or do without. I am just about ready to say goodbye, thanks but no thanks. I truly understand now why so many nurses just quit, no notice, no anything, just no call-no show. I will not do that but I will start looking as of Monday. I am just not ready to give up my whole life for these people.

BRemus · Feb 7, 2009

sounds like your really work for an understaffed facility. As the MDS coordinator I can t count the number of times i have come in at 3 am to cover for a call in or just no nurse available to be scheduled. Our DON doesnt work the floor but would if there were no other options. I hope that you find a job more suitable to your needs. There are flow sheets available but not many LTC's use them except for on their skilled residents. If you do decide to stay on at this job then check out medpass on the internet they have many flow sheets and a lot of time you are able to print up a sample to see if it fits your needs. hope this helps. Good luck to you

BRemus

minnib · Apr 6, 2009

I want to work there..PLEASE:-)

freddiebear · Apr 6, 2009

Barefoot lady- I hear ya. But, the nursing act states that every nurse must perform the acceptable standard of care less one be accused of unprofessional conduct. Charting is basic. For example if one of your residents were found deceased, with a broken bone, aspirated, on the floor etc. by the next nurse that came on and you did not chart their condition you could be accused of gross negligence. The fact you had to much to do and didnt feel like charting at the end of the shift is not an acceptable excuse or justification for not charting your skilled observations of the residents.

My opinion of flow sheets is that they take a lot of time to read every box, you have to read stuff that doesnt apply and it is not possible for them to include everything cause every resident is an individual and charting needs to be individualized. Many people do copy cat flow charting and the stuff they check off doesnt apply to the resident.

But, the forms are up to the facility and their policy. The nursing practice act doesnt care if you document on a flow sheet, a formal form, or a blank piece of paper as long as your documentation is legible, accurate, dated and signed by the author and place in the residents medical record. Of course if a nurse doesnt follow a facilities policy and some harm to a resident results the nurse could be guilty of negligence.

What you are doing makes about as much sense as walking out into traffic with a blind fold on thinking maybe I will get hit by a car maybe I wont.

If you are working too many hours, and getting too tired, maybe it is time to change shifts, cut your hours back or find a less stressful setting to work in.

barefootlady, ADN, RN · Apr 7, 2009

I quit this facility. It was one major problem after another with staffing, missing meds, and no support from administration. The cap was a med pass for 45 residents and many of the meds missing, takes time to pull them from the stock box, fill out paper work for them, only to be questioned about timely med administration. When I told them I was not interested in working under conditions that were so unsafe I feared for my license, they started asking me "what was so unsafe", so I told them. I lasted longer than many and have heard they could not keep the 3 nurses they hired to cover my job. I HATED this job, felt the residents were treated poorly, feed even worse, and

major problems ignored.

During a storm a homeless person came in and watched TV with some of the residents, ate some snacks, and lite up a cigarette. The nurse who asked him who he was there to see and gave him the regs on smoking was not treated well by administration. I have decided to take a break for Easter, then I have something in mind.

barefootlady, ADN, RN · Apr 7, 2009

Freddiebear,

I had worked almost 14 hours, only 1 break and no real lunch, the other 3 nurses in the facility did not chart either. We later entered late entry notes. Thanks for the advice, but I quit and never plan on working in a facility like that again.

Havin' A Party!, ASN, RN · Apr 12, 2009

Travel50 -- You're a wise DON. I work for one also, and very much appreciate it.

barefootlady, ADN, RN · Apr 13, 2009

travel 50,

I wanted to say thanks for the understanding reply you gave me. There were and are several things I cannot write about concerning this facility. I know the state has been called, put this one and one other from the same company on notice, shape up or close down. I really only wanted some type of sheet we could use for times like no staff but could check Y or N and sign regarding care issues and duties preformed.

LTC is so needed, can be so rewarding, fullfilling and even fun if the facility has dependable staff, including DON and Administration. Too bad this one did not. I know that 4 nurses have quit since I did, and that was only 3 weeks ago.