Please help! Questions I haven't read here curious!!! - page 2

Hi, I've read lots of threads here and they are very helpful! I am considering a position in LTC and I'm skeeeeeered! I am SO used to having my own "little" group of patients, and I like to know... Read More

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    Ok - I've been fortunate to bounce around a bit over the years and have seen how different facilities handle admissions. The best, hands down smoothest ones were facilities with an 'admission nurse' - the most chaotic were the ones that 'all nurses' take part in. I always felt when I was the admission nurse that it was the safest - I could go through the chart uninterrupted and would pick up those pesky details buried in the chart - an allergy listed on one page out of 25 that of course wasn't on the face sheet (more common than you think), the length of that PICC, ALL the dx - again not on the transfer sheet, review the labs - and medications - totally be on top of what I needed from the doc in advance.

    Besides being safer, I knew I could give all my attention to my admit, making them welcome, orienting them and getting them settled and comfortable, do a thorough assessment and history, talk with their family, much more than when a rushed floor nurse with other patients.

    First impressions are important, I think facilities that make admissions a priority are more likely to have a better reputation than those that don't.

    The facilities with a lot of nurses with their hands in admissions typically miss info, drop the ball with certain parts of the admission because no one took the responsibility to get it done, or assumed it was done, etc etc

    But that's just my experience,
    AZMOMO2 and BrandonLPN like this.

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    Quote from BrandonLPN
    How a resident takes their pills should be written at the top of their MAR. Third shift writes that sort of info at the top during end of month changeover.

    In most LTC facilities you don't need report on every resident. Do you really need to know Mrs Jones went to bingo and talked to her granddaughter on the phone? Anybody with anything going on should be written on some sort of 24 hour board.

    There should be some sort of daily bowel care log. The third shift nurse should review the CNA flow sheets and initiate bowel care for the other shifts to follow up on. If ts made part of the daily routine it's easy peasey and never gets missed.

    Good facilities will have the unit manager process admissions. Crappy facilities will make the floor nurse do it and interrupt the med pass.
    Well said. We (floor nurse) trying to make management aware but no changes so far.
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    I work at a crappy facility. Sometimes 5 admissions a day all on the 3-11 shift. At best at times the supervisor will help and other LpNs volunteer to help. Most times the nurses that have admissions don't leave until after 2am in the morning. As far as the MAR's , if you yourself don't write on the Mar's crush or whole, it won't get done. I suggest you ask the nurses that are familiar with the patients if they take meds whole or crushed. I hope you are in a good facility and have some good CNAs.
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    The Holy Grail of the Nurse---CYA Because management will always hang you out to dry!

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