Chris81

Chris81

geriatrics,wound care,hospice

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About Chris81

Chris81 has 33 years experience and specializes in geriatrics,wound care,hospice.


I am an LPN working in NW CO in an Eden LTC . Currently at my position 23 yrs. I have worked exclusively in LTC for 33 yrs. I am married with 2 children, boy-21, and girl-15.

Latest Activity

  1. The Cons of Working in Long Term Care

    My use of the word incompetence arises from the basic floor- nursing checklist for skills all nurses are expected to perform,sometimes on an hourly basis,sometimes once every 5 years(vital signs to how you hang TPN&lipids,with a long running IV-A...
  2. The Cons of Working in Long Term Care

    Funny-the crisis when I was a year-old nurse was the introduction of DRGs-veteran nurses were warning us we'd get "fresh radical necks","chest tube with glass bottles on the floor,grab your hemostats" being admitted to nursing homes,booted from hospi...
  3. The Cons of Working in Long Term Care

    Spot on,Commuter.Have also followed your posts regularly and agree. SNF 34+ yrs myself(started at the starry-eyed age of 19) and have recently(thankfully) had the opportunity to continue in LTC in AL/MC 1 month ago,when present SNF taken over and exp...
  4. Questioning the nurse during clinical

    Bravo! You grew your judgement that day-don't feel like a moron,feel like your nursing education(classroom content+clinical rotationsxREAL LIFE EXPERIENCE= a well rounded nursing student,who will be up to the tremendous task of being a nurse. Go ahe...
  5. New RN with attitude...

    This may be one of those rarely seen" probationary period" Do Not Hire situations. She sounds like she really doesn't want to be working there,despite many efforts to address real concerns. OR-give her enough rope.....
  6. Therapeutic fibbing..?

    Research validation. The core of this very humanistic approach to cognitive impairment(acute or chronic) is to accept an invitation into someone else's heart and mind for awhile. Accept that this person is frightened,angry,in despair,lonely,lost,sear...
  7. Medications 6x a day question

    At our facility,we've made a concerted effort to:reduce/eliminate waking elders from sleep to administer meds. MDs are completely on board with this,and nurses will ask if something ordered q4/6/8 could instead be given close to this while awake?ABX ...
  8. Skilled Notes

    Our MDS coordinator laminated heavy copies of these and PERSONALLY handed them out to all nurses in our facility to guide our charting. After years of SOAP,narrative,checklist and general meandering around trying to capture the past 8 hrs.of this pe...
  9. Medical Marijuana

    In our LTC located in Colorado where MMJ is legal on the state level,we do not permit the (state) legal possession,consumption or self-medicating of MMJ on our non-smoking campus because we receive federal dollars through CMS,and marijuana still crim...
  10. Post Fall Neuro Checks

    VS immediately with grips,speech,pupils,mentation. Repeat q 15 minx1hr,q30minx2hrs,q4hrsx24hrs,q shiftx72hrs. restart sequence c each fall(even when multiple falls occur within this time frame. Labor intensive c frequent faller(65
  11. EMARS

    NOTE-[this is from a LTC perspective] I did the end of month recaps for a 59 bed facility on paper for the past 8-9 yrs,noting every order,d/c,edits(time changes,preferences,etc),carry-overs,dx/med.on a 59 bed unit with and average of 7-9 med sheets...
  12. Holy Wound Batman!!

    Don't see too many of these anymore(thankfully!) I'd try to manage exudate first-alginate rope for packing-loosely!-foam as secondary. This will help odor as well. Karaya paste as perimeter to secure dressings to helps in difficult spots. Skin prep t...
  13. Anti-Intellectualism/Autonomy in nursing

    LOVE how you think! Though not a newbie,practicing 30 yrs.,LTC, I'm grateful that I've been able to work in a field that encourages critical thinking every shift. My mind has been sharpened year by year,enhanced by experience and balanced by a hun...
  14. Cutting VAC foam

    Just had visit from our V.A.C. rep yesterday,good to get refreshers/updates/tips! You can cut more than one piece of foam for a wound, if you're not good at eyeballing the shape. Better to have 2 pieces that fit,rather than in/out, or worse-too big...
  15. The Final Word on IV Certification for LPNs

    As scope of practice varies from state to state,so does the elusive and much sought "IV Certification" for LPNs. I was certified in Colorado in '80,at the urging of my administrator in my newish job in a LTC. She was reluctant to hire an LPN c 11yr...