CoffeeRTC, BSN 15,542 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,559 (23% Liked)
Yep. I press #1 for provider if it will skip the wait time. I work in a LTC and we are the ones who call things in for the MD.
Never had a problem.
Doesn't everyone love a change of shift admit? LOL.
3-11 is the best shift for admissions...1 okay, 2 is iffy and when we get 3 or more...forget about it! Prioritize what needs to get done...initial meet and greet, orders verified and meds ordered. Nursing assessment and then skin check. Other assessments can be done after those are finished. Sometimes those get pushed to the other shifts. That is just life.
Don't sign what you didn't do. Either make a note on the assessment what and when you did it or redo it completely.
Reports of abuse must be dealt with by the director. I would absolutely follow up on that report.
Could you or should you? You can do anything you put your heart into, but should you....probably not.
experienced nurses have....more experience
Some LTCs are more like sub acute care....faster paced, more time management needs, clinically complex residents. It takes time for newer nurses to be trained.
Nope! Long time LTC nurse and I would have done the same. You gave a prn and carafate and they were still complaining of pain, diaphoretic, abnormal labs....Yep. As long as you document what you assessed and the interventions you tried and the calls to the doctor, it should be fine.
In my 20 years of LTC, I've never had EMS refuse a transport to the hospital.
We call 911 for emergencies and all others we call a local transport agency that is staffed with both EMTs and Paramedics. If they only have an EMT crew available and the situation warrants a paramedic or if they cannot give us an ETA, we are often told to call the local 911.
When you call for a transport, you should be giving a mini report: Why does this patient require transport to the ER?
If it is not a 911 full code/ cpr in progress/ circle the drain type of event....I call the family, make mini chart copies (one for ems and one for ER), call the ER for report etc. If things are going down fast...it is a 911 call and after they get in and assume care, then i make the calls.
Treat all EMS with respect. When they come into your facility greet them with report, go to the room and go over your assessment and why the MD ordered a transfer to the ER...give them the baseline of the resident and most of all...make sure the resident is ready (not soiled)
Wow...stick with that place if you get the 40 days. That is very generous! There are many threads on this subject in this section..browse thru them to get a little more.
I would make a time line to plan the shift.
7a- 730 Report/ get cart ready
730-8 check for appointments/ therapy schedule..do a quick round to check residents/ treatments
8am -1030/ 11 am Med pass and treatments
11:30 start noon meds and accu checks
12 help with lunch
charting/ follow up calls etc until the end of the shift.
In the morning..residents might be going for therapy or dr appts..try and get them first.
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