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CoffeeRTC, BSN 20,040 Views

Joined: Jan 22, '03; Posts: 3,737 (24% Liked) ; Likes: 1,815
RN LTC; from US

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  • Apr 19

    I echo what everyone said above. POA only takes control when the resident is unable to answer for themselves. Do they have a living will that helps guide the POA for decisions?

    What about the hospice agency covering? Have you reached out to them? Are they providing support and education to the family?

  • Apr 15

    Honestly, 5 hours of paper work for one admit? That's extreme overkill? What assessments are included? Are you doing more than nursing assessments?

  • Apr 3

    Athletic directors can be anyone with a sports background and don't always mean they have any medical or athletic training. My husband is an AD and he is clueless on these matters.

  • Mar 22

    Yeah, I don't think most places would accommodate you on this one, especially since this is the overnight shift. We often have nurses pick up a different shift. If they come in 15 minutes early, they really can be "trained" on the night shift. The facility layout is the same, the residents are the same...there will just be a few different tasks that you may need to perform.

  • Feb 20

    Post in the LTC forum for more answers. This is a great question. We do a two step PPD on all readmits.

  • Feb 15

    NO, No, No!!

    Only thing I've seen in an emergency epi pen given this way.

  • Jan 25

    We haven't used side rails for at least 8 years. I honestly was surprised they are still used in LTC. A nearby facility just had a death due to entrapment.

  • Jan 10

    So, for those of us that are still using paper charting in LTC, maybe we should explain the process.

    The resident is admitted. Has orders on paper from the hospital. Orders are handwritten onto the paper admit order forms, then faxed to pharmacy. New orders are hand written by the doctor or more often than not, verbal orders are taken by the nurse and and then faxed to pharmacy. The faxed to pharmacy part is what scews up alot of things. Are they being faxed? I always wait for the confirmation that the fax went through. The next part is up to the pharmacy. The need to enter it into the profile.

    At the end of the month (at my facility it is the 24th) we get a print out of the next month's orders, MAR and TAR. These orders need to be checked with the orders in the chart and then clarified or adjusted as needed.

    Lots of potential for error but some ways to put in some checks and balances.

    Are the admit orders verified by a second nurse?
    Are the monthly orders checked by a second nurse?
    Is 11-7 doing daily redlining of all the charts to check the new orders?

    Our policy is to do all of the above AND we also go over all new orders in the moring clinical meeting to make sure that the orders were transcribed correctly from admit orders from the hospital.

    To answer the OP question....no.

  • Jan 10

    So, for those of us that are still using paper charting in LTC, maybe we should explain the process.

    The resident is admitted. Has orders on paper from the hospital. Orders are handwritten onto the paper admit order forms, then faxed to pharmacy. New orders are hand written by the doctor or more often than not, verbal orders are taken by the nurse and and then faxed to pharmacy. The faxed to pharmacy part is what scews up alot of things. Are they being faxed? I always wait for the confirmation that the fax went through. The next part is up to the pharmacy. The need to enter it into the profile.

    At the end of the month (at my facility it is the 24th) we get a print out of the next month's orders, MAR and TAR. These orders need to be checked with the orders in the chart and then clarified or adjusted as needed.

    Lots of potential for error but some ways to put in some checks and balances.

    Are the admit orders verified by a second nurse?
    Are the monthly orders checked by a second nurse?
    Is 11-7 doing daily redlining of all the charts to check the new orders?

    Our policy is to do all of the above AND we also go over all new orders in the moring clinical meeting to make sure that the orders were transcribed correctly from admit orders from the hospital.

    To answer the OP question....no.

  • Jan 9

    So, for those of us that are still using paper charting in LTC, maybe we should explain the process.

    The resident is admitted. Has orders on paper from the hospital. Orders are handwritten onto the paper admit order forms, then faxed to pharmacy. New orders are hand written by the doctor or more often than not, verbal orders are taken by the nurse and and then faxed to pharmacy. The faxed to pharmacy part is what scews up alot of things. Are they being faxed? I always wait for the confirmation that the fax went through. The next part is up to the pharmacy. The need to enter it into the profile.

    At the end of the month (at my facility it is the 24th) we get a print out of the next month's orders, MAR and TAR. These orders need to be checked with the orders in the chart and then clarified or adjusted as needed.

    Lots of potential for error but some ways to put in some checks and balances.

    Are the admit orders verified by a second nurse?
    Are the monthly orders checked by a second nurse?
    Is 11-7 doing daily redlining of all the charts to check the new orders?

    Our policy is to do all of the above AND we also go over all new orders in the moring clinical meeting to make sure that the orders were transcribed correctly from admit orders from the hospital.

    To answer the OP question....no.

  • Jan 9

    So, for those of us that are still using paper charting in LTC, maybe we should explain the process.

    The resident is admitted. Has orders on paper from the hospital. Orders are handwritten onto the paper admit order forms, then faxed to pharmacy. New orders are hand written by the doctor or more often than not, verbal orders are taken by the nurse and and then faxed to pharmacy. The faxed to pharmacy part is what scews up alot of things. Are they being faxed? I always wait for the confirmation that the fax went through. The next part is up to the pharmacy. The need to enter it into the profile.

    At the end of the month (at my facility it is the 24th) we get a print out of the next month's orders, MAR and TAR. These orders need to be checked with the orders in the chart and then clarified or adjusted as needed.

    Lots of potential for error but some ways to put in some checks and balances.

    Are the admit orders verified by a second nurse?
    Are the monthly orders checked by a second nurse?
    Is 11-7 doing daily redlining of all the charts to check the new orders?

    Our policy is to do all of the above AND we also go over all new orders in the moring clinical meeting to make sure that the orders were transcribed correctly from admit orders from the hospital.

    To answer the OP question....no.

  • Jan 9

    So, for those of us that are still using paper charting in LTC, maybe we should explain the process.

    The resident is admitted. Has orders on paper from the hospital. Orders are handwritten onto the paper admit order forms, then faxed to pharmacy. New orders are hand written by the doctor or more often than not, verbal orders are taken by the nurse and and then faxed to pharmacy. The faxed to pharmacy part is what scews up alot of things. Are they being faxed? I always wait for the confirmation that the fax went through. The next part is up to the pharmacy. The need to enter it into the profile.

    At the end of the month (at my facility it is the 24th) we get a print out of the next month's orders, MAR and TAR. These orders need to be checked with the orders in the chart and then clarified or adjusted as needed.

    Lots of potential for error but some ways to put in some checks and balances.

    Are the admit orders verified by a second nurse?
    Are the monthly orders checked by a second nurse?
    Is 11-7 doing daily redlining of all the charts to check the new orders?

    Our policy is to do all of the above AND we also go over all new orders in the moring clinical meeting to make sure that the orders were transcribed correctly from admit orders from the hospital.

    To answer the OP question....no.

  • Jan 9

    I took it as an elective in my last semester of BSN school. I loved it!!! It was a bit easier and kinda fun and a great way to learn different assessment skills and critical thinking. I took the tests and passed and got my NR-EMTB. Sad thing was that I never practiced as an EMT. To this day, 20+ years later, I still have some of the nemonics for assessments in the back of my head. That and I was awesome at CPR with all the practice we did in practicals and clinicals for that class.

    Do it!!

  • Dec 20 '17

    I did 3-11 and 11-7 for most of my 20 years. It worked better for my family schedule and as the others mentioned, less family and less of the office staff.

    Honestly, I never thought I'd say this, but I now prefer 7-3. It moves so much faster and there is less to do. Yeah, am meds are horrible and there are therapy scheduled and appointmens and two meals to work around. BUT..3-11 has less staff,no one around to answer the phones, clean up a spill, etc. We get all of our admits on 3-11 and then the sundowning starts as soon as the bulding empties out at 5pm.

    I wouldn't worry about not wanting to work the other shifts...unless you signed up to work all shifts. We would love to have a nurse that prefers 3-11 or 11-7 and is awesome at it!

  • Dec 18 '17

    lol. ...because you are the principal!


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