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CoffeeRTC, BSN 19,383 Views

Joined Jan 22, '03. CoffeeRTC is a RN LTC. Posts: 3,732 (24% Liked) Likes: 1,811

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  • 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!

  • Nov 23 '17

    NO, No, No!!

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

  • Nov 18 '17

    Yikes. I would be working with the MDs and pharmacists to get the list of meds whittled down....especially all the extra MVIs etc.

  • Nov 16 '17

    Geri psych stay?? Danger to self (hygiene issues that can lead to serious infections) and danger to others with the hitting, bitting, and bruises. Of course you are doing event reports for the staff injuries? Family involvement??

  • Nov 14 '17

    Psych eval? Depression related to nursing home stay?

    I'm the LTC nurse that would be calling you. I like the idea of having the resident sign off on getting the medication too. Does the fent patch need to be increased again? If he is truely in pain, that might help. I'd also make sure he is on a good bowel regime. Of course, I would be making sure everything is documented out of the wazoo and care planed.

  • Nov 14 '17

    We use this brand of foley and collection tube. The flush port on the actual foley is accessed by a needless Luer lock syringe
    and the specimen access on the drainage tube with a needle.


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