CoffeeRTC, BSN 16,991 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,635 (24% Liked)
Why can't the DON just rewrite it?
I've had a similar thing happen to me. Its been a while so I don't remember the exact details. I reported missing narcotics and it was reported to the state. Someone from the department of health did call me at home for more information. I only work part time so it was easier for the call than having me go into work.
Did you call back??
I really hope this is homework.
Chart what you saw and what you did. I hope the MD was notified for some type of orders. Something is going on. You didn't mention what the resident did on the toilet. Was it a vagal response? Do they have s/ s of a uti? Diabetic? Low 02 sats?
As a nurse, I hope you know how to chart. We get a few new grads in my SNF and when asked, I will always help with charting etc, but allnurses shouldn't be your first resource.
I have 3-4 of these type of patients in my SNF right now. Very frustrating.
Every body is so danged sensitive these days and I think people go out of their way to get their panties in a wad. If it were my family member in a long term care / skilled nursing etc where they are not necessarily going anywhere for a while and the staff was telling me that there was an issue with them having an odor problem then (and maybe this in just my reasonable nurse brain speaking here) we look for ways to solve it. We don't shoot the messenger and get her suspended. Maybe Aunt Mable needs a stronger deodorant. Maybe the room is too hot. Maybe we don't realize that she asks for 4 blankets at night and she sweats like a mma fighter. Maybe she refuses her bath for everyone but this nurse. Maybe there is a little infection going on. There could be a much bigger picture going on that needs some cooperation of the family and the rest of the staff - not suspensions and hurt feelings because someone voices a concern.
Wow. I would love to work with those ratios. A secretary and unit manager? Sign me up.
We max out at 48 residents and normally hang out around 46. They just took the unit manager position away from days and have one floating between 7-3 and 3-11. They only want to staff with 2 nurses each of those shifts with the floater. CNAs...varies should have 5 on 7-3 and 4 on 3-11 but we've been at 3-4 and 3. I'm a well seasoned RN and things of leaving if this keeps up. Way too many geri psych and clinially complex residents.
It all depends. Pressure ulcers are preventable. We all know that. In a perfect world with adequate and above average staffing, great food, plenty supplies, restorative nurses where all the residents get the best care, your numbers still might not be 100%. Some residents just decline. The hospice patient that hasn't eaten in days and is in so much pain that the staff decides frequently turning causes too much pain...your in-house aquirred numbers are unavoidable. We all still strive for that number.
Same with skin tears. Accidents happen.
I've been a "lame" LTC nurse for almost 20 years. I used to think I need to try acute care to get the "real nursing" experience but have since wised up. I wonder what people think of when they hear LTC? Old confused grannies that wander around the hallways? Old folks just laying around with contractures and bedsores? Horrible smells? Tons of bingo????
It really isn't like that. Most of our LTC residents are up, dressed and out of their rooms every day. PT/OT/ SP or restorative nursing for most on a daily basis. Yeah, we have a ton of bingo. On the skilled side...we have complex wound care, TPN, IV antibiotics, PCA pumps, trach care etc. Nope, I'm not hanging cardiac drips or intubating folks, but we run like a sub acute unit in addition to our LTC stable folks.
I enjoy what I do. I'm really good at it too. We don't eat our young, but we sure do run nurses out that are not there for the right reasons.
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