Latest Comments by CoffeeRTC

Latest Comments by CoffeeRTC

CoffeeRTC, BSN 13,648 Views

Joined Jan 22, '03. CoffeeRTC is a RN LTC. Posts: 3,497 (22% Liked) Likes: 1,492

Sorted By Last Comment (Past 5 Years)
  • 0

    Its been years since I've seen or had to do one. Years ago it was common in LTC, but now it is classified as a sentinal event. Now everyone is on a plan and we have a protocol to prevent. I know you need an order but are you asking if it is in the scope of practice?

    Try sending someone to the ER for a disimpaction.

  • 0

    Might want to include dignity covers. Some foley bags come with flap on them now or we use the bags attached to the bed/ wheelchair. You would also want an infection control plan to keep those clean.

  • 1
    IowaKaren likes this.

    Wow.

    A few things. Before you send a resident to the ER, if it is non emergent, make sure you are sending some information to them about the resident. Transfer sheet should cover the basics with a brief history of what is going on, baseline for ADLS, LOC, diagnosis list, etc. We also call to give a verbal report to the triage nurse. This is important especially if you cannot get the paperwork together fast enough. If you are giving them a good picture on what you suspect is going on and their baseline that helps tremendously. Let the ER know that you did xyz before sending them.

    When EMS comes for pick up, give them the same report. Treat them like another part of the care team....they are. Sometimes we bounce ideas off of each other. (and take bets on who is right, lol)

    When the ER calls to tell you they are sending the resident back...ask....hey, what were the results of XYZ labs? i need a copy please! If you send someome out for cardiac S/S...ask about the EKG, troponin levels, labs, chest etc.

    i think that some ERs just get sick of getting residents that are dumped and sent blind (without report) and when they show up without family or with dementia, they might look for the quick fix and send them back thinking the drs in the LTC will deal with it in the morning.

  • 1
    Ladyscrubs likes this.

    I was thinking mattress too! Have you took a culture of the wounds?

  • 1
    Nursenicole1 likes this.

    As a LTC nurse, I find this very frustrating and a common occurance. I've seen it happen a lot.

    if ther is one nurse that is the only person that medicates all the patients all the time and you have really good, top notch nurses on the other shifts that do their jobs and medicate PRN....There probably is something up. It escalates too. Maybe their med isn't helping them like it should (because they really aren't getting it) so the doc gets called for an increase. I've see this happen. Or a resident that might get it once a day now seems to be getting it every 4 hours like clock work when the nurse is going a double. Normally it is the more confused or non verbal resident this would happen on.

    Diversion is so easy in LTC but hard to prove. What we try to do to prevent it is d/c meds that aren't used a lot. Change up the nursing assignments. If you can interview residents do that to get as much information as you can.

  • 0

    This is a very touchy subject for me right now . We are soooooo short staffed at work right now and while I'm not in on all the meetings, there seems to be little done about finding staff/ hiring. I see nothing in the job sites/ news papers etc. Agency is not being permitted. Staff nurses are forced to work OT...same with CNAs. LPNs and CNAs are unionized so there is a bit of protection for them, but it is insane.

    DNS is young....leaves after and 8.5 hour day and loves to post on social media her bar hopping activities. Tell me how this is OKay?? I'm talked about becasue I'm only part time, older and wiser and just say no to the extra shifts. Yes, I try to help when I can, but family situations don't permit me to work more hours.

  • 0
    In Pay

    It will depend on your area.

  • 0

    Most facilities have a complinace hot line. It should be posted.

    Try to work up the chain first. If all else fails, you can call the compliance hotline or state department of aging.

  • 0

    So does this resident just sit in their room and what??? Yikes! At the very least orders should have been put in for the resident.

    A full admit takes at least 3 hours to complete and that is when you have all the information and the resident is alert and able to sign things and answer questions...we are still paper charting.

    Who sets up the admission? They should have got the basic information from the last facility. Med list and H & P, face sheet info, recent labs. I'd be on the phone to the other facility asking them to fax that info STAT.


    how can one nurse do 40 admits in a shift?? How big is your facility??? We try to have a "desk nurse" to do the admits. One admit and working the cart might be doable, but anymore than that is crazy. BTDT and have the Tee shirt!

  • 0

    Does she have a pet that might need insulin? My first though was at the diversion or illegal use, but ????

  • 1
    xoemmylouox likes this.

    So, you are supposed to tell staff to keep their cell phone in their lockers at work, but to take a picure of the offenders you need a cell phone??? Wow. I've seen many a crazy rule but what the what?

  • 1
    NotAllWhoWandeRN likes this.

    LOL. I totally got this post from the get go. Some days I really don't have time to pee when I want to and yes, we end up holding it untl we almost burst.

    I really love when my co-worker will say the same BUT she oldly has enough time to smoke?? Hmmm. I guess I do have my priorities wrong, LOL.

  • 0

    Long time LTC nurse. If you can get your foot into the acute care setting, do it! Starting out LTC isn't easy. If it is your goal/ passion, then okay but both jobs as a new nurse....no.

  • 6

    Recently changed my name to stay more private.....Coffee RTC...how doesn't need coffee round the clock ?

  • 3

    We do it as you described. One page per med. Started when you get the med and just signed off with each does. We then have a page at the start of the book/ binder that we sign on at the start of the shift and off at the end of the shift. Each nurse has a spot.

    I might have at least 20 or more different carts, boxes of patches, injectables or liquids on my cart. I couldn't imagine doing all of that double charting. Is this a pharmacy consultant or nursing? I'd want to see the reg or back ground for the new requirement.


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