Latest Comments by CoffeeRTC - page 2

CoffeeRTC, BSN 20,061 Views

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

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  • 0

    Anyone with experience in this field? I've posted this in the LTC forums and have got zero responses.

    I've been filling in at the Risk Manager / Staff Development Nurse in our LTC on and off for a few months. I'm currently self-taught. The LTC is a small non-profit with a small group that provides consultant services for a group. The set up is weird.

    I have a good general understanding of the position but was looking for more resources or support. I've even looked on Facebook groups but have come up empty.

    Can anyone here point me to support groups, organizations or resources?

  • 1
    sallyrnrrt likes this.

    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.

  • 1
    BeckyESRN likes this.

    lol. ...because you are the principal!

  • 1
    brownbook likes this.

    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!

  • 0

    Following this post. We have Relias too. I'm still trying to figure out how to set it up for new hire orientation. Do you do it as part of a classroom orientation?

  • 0

    Did you have the interview yet? I too am interested in a position in RM. I'm not finding much as far as support groups or message boards for support.

    I think RM would fall under the supervision of the administrator and not the DON. We've been looking for a RM/ SDC for a while and I've been filling in. One of my questions (when I finally give my intent to take the job) would be just that..."Who do I report to?" I assume the RM would then make suggestions, referals and then educate the nursing staff (SDC part of the job).

  • 0

    I think it all depends on your area. In some areas, LTC nurses are a dime a dozen. Some facilites are just happy to have a new hire to fill a spot and just want a warm body.

    You can't be blamed for the past citatations, but would be held accountable moving forward. They might give you some leeway for getting things up to par. Will you have support of consultants from the company or outside of the company? What about the people left in the facility?

    I don't think taking this job would necessarily mean career death, it sounds like a challange and it will be stressfull.
    I really think it depends on the LTC market in your area.

  • 0

    Quote from KelRN215
    Was it a PEG with a crossbar or a tube with a balloon? And did you have a replacement tube on hand?

    G-tubes replaced in existing tracts do not typically get XR confirmation, in my experience. In pediatrics, our patients have MIC-Key buttons or AMT tubes and parents are taught to replace those q 3-4 months at home.
    We haven't had residents with feeding tubes for years, but often times we were able to replace in the facility and then call for an xray to verify placement.

  • 0

    Please tell me her refusal for care is well documented and care planed out the wazoo? Why is she refusing care? Pain issues? Has psych seen her?

  • 2
    BeckyESRN and HeyHeyitsMaay like this.

    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.

  • 0

    Are there any LTC Risk Managers on here?

    I've been filling in for our facility. Right now I'm self-taught. I've skimmed our intranet and tried to pull up all info in the RM tab.

    How are you tracking your events (incidents)? Do you have a program or spreadsheet?
    There seems to be little info provided by our company.

    Right now I've been reviewing the event report and any witness statements (hunting them down if they were not done), reviewing the nurse's notes, checking orders and care plans. With this, they have an analysis form. It asks for a description of what happened, the cause, the immediate action or intervention that was taken and then any follow-up actions.

    Are there any resources for RM in LTC? Groups or organizations?

  • 0

    I work LTC. We have a mix of skilled residents that need a lot of care and long-term intermediate care residents. When you say 35 residents do you mean each or split between two nurses? Were there CNAs too?

    Abandonment only occurs if you accepted the assignment in the first place. If you took report or the keys then yes.

  • 1
    papillonailes likes this.

    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.

  • 7
    Beth1978, cyc0sys, NutmeggeRN, and 4 others like this.

    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??

  • 0

    Quote from JasBSN
    I work in LTC, we recently had a rep from the company who makes the briefs we use come in and inservice our CNAs. If a brief is leaking and you feel like the resident needs to be double briefed, you are most likely using a size too big. A standard brief can hold about a gallon of liquid if it fits properly. I have been told that it is illegal to double brief in my state (IL), but I have no proof to back it up. I do know it is against my company's policy and at the very least will earn you a write up.

    ^^^ This^^^

    You will not find it wrintten specifically "no double briefing" but it is a dignity and neglect tag.

    We've had "heavy wetters" before and I've seen CNAs do different things...full double brief, brief with a women's incontinence pad, brief with wash cloths or folded towel.

    Appropriate interventions might include a toileting or changing schedule that is resident specific or monitoring timing of fluid intake. Maybe that resident needs checked and changed hourly from 11pm to2 am? Maybe they need to increase fluids at breakfast and lunch and monitor intake after 9pm.


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