CoffeeRTC, BSN 14,257 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,519 (23% Liked)
i love the fact that our new ADM is a nurse!
This might get a better response in the general nursing section.
I have had a coworker call out for not enough sleep. She wasn't punished... it was her PTO...
...but none of us felt very kindly towards her after absorbing her shift, her excuse spread through the gossip channels, and people stopped being willing to trade shifts with her, cover for lunch, etc.
You had time to sleep.
My facility pays for it. We've had local EMS come in to do the class and the last time it was a hospice agency's educator who did it for us. Not sure if they charged the facility or did it for a kick back type of thing and just charged for the cards.
Once you get into a routine, it will be okay. Moving around from place to place with out LTC background could be tough. Your ICU skills will be useful when assessing residents. Things get missed without a careful eye! Other skills will be used too...we start our own IVs and do a good bit of off hour blood draws!
Yikes, I couldn't imagine doing agency in LTC and not having LTC experience.
Will your agency send you to the same facility? Is this a long term assignment?
I have to agree...the 1:10 is a lie unless they are including nurses in with the CNAs? Even then it doesn't add up.
I would go thru and read some of the "new nurses in LTC" threads in the Geriatric/ LTC section.
Will you be house supervisor and/ or work the cart?
Organization is key. I work part time, so I try to come in a few more minutes early and read up on the 24 hour report for the last week or so. Get a census sheet and take brief notes. That way during report you have an idea what is going on with the residents. I like to know who is A&O, crushed meds, thickened fluids, fluid restrictions, IVs and any on going issues. For the most part, most of the residents are stable and do sleep at night. Its helpful to know the last prn pain med. (most get them on the 9pm round, so I will then know who is due early in the shift)
Start with the 12 a med pass and get the few treatments that need to be done then. Some IVs need hung then too.
After that i do the restocking/ checking the supplies and getting a list together for ordering.
Checking the lab book (labs from the PIC lines, specemins etc)
6 am med pass is a bit heavier with am accu checks and meds.
11-7 does the line changes too.
Well.. I see there is a certification in college nursing.
norco/ vocodin, percocet, oxycodone, oxycontin, Roxinal ....meds we see a lot for pain.
Yes!!!!! I argue this point all the time. If I was unable to transfer myself for what ever reason and I had to wait forever for someone to answer my call bell and help me to the bathroom, I would be incontinent. So when the CNAs are doing their charting and marking incontinent because they were....look at how it skews the #s!
Sometimes it is a fact. 2 CNAs, one nurse and 10 residents that need max assist at once....do the math.
I see most of the threads on hear are for the younger school aged children.
Are there any nurses here on the college/ university level?
Looking for what a typical day would be like? What type of work experience would you need?
This is right on line with the "offers you candy, reports to family that candy is stolen"
Showers/ baths are a big one. Document, careplan, document and make sure family is aware of all of it.
After you check the policy and procedure manual and get the go ahead, the biggest thing to remember is that they need to be replaced asap or stat. Many moons ago when it was common to use a foley for a g tube and we were able to replace them in house. These might have been used on the dementia residents that pulled at everything under the sun. At that time, we used a betadine scrub, lubed up the tube and inserted it. Wait too long and you were meeting resistance. We would follow up with checking placement and getting an xray.
I've worked in a small 50 bed facility that was owned by a for profit big chain and then changed to a small not for profit owned facility. I miss the big for profit so bad!!! With a corporation, there are clearly indicated chain of command, policies and procedures ordering practices, manuals.....etc. So so much with the smaller not for profit. There are different consultants for everything.
I've also worked in a few facilities that were around 200 beds. I like my little facility better. We know our residents and families. Staff is tighter knit too.
If you find a discrepancy and it isn't due to a math error, then what? What is the general policy? I looked at our pharmacy website and they had a nice educational video on this and included the Ftags etc.
I'm in PA and I thought it was all interactions. Let the state evaluate it and determine if it is serious or not.
Do you have a compliance hotline to call?
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