CoffeeRTC, BSN 18,076 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,689 (24% Liked)
Sounds like you need to bring this up with you manager or maybe you have?
I haven't worked with an RT in years since I do LTC, but that sounds like a lot of patients for 2 RRTs to cover? Do they really go over to the nursing home section? Unless they have vents, why?
Put them in, less chance of them getting lost or droppped.
As long as they fit, it only takes a minute.
Um, no. Don't go buying supplies. I've worked in a place like this. (I think you do rehab too?)
I know for a fact that sometimes supplies don't get ordered until the last minute because of the budget. We order supplies from a pre approved vendor and get them once a week or sometimes every two weeks. The problem is that a non medical person orders supplies and doesn't ask nursing for any input (we've since started leaving a notebook where we ask for supplies or tell them what is low) Sometimes this non medical person needs some info on why we might need a certain thing sooner than the next delivery..maybe we get alot of residents with extensive wounds and need more abds or 4X4s or it could be cold season and we are using more OTC meds like tylenol or cougy meds.
If we run out of a supply we can do an emergency request from the pharmacy (much more expesive than the other approved vendor) but when you need supplies, you need supplies. I've had to do this for test strips for the glucometer, syringes etc. We are supposed to get approval from the DON first. A few calls in the middle of the night asking for supplies normally get things ordered more efficiently.
It really is going to depend on what facility it is? Isn't Genesis a big company?
Faint wheezes to me would mean that they were hard to hear but there.
A few tips that could help.
Get to your unit a few minutes early. Get a report sheet/ census sheet or whatever you use for your notes. Skim thru the last few shifts of report (if you have a 24 hr report book), check the appt book or lab book, pull up your list of res with no bms etc. Jot this down before your verbal report. While you wait for the next shift to get report...stock your cart (if it needs to be done) Skim thru your treatment book and make a few notes too.
If you need to do staffing/ assignments do it now.
These few minutes can mean the difference of a good vs bad shift. I try toget to work at least 15-20 minutes early since I don't work that often and catch up.
Once your body adjusts to your activity at work, it will slow down on the weight loss. I wouldn't be worried about it or complain! What did you do for activity prior to nursing? If you were sedimentary before, what you do at work could be a big increase in your activity level.
So, when you see them not following p and P and a resident gets hurt with a transfer, then what?
Not a good situation.
What part of PA? It varies in the different regions. I work for another chain and it varies from facility to facility even in the same region.
I would ask if she has something in her eye.
If I've been working alot of days in a row, I might need to know a lot less. I work weekends so I need caught up a bit.
New residents I want to know the primary dx (what are they here for) level of orientation, pills whole or crushed, any IVs, Diabetic or not? That's a good start for a quick type of report. The rest I can look up.
Are these nurses that don't want report full time regulars? Not much changes that fast in some LTCs so that I why report can be streamlined.
Wow...not like that were I am.
How often are the docs coming in to see the residents? What type of supporting documentation are you doing for the pain meds and assessments?
If there is really that progression of pain meds then there is a problem. For the most part, we are treating and healing or reducing what caused the need for pain meds in the first place. Granted, some people have chronic pain so that won't go away and is a valid reason for the progression of pain meds.
I'd say the MD needs to be evaluating them more often and pharmacy needs to get involved in the treatment plans.
Oh, as far as standing orders. On our admit paper work there are a few..tylenol for temp and mild pain, and then our bowel meds, mom, supository or fleets.
Great advice by the above poster!
One more thing to add...your assessments are going to be different than those you did on your hospital pts. Head to toes don't really happen but you will be more focused on the primary problem. Your assessment will start with what you see and hear. I will run down the hall and eyeball everyone at the start of the shift. When you pass meds or do treatments you will do a little more.
Don't get upset if all you have time to do is pass meds and do the treatments and have little time to interact with the residents. Alot of times, you will only have that time. That's okay...you need to concentrate on the tasks. On the other hand, don't get too focused on the tasks that you forget to look at the resident/ whole picture.
Take a few minutes each shift or when you feel stressed to breath!
Yep. Have a meeting with them and try to get the DON or someone else present. Give them time to change, but not forever. It is hard to be young etc and probably the only nurse in the facility/ unit but I can tell you it can be done! I have the BTDT and T shirt to prove it!
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