CoffeeRTC, BSN 20,054 Views
Joined: Jan 22, '03;
Posts: 3,737 (24% Liked)
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RN LTC; from
Double briefing is not an appropriate care measure. Get a Foley or a supra- pubic catheter order. You will not have enough time to check/ change your patient every hour. Trust me on this... they will be lying in their own urine for hours.
Welcome to nursing.
I miss being a part of a big company. We had programs for everything. I'm sure I can come up with a spreadsheet of some sorts but just didn't want to re-invent the wheel.
I see that this is an old post, but updated. You would have known by now if it was reported to the state and if there was any actions against you.
As far as suspected abuse. If the CNA saw a nurse handling a resident in a rough manner, they must report it. It is up to the facility to investigate it and determine if in meets the definition and also to report the allegation of abuse to the state.
Every facility should have their own p and p for wound care.
We measure wounds weekly. We are still paper charting so all of our treatments are in a book. We have all wounds (pressure and non-pressure wounds including bruises, incisions etc) on thier own sheets. If we had a question on the size or appearnce of the wound, we are able to see what what documented at the last measurement. If they are on skilled charting for the wound, then there should be a daily nurses note about it.
I have never seen these in SNF or in my state.
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?
Post in the LTC forum for more answers. This is a great question. We do a two step PPD on all readmits.
C'mon now, "Bad guy" is in our job description. Next topic.
This would be an "Assist to floor." I would report it. Reporting events like this help in the long run. Does this resident need evaluated for therapy for strengthening or transfer training? Would they benefit from a restorative nursing program? Should they be classified as a two person transfer or use a sit to stand lift. Evaluating this can only help and make it safer for the resident and staff.
I personally haven't worked as an admissions coordinator, but share the office with ours. Ours is called a referral manager. She is not a nurse. Her job is definitely more sales and marketing. As far as a nursing review of potential admits....she asks me or takes it to the morning meeting for the team to review. I would say your experience is helpfull in knowing what type of care the potential admits would need and your other LTC experince is very relevant too.
NO, No, No!!
Only thing I've seen in an emergency epi pen given this way.
Is it one Dr that gets upset or different ones?
Working part-time in LTC as the charge, i'm often calling doctors on off shifts and getting an on call. Some of them may have see the patient before in their office or during their office stay...how am i to know.
i start my calls by saying "Hello Dr Jones. This is Mary calling from Happy Homes. I have Mr. Smith (admitted under Dr Blue). Are you familiar with him?"
Yes, I saw him yesterday and did his discharge..what's up? or
No, I don't recall.. Then they get the full run down.
I've been doing this too long to care about nasty attitudes from the on calll MD. It just rolls right off my back. I have a job to do and will remind them of thiers if they want to give an attitude.
We just started using agency to supplement our CNA staffing. We are a small facility with 50 beds. Some days it is up to 3 agency CNAs we are using. Our pay rate is horrible and the benefits stink. It is hard to attract staff. It won't change either. The CNAs are unionized. The staff that has been there for a while get nice $$, but in the contract the starting rate is what it is.
So, with new management, they have weeded out some of the CNAs leaving a huge gap, hence the use of agency staff. We are about two months in and I see the company shutting this down real soon. We've currently hirred 6 new CNAs... I think 3 might make it pas tthe one month mark.
Solution....that is the million dollar question! I've been suggestion recruiting new CNAs or restarting a CNA training program. CNAs with zero experience don't demand high pay rates. If we can train them and retain them for over a year, that would be a huge step.
As far as nurses....we have a large amount of part timers and some LPNs that love OT, so we've been lucky. RNs are a bit tighter, but out managers rarely have to work the cart and if so, it is just the unit manager.
Are you investigating a bruise or trying to determine when an injury occurred?
Great question! We have the same issue but with a much smaller facility. Couple questions for you. Do you have computer access for your staff to complete the modules at work? Do you set aside time for them to complete them while at work? Do you pay them to do the training? How do you let staff know what is due and when?
We have limited computers access at work. The internet seems to be spotty or maybe it is the actual computers that freeze up. It is horrible! We don't have an SDC right now so no one is really in charge. I was filling in for a short period of time, so I have a little bit more access to the relias site. With the 6/30 deadline, I was able to get a few of the modules printed out so that staff could complete them and do a paper test. This helped.
With this last round, I believe the DON was giving verbal warnings (not sure if it happened) but there was no deadline for late education to be completed.
Raises based on performance, hahahah. We are a union facility so they are guaranteed raises.
Viva and Capecod some to mind.....
Fair management abilities.
Compassion for the residents...not forgetting that they are why we are working.
Common sense and critical thinking abilities.
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