CoffeeRTC, BSN 15,873 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,581 (23% Liked)
Wow...stick with that place if you get the 40 days. That is very generous! There are many threads on this subject in this section..browse thru them to get a little more.
I would make a time line to plan the shift.
7a- 730 Report/ get cart ready
730-8 check for appointments/ therapy schedule..do a quick round to check residents/ treatments
8am -1030/ 11 am Med pass and treatments
11:30 start noon meds and accu checks
12 help with lunch
charting/ follow up calls etc until the end of the shift.
In the morning..residents might be going for therapy or dr appts..try and get them first.
What sad is that some of these things are still common in a good bit of LTC facilities and the VA systems.
Hmmm...is the money good? Do you have any team members that are supportive or on board with the changes? If the answer is no....i'd use my running shoes!
We admit residents from any local hospital and it all depends on the insurance of the resident on where they like to return. Your admissions or business development person should have contacts at the local hospitals. Reach out to that person.
Home health would probably be more flexable. How about dialysis? They do 10 hour shifts around here and have nights, Sundays and holidays off.
LTC/ SNF... if you have a choice in your area, do some research on the facility.
Check your facility policy and procedure manual. It might be under irrigating a foley. Are you sure it is a bulb syringe and not a piston syringe??
You clearly don't know how LTC works.
experienced nurses have....more experience
Some LTCs are more like sub acute care....faster paced, more time management needs, clinically complex residents. It takes time for newer nurses to be trained.
I find there is very little patient education in my facility. Yes, we are so rushed just getting the basics done. That will never end, but when I'm getting ready to discharge a newly diagnosed insulin dependent diabetic that will need to go home with injections and accuchecks and I ask if they are comfortable with the injections and they've never been taught or performed one I get a little bit crazy.
Education can be short little sessions with the resident or family over time. It doesn't have to be a big class. We have forms that we can document what education we provided the family or resident but we have no real program or materials.
This really is a need.
Sounds like in those 5 minutes the patient lost their pulse? So then yes..CPR was warranted. A lot can happen in 5 minutes! Breathing and pulse, no CPR. No breathing and pulse...rescue breathing. No pulse CPR.
Not all LTCs have AEDs...most do. Most are located on each unit, close to the nurses station. If it is a large facility, they normally have them one each unit, near the front lobby and or in the dinning hall or activity room. As soon as things start looking bad, I would grab it and a cart if you have it (ours has a suction machine, O2, ambu, back board ) and head down to the room. Don't wait until things worsen. Now....the tricky part is having some one use a phone to call 911 etc. The phones in our hallway only take calls in bound. To call out, you need to head up the the desk or yell for help.
Nope! Long time LTC nurse and I would have done the same. You gave a prn and carafate and they were still complaining of pain, diaphoretic, abnormal labs....Yep. As long as you document what you assessed and the interventions you tried and the calls to the doctor, it should be fine.
Do you have any consultant psych services? I'd ask one of them or maybe you can get someone thru your pharmacy to come in and talk about meds or dose reductions?
Would something like Adaptic be similar?
Head on over to the LTC threads....tons of good info!
Get to know your doctors on staff. Some DRs what to be called with every little thing, some don't. Each facility will have their own method of communication with the drs. Some of our docs want everything faxed to them during business hours. I will get a huge list together with the request and some suggestions and fax it to him. If I don't hear back in a hour or so, I call the office staff. Another doc, I need to call the office with my requests/ concerns.
Falls/ incidents/ injuries/ critical labs etc/ changes in conditions that require treatment get a call/ page asap.
Family issues that are not critical can be added on the list or added into a call later on.
Once you get your butt chewed out for calling or not calling you learn real fast
Very similar to what I am experiencing now
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