CoffeeRTC, BSN 16,247 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,612 (23% Liked)
If you do a google search you can find tons of information. The adaptic or oil emulsion dressings prevent the dressing from sticking to the wound. It might also trap drainage. If there is a lot of drainage, is the adaptic really necessary? It might be if the drainage dries. I like adaptic because of the mesh. It is more breathable than a vasaline gauze type of dressing.
Um, no. I''m only signing for the hours they came in to work.
As sad as this may sound, I wish there was this much scrutiny at my last job.
Sounds like a really tough situation. Won't most places keep the name of the person filing the abuse tip annon? At the very least, I would file the complaint. There will be a file or trail started even if the victim won't stand up. Maybe something will shake loose.
I have to agree, he is probably weaker in the evenings and requires more assistance.
How is he being taken care of when he is OOB all day?
I think the MAR is appropriate place to have it noted and boxed off. I think it should probably be more specific too "Call/ notify MD with an update on recent behaviors or xyz"
I also place a note in our appointment book so that the desk nurse aka charge nurse is aware that a follow up needs done.
Ask the MD what their reasoning is for refusing to manage the pain?
In LTC we have a medical director we can go to for issues like this.
Get the family involved?
Pop the pills out of the bubble while checking against the MAR. Initial MAR, walk in room to give to patient. If they take all of them...good. If not, we circle initial and not on the back of the MAR why it wasn't given.
Doesn't everyone love a change of shift admit? LOL.
3-11 is the best shift for admissions...1 okay, 2 is iffy and when we get 3 or more...forget about it! Prioritize what needs to get done...initial meet and greet, orders verified and meds ordered. Nursing assessment and then skin check. Other assessments can be done after those are finished. Sometimes those get pushed to the other shifts. That is just life.
Don't sign what you didn't do. Either make a note on the assessment what and when you did it or redo it completely.
Well, you have us all confused with the little details. I'm going to try and guess at a few things.
MDS nurse....so you work in LTC? Was it false documentation from another nurse? Did they use your name on documentation?
I'm not sure what would make you leave so abruptly and abandon you position. I've been pulled into some deep situations but still have to scratch my head on what would make you up and leave? Did you give report to another nurse that was qualified to accept your duties? Did you call you malpractice insurance provider right after you left?
Yep. I press #1 for provider if it will skip the wait time. I work in a LTC and we are the ones who call things in for the MD.
Never had a problem.
Could you or should you? You can do anything you put your heart into, but should you....probably not.
Reports of abuse must be dealt with by the director. I would absolutely follow up on that report.
In my 20 years of LTC, I've never had EMS refuse a transport to the hospital.
We call 911 for emergencies and all others we call a local transport agency that is staffed with both EMTs and Paramedics. If they only have an EMT crew available and the situation warrants a paramedic or if they cannot give us an ETA, we are often told to call the local 911.
When you call for a transport, you should be giving a mini report: Why does this patient require transport to the ER?
If it is not a 911 full code/ cpr in progress/ circle the drain type of event....I call the family, make mini chart copies (one for ems and one for ER), call the ER for report etc. If things are going down fast...it is a 911 call and after they get in and assume care, then i make the calls.
Treat all EMS with respect. When they come into your facility greet them with report, go to the room and go over your assessment and why the MD ordered a transfer to the ER...give them the baseline of the resident and most of all...make sure the resident is ready (not soiled)
I've been considering getting my certification for school nurse. In some areas it is a very difficult position to get. (Pittsburgh area)
Many school districts pay along the lines of teachers salary.
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