CoffeeRTC, BSN 15,878 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,581 (23% Liked)
Well, that just about covers my facility. Our acuity varies. The CHF patient with fluids and hypocalemia...that would have put me over the top due to the constant need to monitor. This patient should have been sent to the hospital for closer monitoring. Sad, but this it what a good bit of LTCs are looking like.
I think in PA, the lpns must have this certification. We recently had our pharmacy IV nurse some in and do a two day in-service. I found it to be a great review and informative. (I never thought i would say that
Welcome to LTC!!! A mod might want to move your post to the Geriatric forum.
Anyone can "lose their license." Being in LTC for the last 20+ years, I haven't seen it due to being a nurse in LTC but more for the nurses actions like stealing/ diverting drugs.
3-11 is a busy shift. The bulk of the admits occur on 3-11 shift, labs need followed up on and there are generally less staff and less support staff in the building.
My routine as a staff nurse:
2:45 arrive at work and get myself ready...pens, census sheet etc
3pm-3:30...make assignments, report, quick walking rounds and set up my cart, take off orders and look at any labs back
5:30-6:15...assist with dinner, monitor meal pass etc.
if able, take a lunch after residents have dinner, charting, follow up on order/ labs start treatments
7:30 start pm med pass and do treatments
10pm...finish med pass, more charting
We generally try to have a charge nurse that will work on any admits, md orders and labs......that is a huge help. If not, it is all sqweezed in the above schedule.
if they don't have a census or cheat sheet, make your own.
I list the res room #, name, Md, full or no code, an area for quick notes and then a spot for IV/ accu checks. You might want to include their top diagnosis until you get to know your residents.
i work in a much more laid back area of LTC nursing, well sometimes it is LTC and a lot of times it is more short term rehab. For the most part, I love finding out if there is a nurse or someone with a good medical or nursing background in the family. Right now, we have a few nurses as patients and it really makes things easier. I still do all the teaching I would do with a "lay" person, but it is just different.
In LTC and other home type of settings it is often the nurse who is explaining the procedures, coming up with a nursing diagnosis and then telling the doctors what we need or what they need to look at. Working with the patient or family member with the background makes things flow better. .....well after the initial culture shock of LTC!
Me....I hide the fact I'm a nurse unless it comes down to being needed. I'm not versed in ICU or critical care and my only experience with L and D comes from having 5 babies and I'm not even going to begin to think I'm up with onocology BUT...I'm always up to be a supportive family member and help my loved one with ADLs etc.
This is universal to nursing. I work LTC and have days like this. 3-11 and 11-7 run on much less staff, no support staff either. Accidents happen close to shift change too. Nurses need to give and get report.
We tried to solve some of these issues by staggering report and having the CNAs get their assignments as soon as they walk in the door and get them moving.
i love the fact that our new ADM is a nurse!
Ahh...I re-read this and when you say " i didn't bother looking" did you mean looking for meds to borrow or for the actual resident in question?
You are correct in not wasting time looking for the meds from the other residents. Supervisor should have when to your emergency box to get the meds. We are not permitted to borrow meds. Yeah, in the bunch card system we might still do this, but it is wrong.
Treat any order for controlled substances extra carefully. Always double check if you have a question or the order doesn't seem right. You can never go wrong when you do this.
study the above suggestions but also take into consideration the changes in the elderly.
Wait, is it every time you give the med? or just at shift change?
Can you ask your pharmacy services about "the reg"?
??? Not sure what you are asking. If this is a need for a certain program you are in, ask them for examples or suggestions.
LTC RN here. We've been doing respiratory txs for years...I think it was almost 15 years ago the last time I saw an RN in a non vent stetting. We use room air and have the portable nebulizer machines. If they are on O2, we keep that on.
I enjoy the posts that have a patient that the Nurse is looking for input on from the other nurses on this board. I am always amazed and fascinated at the clinical knowlege that the many different posters have and how there are so many aspects to patient care. I think that is why the psuedo articles that disguise themselves as clinical facts frustrate me so much. I love nursing and respect the knowlege of my peers and do not like to see this disrespect to the intelligence of nurses.
I brought candy bars in to sell to the staff at work. (we have a loose policy on this) and felt funny when a resident insisted on buying one. (this was LTC). I got bullied into it by them "Listen, I am already on my way to the vending machine so I either buy it from you and support your kids school or give it to the "man" LOL.
I'm an occasional poster and lurker.
I'm not the best with grammar and spelling but I do have to really wonder or scratch my head when some posts are very difficult to read and the poster is asking "did I do something wrong" "should I be fired" or "they are out to get me posts."
We have a good bit of non English speaking posters...those are recognizable and understandable but as professional nurses we should be able to express ourselves using clear and basic typed words.
The text speak doesn't bother me that much either.
I will still read the post and if I feel like I have something worthwhile to add, I normally will post to it.
Cranberry seems like a nice area. Bever....not sure. LOL. I'm no help, sorry!
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