Latest Comments by michelle126

Latest Comments by michelle126

michelle126, BSN 12,199 Views

Joined Jan 22, '03. michelle126 is a RN. Posts: 3,467 (22% Liked) Likes: 1,470

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    We also do an investigation as part of the incident. Each person on that shift that may have come into contact will need to do a statement.

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    Quote from sjalv
    Have you tried asking these doctors why they think an increase in Lasix is not the best option?
    This!!!

    Often times we nurses get things in our heads and want what we think is best. Working in LTC, we do a lot of suggesting to the drs since we are the ones assessing and calling them MD. If I really think they need XYZ and the DR denies the request, I'm always willing to be educated.

  • 1
    emmy27 likes this.

    LTC perspective: I worked for a facility that was owned by a huge for profit company. There were systems in place, rules for everything, corporate support...you know the thing. That company wanted to get out of the US and focus on their Canadian holdings (too many regulations in US) Fast forward, we were excited that a non profit organization would be taking over. The care would be better, owners that cared about the business....all that jazz, right? There is a huge difference in non profits. A non profit with a faith based organization vs just some people who own run facilities. Cost were cut dramatically..food supplies were cut, wound care supplies cheaper, meds/ supplements, personal care supplies, paper towel, incontinace care supples....cheap. No organization. Very little structure. I've always wanted to work for a non profit, but I guess what I'm saying...not all are created equally.

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    Thank you! This was what I was looking for.

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    So, that would be an incident report, place on 24hr report, place on alert charting list for 3 days (all incidents get 3 days), would need a non presure ulcer skin sheet (measurements and location), would need to get order for treatment (call doc), call family and then a nurses note.

    If it is change of shift, I would want the person that found it to at least do the incident report...if they saw what happend. I would take care of the rest.

    So, were you dumped on by the last shift?

  • 0

    Help! We have a resident with a severe rash under her breasts and in her abd/ groin folds/ peri area. I think there are many things going on here. First off, I'm just part time, so I only see her a few times a month. Yes, this has been going on for more than a few weeks.....month in fact. (sad) She is somewhat independant and needs little set up for care, but really needs more help with washing etc. She has a red excoriation under her breasts and in the panus folds. It is sore and sometimes bleeds. When this started or I first noted it months ago, it was reported and nystop powder was ordered. For many issues similar rashes, this should have cleared it up IF it was done..wash, pat dry and apply the powder 2-3 times a day. I suspect assistance with care isn't being done. It is much worse. They've got drs to look at it and order other creams and soaps. She's now ordered nizoril shampoo and cream with the nystop powder.

    These areas are very moiste aside from using abd pads to catch the drainage, is there another product you can recomend?
    I'm upset that the other nurses are not following up with the treatments and care....that is an other huge issue.

  • 3

    We have a few rooms with 4

    It does sound like harrassment.

    Are there privacy curtains in the rooms?

  • 1
    Cola89 likes this.

    Do you have a corporate complaince line? They should be third party and you don't need to leave your name to file a report.

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    I dunno. I would probably take it. I do every other weekend right now. 3-11. I have 5 kids at home and run all week with them and volunteer during the day and evenings during the week. A 10 bed hospice at night doesn't sound bad. We have 2-4 hospice patients along with our other 20 or so SNF in addition to RN manager duties.

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    We were getting away from geri psych and moving to more of rehab but now we are back with more geri psych. The OP's post if very fresh to me. Resident to resident contact/ abuse does warrent an incident report which includes calls to both families, doc, risk manager, nurses notes, alert charting and updating the care plan/ behavior plan is necessary. That type of documentation can go away.
    Our local ERs would not accept a patient for the behaviors you listed above. Since you have psych services in your facility, I would try to see if they have a crisis phone #. If a 302 is needed, they can help you with this and get it started.


    I wouldn't go after the DON, sounds like he will sink his own shift.

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    I think out therapy department has an assessment. Check with yours.

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    Your the one we com e to for advice like this Yes and no on the 4 weeks. If it will burn a bridge that you need, then I say yes, give the 4 weeks. If you can get away with less, go for it. We've went thru so many DONs in the last few years, many didn't give the 4 weeks or even two. It is amazing how things have changed and these people land back on their feet.

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    When can you start? LOL...just kidding. They will ask you more than that. It has been years since I interviewed or have been on interviews, but you will most likely get the normal interview questions how would you deal with this or that situation, what are your strengths etc. They might ask about your phlebotomy or IV skills too, delegation etc.

    All LTCs are different now day's but have a lot of similarities. Some are strictly long term care. People come and people stay and die. Some are more short term care. Rehab and then home. Some have both.
    Patient loads are high..1-20 or more is common. Acuity will vary. My facility gets everything but vents...we do trachs, TPN, complex wound care with vacs, feeding tubes, hospice or palliative care patients, hip/ knee fxs, cardiac rehab and a few LTC, dementia patients.

    There is a great bit of family involvement too but the nice thing is that you get to know them over time.

    Good luck!

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    This will vary from facility to facility and depend of the size of the place too.

    UM in my smaller LTC, is the "desk nurse". We take care of rounding with the MD, taking orders, calling MDs and families, dealing with labs, new admissions and discharges, care plan meetings, wound rounds, infection control monitoring, setting up dr appts and transportation and generally overseeing the LPNs and CNAs.

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    Someone has to be in charge. What about the administrator? Is this a free standing facility or a unit part of a big system?

    We are a small facility with 50 beds. I can't imagine not having someone in charge while the DON is away. If you are going thru a survey, they will have a field day with this one.


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