CoffeeRTC, BSN 20,263 Views
Joined: Jan 22, '03;
Posts: 3,741 (24% Liked)
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RN LTC; from
Another post in a different thread got me thinking about this med.
Do you carry the nasal or injectable forms in your E Box?
Oh...hell no! We are a similar issue with this. I really don't want to be the nurse on duty when residents are sneaking or signing out, getting wasted and then coming back into the facility. BUT...for some reason this seems to happen. What needs to happen is the MD needs to sign a no LOA order. If they sneak out or leave without an order, they should be considered AMA or elopement and then discharged from the facility.
We should be able to drug test too. yes...we have narcan on hand, but for real???
30 residents on an evening shift won't be that bad. Might be a good way to get your feet wet again.
Yikes. I would be working with the MDs and pharmacists to get the list of meds whittled down....especially all the extra MVIs etc.
LPNs can be supervisors, staff development coordinators MDS nurses and the list goes on in LTC. Since you wil be a supervisor, I would go up to her and ask her about last week.
Sounds like it will be interesting. LTC is not for the faint of heart.
I've always wanted to move/ work in that area. My oldest will probably be going to school in DC.
I'm from Southwestern PA and work in Ltc and make $35/hr. I would hope the pay would be higher in DC
I detest our Event reports and would love to redo them. They are way too basic and really don't tell me much but instead, they rely on the witness statement forms that no one fills out. I remember complaining about a three page incident report our old company had us complete. I would love to got back to them and get rid of the current form and process. For most events i get a general location, check off for a fall and then that is it. The witness statements do not inlude much. Ask a CNA to fill it out and I get "found Mary on floor and called for nurse. Nurse looked at Mary and then we picked her up and got her to bed" yep....that's about it.
Think about the time it takes to prepare the medication and quickly assess the patient prior to medication administration. By the time you complete this initial process, return to disconnect the nebulizer, reassess, then document, would that not equate to at least 15 minutes after adding actual inhalation time? After all, you are having them to cough and deep-breathe after, correct? This will kill 15 minutes easily if done correctly. Factor in a productive coughing spell, and there you have it.
In LTC, time is limited or non-existent. But CMS doesn't care about that. The proper process is expected since they are funding the care of most of these residents; it is up to your facility to ensure that you have adequate staffing to properly care for the specific resident population.
As a state surveyor, we observe and time this process because of the regulations, and believe it or not, CMS-appointed surveyors come down to observe us as we observe you. If I was standing there with my pad and pen, observing you, I assure you that the process would take up the entire 15 minutes as you carefully complete each task...even if you stop the timer as you proceed to another patient, and restart it upon your return.
On a rare moment when you have nothing left to do, go in and administer one of your neb treatments without leaving the bedside, timing it from start to finish, and compare your findings to what you believe takes only 5 minutes.
I was feeling very glam last week at work. I was helping the CNAs shower a combative resident. He tried to pinch my backside and then said I had a "luscious behind"
I work LTC: Resting in bed with eyes closed. VSS, afebrile. Continues on IV antibiotics with no n/v/d. Resp easy and unlabored on room air. Denies pain. Dressing to left lower extremity clean, dry and intact. IV dressing clean dry and intact. No redness, warmth, edema. Both lumens flushed per protocol. Resident remains continent of bowel and bladder. Assist X1 to ambulate to the bathroom with wheeled walker. Bed alarm inplace and functioning. Fall mats intact to both sides of bed. Call bell within reach.
Maybe one of the mods can move this to the Geriatric/ LTC forum for more responses?
It sounds like that patient would have picked on you or another nurse for any reason. I used to get this a ton and still do. It only bothered me when people would think "you are too young to be in charge." (I was a house supervisor in a LTC)
If you are confident in your abilities, no one will see your age.
Now that I'm starting to get the grays and wrinkles around the eyes.....I miss the "you are too young"
I have no info on this, except Pitt is a reputable school.
If you are on Facebook, there is a Pittsburgh Nurses group with frequent questions about online BSN programs. Try there!
It really all depends on where you are working. Some unit managers function as mini DONs with 24 hr accountability of the unit and others are more of just more of a supervisor.
Where I work, we make out shift assignments for the CNAs and nurses, check the daily staffing needs and fix when needed, follow up with all calls to MDs and families, schedule appointments and pick up arrangements, supervise staff, take off orders and follow up with labs. Meetings, meetings and more meetings....daily clinical review, morning and afternoon stand up/ stand down, care plan conferences.....etc.
What is the policy of the facility? Are nurses in LTC responsible for the patients in the assisted or independent living? If so, where do you go to find out medical history? I wouldn't feel good in this situation either.
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