CoffeeRTC, BSN 18,739 Views
Joined Jan 22, '03.
CoffeeRTC is a RN LTC.
Posts: 3,715 (24% Liked)
Are you new to LTC or nursing? If not, I say two weeks is a super orientation.
As above, get to know your physical layout, phone numbers and who does what and where.
Familiarize yourself with the nurses station...files, binders, charts etc.
Keep a note book and jot down notes.
Get involved. Instead of just watching the nurses do things...ask to do it.
If it is considered unapproved OT, then yes...I can see how it can happen but I've never seen this happen.
We were just talking about this at work. The charge nurse is tasked with finding replacements when we have a call off. This is in addition to working the floor.
Suggestions we have are to update the staff list weekly or at least every two weeks with who is still employeed (yes, sometimes it is that bad)
We are union, so making sure you have it listed by seniority is important too. We also were thinking about having it listed by who is okay with texts. A group text is soooo much easier than 20 plus phone calls.
You are probably right. I am doing an in-service this week. It is just so sad and frustrating. Most of our nurses have plenty of experience in nursing and at our facility but still, cant seem to complete an event report correctly or even critical think on how to provide and immediate intervention to precvent further occurance. They do nothing. A resident falls, they might or might not complete an event report and place the info on report. No follow up, nothing.
How much of this falls on to you?
Fall occurs. Nurse completes an event/ incident report. What do your forms include?
We have a one page event report that nurse completes. Then we have witness statements. Everyone that had contact with that resident should complete one. The nurse and CNA assigned and those that responded to the event.
That is all we do. It gets shipped off to the DON then the risk manager.
The event should go on our 24 hr report and alert charting should be done for 3 days. Neuro checks are hit or miss and so is the charting. No one seems to be doing any immediate corrective action or critical thinking.
A lot of this just seems like common sense to me, but we are having a hard time with this.
I'm tying to come up with some type of reminder check off list for the nurses to do along with the event report to cue immediate intervention. I want to keep it simple.
Anyone have suggestions? or can you point me to a webiste etc?
Before anyone mentions increase staffing and assign sitters or voices a complaint about adding another form to fill out, I just want to mention that I'm still working in the trench and most of my duties include hands on care. I get that no one wants another form to complete, trust me.
Never, ever go into this resident's room alone. There should always be a buddy system and if possible the nurse should be there too. Not easy in LTC. I've taken care of my share of residents with similar behaviors. As a nurse, I would document word for for word what the resident is saying. His behaviors need to be care planned and there needs to be limits set. Family should also be involved and the facility should contact the ombudsman.
Um...not a totally bad idea, but like Ruby said...we need more information.
UGHHHHH. I can just scream about this issue. Can you tell I'm dealing with a similar issue? I find it amazing that the vital signs are done without the equipment moving from the desk. Amazing!
Vitals for meds.....I do, unless i see the CNA just walk out of the room before i'm going to pass the med.
So tonight I've had my fifth evening off orientation and it was my first bad one. I came in to work to know I forgot to give one pill last night (it was ferrous sulfate so it didn't had any consequences on the patient). The worst is that I signed it on the MAR but got distracted and forgot to give it and didn't even notice!
When others go on their breaks at 6PM, I am alone with 1 CNA and 1 LVN for 32 patients and sometimes it's just crazy? Like yesterday a super confused and agitated patient just walked into another patient's room and hit another patient with his cane? And today the same patient walked into another patient's room, pulled down his diaper (sorry I don't know which emglish word is more respectful for elderly people) which was full of feces, sat on a char and started putting his feet in the feces and made a big mess. While I had to handle this, there were many bells, a patient who needed supervision to walk got up and went to the bathroom alone, it was chaos! I probably looked like a headless chicken to the others. For the first time I had to start parenteral nutrition and the pump just kept ringing and I couldn't figure out why. Turns out the tubing was just misplaced. Had to get the other nurse to figure this out -.- Finally, I was alone for passing meds and installing half of the 14 patients for the night and wasn't done at all when everyone came to help; we were 6 in the room to install/pass meds for 3 patients and I almost started crying because I felt so slow and incompetent..
Now I'm scared that next time I'll go to work we'll tell me that I forgot to give a med or something else, or that I did something wrong :'(
I know this is a normal feeling but I've only been working for 5 days and made my first med error, I'm just a little down, needed to vent.
I'm not sure what you mean by a wound care kit? We do not use these. As far as what supplies to order, would depend on where you order supplies. Does your facility have a wound care policy in place or contract with a certain supplier?
We use Medline, so all of our supplies will come from them.
What do you use betadine for now days?
Any in the group? I've been filling in for one and thinking about taking the position. I'm sure there is some support from consultants, but I've been coming up empty for a few forms.
We have the event/ incident report and statements that the nursing staff complete. The RM then completes the event analysis and logs the event in a book.
I'm looking for any forms that you might have that would help with tracking or trending or getting to the root cause.
Are there any groups out there or resources for RMs?
Sounds like they want to save money by using an LPN in that position and their mind is made up. i don't thnk it would hurt to ask though.
I've been in the business since the '80s. Limited duty was only offered to employees who were injured on the job, never for post op people or those who were injured on their own time.
Most SNFs I've worked at are very relaxed when in comes to these things. You could submit a letter to the DON, but what about just asking for a meeting? Go in and tell them you want the position and tell them why you would be a good fit
Honestly? It is the pay that keeps me coming back. I've worked other places PRN, so I realize that it is the same type of problems in alot of the facilities. I'm starting to wonder though, lol.
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