Latest Comments by CoffeeRTC

CoffeeRTC, BSN 18,926 Views

Joined Jan 22, '03. CoffeeRTC is a RN LTC. Posts: 3,726 (24% Liked) Likes: 1,809

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  • 0

    I have no clue, I'm in LTC there is a Pittsburgh Nurse's Facebook page that is active and had a discussion about it

  • 1
    ruby_jane likes this.

    I took it as an elective in my last semester of BSN school. I loved it!!! It was a bit easier and kinda fun and a great way to learn different assessment skills and critical thinking. I took the tests and passed and got my NR-EMTB. Sad thing was that I never practiced as an EMT. To this day, 20+ years later, I still have some of the nemonics for assessments in the back of my head. That and I was awesome at CPR with all the practice we did in practicals and clinicals for that class.

    Do it!!

  • 0

    Did you take the job?

  • 5
    ruby_jane, rn1965, TriciaJ, and 2 others like this.

    So, for those of us that are still using paper charting in LTC, maybe we should explain the process.

    The resident is admitted. Has orders on paper from the hospital. Orders are handwritten onto the paper admit order forms, then faxed to pharmacy. New orders are hand written by the doctor or more often than not, verbal orders are taken by the nurse and and then faxed to pharmacy. The faxed to pharmacy part is what scews up alot of things. Are they being faxed? I always wait for the confirmation that the fax went through. The next part is up to the pharmacy. The need to enter it into the profile.

    At the end of the month (at my facility it is the 24th) we get a print out of the next month's orders, MAR and TAR. These orders need to be checked with the orders in the chart and then clarified or adjusted as needed.

    Lots of potential for error but some ways to put in some checks and balances.

    Are the admit orders verified by a second nurse?
    Are the monthly orders checked by a second nurse?
    Is 11-7 doing daily redlining of all the charts to check the new orders?

    Our policy is to do all of the above AND we also go over all new orders in the moring clinical meeting to make sure that the orders were transcribed correctly from admit orders from the hospital.

    To answer the OP

  • 0

    Thanks for the hints. I see a ton of risk management for acute care, but not very much specialized to ltc and a good bit of it was focused on documentation issues.

  • 0

    Have you checked with your pharmacy? They should have something.

  • 0

    Anyone with experience in this field? I've posted this in the LTC forums and have got zero responses.

    I've been filling in at the Risk Manager / Staff Development Nurse in our LTC on and off for a few months. I'm currently self-taught. The LTC is a small non-profit with a small group that provides consultant services for a group. The set up is weird.

    I have a good general understanding of the position but was looking for more resources or support. I've even looked on Facebook groups but have come up empty.

    Can anyone here point me to support groups, organizations or resources?

  • 0

    We haven't used side rails for at least 8 years. I honestly was surprised they are still used in LTC. A nearby facility just had a death due to entrapment.

  • 1
    BeckyESRN likes this.

    lol. ...because you are the principal!

  • 1
    brownbook likes this.

    I did 3-11 and 11-7 for most of my 20 years. It worked better for my family schedule and as the others mentioned, less family and less of the office staff.

    Honestly, I never thought I'd say this, but I now prefer 7-3. It moves so much faster and there is less to do. Yeah, am meds are horrible and there are therapy scheduled and appointmens and two meals to work around. BUT..3-11 has less staff,no one around to answer the phones, clean up a spill, etc. We get all of our admits on 3-11 and then the sundowning starts as soon as the bulding empties out at 5pm.

    I wouldn't worry about not wanting to work the other shifts...unless you signed up to work all shifts. We would love to have a nurse that prefers 3-11 or 11-7 and is awesome at it!

  • 0

    Following this post. We have Relias too. I'm still trying to figure out how to set it up for new hire orientation. Do you do it as part of a classroom orientation?

  • 0

    Did you have the interview yet? I too am interested in a position in RM. I'm not finding much as far as support groups or message boards for support.

    I think RM would fall under the supervision of the administrator and not the DON. We've been looking for a RM/ SDC for a while and I've been filling in. One of my questions (when I finally give my intent to take the job) would be just that..."Who do I report to?" I assume the RM would then make suggestions, referals and then educate the nursing staff (SDC part of the job).

  • 0

    I think it all depends on your area. In some areas, LTC nurses are a dime a dozen. Some facilites are just happy to have a new hire to fill a spot and just want a warm body.

    You can't be blamed for the past citatations, but would be held accountable moving forward. They might give you some leeway for getting things up to par. Will you have support of consultants from the company or outside of the company? What about the people left in the facility?

    I don't think taking this job would necessarily mean career death, it sounds like a challange and it will be stressfull.
    I really think it depends on the LTC market in your area.

  • 0

    Quote from KelRN215
    Was it a PEG with a crossbar or a tube with a balloon? And did you have a replacement tube on hand?

    G-tubes replaced in existing tracts do not typically get XR confirmation, in my experience. In pediatrics, our patients have MIC-Key buttons or AMT tubes and parents are taught to replace those q 3-4 months at home.
    We haven't had residents with feeding tubes for years, but often times we were able to replace in the facility and then call for an xray to verify placement.

  • 0

    Please tell me her refusal for care is well documented and care planed out the wazoo? Why is she refusing care? Pain issues? Has psych seen her?