americanTrain

americanTrain

ICU, ER, MS, REHAB, HOSP ICE, LTC DON

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About americanTrain

americanTrain has 14 years experience and specializes in ICU, ER, MS, REHAB, HOSP ICE, LTC DON.


Born in the Big D, raised in the country, live in the country

Latest Activity

  1. Medical Specialty Unit in Long Term Care

    Yes they are always skilled, the difference is I have a separate unit for private suites, the dining is separate as is all the activities. We have a wonderful 8000 sf gym for rehab. The ones who qualify for the MSU program have to be willing to do t...
  2. Medical Specialty Unit in Long Term Care

    mso819, sorry about the name mix up, it's been a while since I've been on here and they have added the color codes, lol
  3. Medical Specialty Unit in Long Term Care

    Thank you Bronze 2, I am really surprised I haven't gotten more responses.
  4. Medical Specialty Unit in Long Term Care

    Several larger nursing homes are adding Medical Specialty Units. ( MSU ) This is separate from Skilled Care but more advanced than Rehab where the focus is on quality indicators, outcome measurements and teaching. The core of these programs is indivi...
  5. experienced and empowered?

    Do what makes you happy, if they are begging you to come back, weigh out the pros and cons. As a nurse you need to be happy where you are. I drove a commute for 3 years and loved the job until a lay off. Now I work 8 miles from home. If the commute i...
  6. Medical Specialty Unit in LTC

    Several larger nursing homes are adding Medical Specialty Units. ( MSU ) This is separate from Skilled Care but more advanced than Rehab where the focus is on quality indicators, outcome measurements and teaching. The core of these programs is indivi...
  7. Supra Pubic Catheter Question

    Seems to me that the Urologist would have inserted a larger one, not smaller, which they usually do on intervals until the right size fits the stoma. Im not a Urology nurse, and if I'm wrong, I admit. I have seen this in our place too.
  8. What to manage a painful dry eschar?

    Is this resident Diabetic? You may be looking at gangrene instead of eschar.
  9. What to manage a painful dry eschar?

    In our facility eschar is left dry and OTA, with offloading, LAL, etc. The eschar provides protection. Unless there is an underlying infection, which it sounds like may be the case with yours, with erythma, tenderness and warmth, whether there is dr...
  10. Christy, you are exactly right! I just wanted to hear it from another nurse. There is one particular hospital that refers to us, these patients become our residents and we are supposed to fix their mistakes. I figured it was a reimbursment issue, muc...
  11. OOPS! They did it again! Arggggg..... I really dislike some hospitals who want to say that LTC causes all the wounds.
  12. Returning to work and want to get into wound care nursing

    I agree with the others, get your certification in wound care. Im not sure with a BSN if you have to have the hours or can just take the class. AD RN's have to have 2 years of full time wound care experience before taking the course and test. I start...
  13. Cutting VAC foam

    The first vacc foam fitting is the hardest for me, I measure the L,W,D of the wound bed and calculate in my head about how much I will need, I like to use a separate piece if needed the first time. But I always write down on my cheat sheet the lengt...
  14. What's the deal with hospitals today, do they not get reimbursed for a hospital stay if the patients develops a wound? When I worked in Med surg, all wounds had to be documented on admission and discharge. We are getting admissions from hospitals wh...
  15. How many residents can use safely care for as full time wound care nurse

    Bblessing2u , we don't have any of the charge nurses doing skin assessments or treatments, I do it all. Iam full time, so I really don't want to complain too much, but it takes a steady pace to get everything done just in one day without going into o...