Latest Comments by laderalis

laderalis, RN 3,087 Views

Joined: Dec 8, '09; Posts: 58 (31% Liked) ; Likes: 54
unit supervisor; from US
Specialty: 4 year(s) of experience in LTC

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  • 3
    xoemmylouox, lindarn, and sallyrnrrt like this.

    We use pictures too, but they are in color. We only use name bands on new admits before we get a picture.
    It was weird for me to have someone else ID the resident, but you will learn them in no time.

  • 1
    poppycat likes this.

    I use the Davis drug guide app for iPhone and epocrates

  • 0

    We are not entirely sure where the pain is because she is non-verbal and has dementia. From her body language it appears to be in her hip/leg. She will not take much by mouth. I'm guessing either due to the dementia or because of the taste. One time i dissolved a sugar packet in her 5ml of Lortab and that went a little better. All the nurses are tired of coming at her with meds that she hates taking, so we were trying to find a non-PO alternative.
    She is very frail so I don't know how well a subQ infusion would work.
    She has an allergy to some oral narcotics, I can't remember which one specifically. It's not an adhesive allergy. We also don't know what exactly her allergic reaction was. It could have just been an adverse side effect and not a true allergy.
    She is taking Lortab 5ml TID now, so I don't know how much a lidoderm patch would help?
    I hadn't thought about per rectum, I'll ask our hospice nurse about that.

  • 0

    We have a resident that often refuses anything oral. She has some pain in her hips/legs that was are treating with Lortab elixir. We cannot use a fentanyl patch because of an allergy. Is there another non-PO pain med option out there? She has some mild anxiety occasionally so I was thinking maybe some Ativan gel might help. Any other ideas?

  • 0

    I tried searching for this topic and didn't come up with much. If you know of an existing thread already, let me know.<br><br>Our facility is going to be implementing a more flexible med time schedule pretty soon. We currently have traditional med times like 8am, 11am, 5pm etc. We are going to move into an 'am' 'pm' and 'hs' med pass soon. so instead of a med being due at 8am (really 7-9am) it will be due between during the 'am' pass (7am and noon, or something similar). I wondered if any one else has been doing this. Do you like it? I think it will make my routine more flexible but i worry about the med pass taking up the whole day.<br>How do you handle bid/tid meds? Is there anything that is still on a strict schedule? Do you give antibiotics on the flexible schedule or at the same time each day?<br><br>Thanks for your thoughts.

  • 2

    Sounds like a bad facility. I work in a LTC/SNF and we have 17-24 residents on days/afternoon and 36 on NOC.
    Not all facilities are bad. Look around if you can. Give it a second chance. I love my job, even the busy days.

  • 7

    And what if she really was too tired? Would you want someone with no sleep working? That just isn't safe.
    If its habitual, then there is a problem, but habitual call-ins happen for a number of different reasons.

  • 6

    DNR means, in my facility which is a rehab/LTC, I'm not going to hook them up to the AED, should they be found not breathing with no pulse.
    It has NOTHING to do with treatment before that point. I would do the same for them as I would for a patient that is full code. Hospice, however is another ball game. DNR does not mean hospice.

    DNR means do not resuscitate, NOT do not treat.

  • 0

    Haha cape cod. That reminds me of something a nurse said to me that doesn't pertain to this but is funny. I was off almost a week and when I came back I asked the reporting-off nurse "so, is there anyone new here?" I meant new residents that I didn't know yet. She says "No, they're all a bunch of old people" I've never laughed so hard in report...

    Two weeks is not enough. Is that two weeks on each shift or every shift in two weeks?

  • 0

    I would not have dc'd the order. She should have written out a proper order instead of dc'ing it. If that's what the prescriber wrote on the lab sheet that's the order they want. We would still need to write the order out on a telephone order sheet.

  • 0

    You could apply at a LTC place. They are all not bad (I work at a good one). You would certainly get adult experience and even some hospice experience. There are usually openings available, too.

  • 0

    Two of the three cards were brought back but I don't know exactly how and I don't know what was said.
    Assuming the DON called and they were retrieved by an employee.
    I don't know if the nurse that signed for them was disciplined.

  • 0

    My question is about sending a controlled substance home with the wrong person! We send home narcs often, just not to the wrong person.
    At the minimum it's a HIPAA violation!

  • 4
    IowaKaren, NutmeggeRN, sharpeimom, and 1 other like this.

    I hand people their inhalers all the time. I don't think that was the reason. I think they tried to make you the scapegoat.

  • 0

    We only send home narcs and opened items, like inhalers, insulin vials etc because we can't send them back to pharmacy for the resident to get credit. All other meds go back to pharmacy and the resident gets a credit for the unused med.

    These were three whole blister packs, full packs, (90 pills) that were sent home with the wrong resident.