itthybitthythpider

itthybitthythpider specializes in LTC, MDS.

Latest Activity

1. Assited Living: The new skilled care

   itthybitthythpider replied to NJayne17's topic in Geriatric

   Ive noticed the trend with skilled, too. SNFs are the new sub-acute and sub-acute is the new med-surg. So all the long-term SNF patients are being sent to ALFs and ALF patients are staying home

2. Just wondering if this is the norm..

   itthybitthythpider replied to SeeTheMoon's topic in Geriatric

   Even a wet to dry shouldn't be soaked through. But yes, it would definitely need to be followed up on if you felt there was a mistake. If you look through the chart and everything and it does say "change q3 days and not a moment sooner" I would ask s...

3. Just wondering if this is the norm..

   itthybitthythpider replied to SeeTheMoon's topic in Geriatric

   Even if the order states Change every 3 days, they should be changed as needed, also, especially if they are soiled or soaked through. Leaving dressings on that are soaked through is not the norm. I know where I work, we automatically put a change PR...

4. Complaint Survey

   itthybitthythpider replied to txdon's topic in LTC Directors

   Oooh! I'd never heard that before. Just the clocks.... That's an interesting idea!

5. Q.I.S.

   itthybitthythpider replied to Nascar nurse's topic in LTC Directors

   I've got my fingers crossed for you, too. Good luck!

6. Complaint Survey

   itthybitthythpider replied to txdon's topic in LTC Directors

   How do you determine tissue tolerance?

7. Transition to LTC nursing

   itthybitthythpider replied to CassB's topic in LTC Directors

   You are lucky, coming from a psych background! We get a lot of psych patients in LTC. Some nurses forget they are supposed to be more than passing meds and charting! You'll get the hang of it, though. As far as patient load, it's usually 20-30, depen...

8. new to management..Need help

   itthybitthythpider replied to supervisorhatchet's topic in LTC Directors

   Vancomycin needs lab draws, too. and procrit and epogen

9. is this legal?

   itthybitthythpider replied to cheng1988's topic in LTC Directors

   And the argument that ensues during change of shift takes longer than getting the actual work done and staying over! Plus the next shift never has time to get their work done, so then you have extra work that you pass on, then extra extra work is pas...

10. How do you handle this?

    itthybitthythpider replied to motownrn's topic in Geriatric

    I've had a couple get upset at me for sending a res out (and especially for sending them out without telling), but I can always justify myself to them and my DON!

11. Most important thing to know in LTC

    itthybitthythpider replied to beatrice1's topic in Geriatric

    Keep your "brain" (the piece or paper or papers you write everything on) close and use it often! I like to color code mine with different pens and I write EVERYTHING down, even if "I won't forget /that/."

12. Calling EMS to pronounce

    itthybitthythpider replied to fallinnstyle's topic in Geriatric

    For a DNR, we call the doctor and the funeral home and family, and that's it. I have seen police involved, but I think that was for unexpected deaths. The doctor will pronounce when we call with our assessment. Quick and easy, really.

13. When do you stop feeling dumb and feel like a confident Nurse??

    itthybitthythpider replied to beatrice1's topic in Geriatric

    One thing that helped me when I was learning was to take a list of meds I didn't know home and look them up in the drug book. Same with new diagnoses. I'm still learning everyday, too! I love nursing just for that reason

14. Long Term Care Cutbacks

    itthybitthythpider replied to katoline's topic in Geriatric

    Cheaper supplies, cutting out unnecessary supplies. They don't pay for over time. HUGE focus on therapy, so we have to bend over backwards for them to get minutes in. Skeleton crew for CNAs. No holiday pay for this fiscal year. Luckily, no pay cuts....

15. Do Not Enter - No Boys Allowed; Setting Boundaries

    itthybitthythpider replied to tnbutterfly - Mary's topic in General Nursing

    They are repeat offenders. I am getting better at saying no, with the help of a couple of other nurses who see what's happening, and my DON. Thanks!