Aem1215 replied to dcrawford1's topic in LTC Directors
I would be asking about the training you would be receiving first of all. I have spent my entire nursing career in LTC, and I am always glad to see someone interested in it, but sadly I have seen more than one acute care nurse go down in flames becau...
Aem1215 replied to jiggetts45's topic in LTC Directors
My facility does IV Lasix, IV Solumedrol, TPN, maintenance weight based Dobutamine infusions, and maintenance weight based milrinone drips. I know it seems scary, but really it's not as bad as you would think. We take LVADs and Life Vests too. We tre...
Mom nurse, take heart. If you brought this to the DON's attention, she may well have done something about it. My facility has a progressive discipline policy, and I imagine most do. The other thing is I am obligated to protect my staff's privacy as m...
Aem1215 replied to CapeCodMermaid's topic in LTC Directors
Sadly, I have been in this EXACT situation! These ladies and gentlemen do not understand how lucky they are that I have such a good filter because they would be shocked and horrified if I said to them what I really thought sometimes. If it makes you ...
We have a shower bed at our facility. I have wrapped the arms of the shower bed with bath blankets to protect skin during the shower. It's considerably less costly to purchase the shower bed than to ruin gerichairs and have to replace them.
Aem1215 replied to LTCRN4LIFE's topic in LTC Directors
When I first started to be a DON, for the first few months, I kept thinking that once I got all the fires put out, I would really be able to get some stuff done. At about three months in, as the DOH was walking into the building again for a complaint...
Aem1215 replied to thisismyname's topic in Geriatric
Hang in there! I'll bet new grads in hospitals working on their own for the time feel the same way. Speed comes with time. Its not even about taking shortcuts, but becoming comfortable in your position and confident in your clinical skills. Don't put...
2 days of orientation just isn't enough. My nurses get 10 days of orientation and more if they ask. Put in 2 weeks notice though if you quit, you'll be doing you professional self a favor.
Aem1215 replied to CapeCodMermaid's topic in LTC Directors
I sympathize with your nervousness! Neither of my admissions people are clinical. My company employs people who are positioned in our feeder hospitals, some are nurses, some aren't. What chaps me is on the rare occasion I do say no, its a national cr...
For fluid overload and ascites, you need to treat the immediate need of fluid overload first, so IV Lasix first. Overload can cause respiratory difficulty, so Lasix is the quicker fix for that. Then the IV albumin. Albumin will help the ascites as l...
We have a wound team at my facility that consists of myself, my DCDs and the dietician. We round weekly and measure and document on the pressure ulcers. The floor nurses are responsible for the day to day dressing changes. Also, the floor nurses meas...
Aem1215 replied to ltclovnrn's topic in LTC Directors
We have an AED and a basic crash cart. I actually have used it many times now, but I have to tell you, AEDs shock when they detect v- tach or v- fib, thats it. It doesn't shock for asystole, it just tells you to continue CPR. Its nice because our reh...
Don't sweat too much. You did the right thing or the resident wouldn't have been admitted to the hospital. Speaking from the point of view of a DNS who has been working for a long time in LTC, sometimes we can see things in hindsight that maybe could...