Specialty Units in LTC

[DSmith]

I have recently changed my job from a critical care coordinator to nurse manager of a 20 bedded specialty unit in long term care. We take chronic vent patients/residents and recently had an issue related to the admission of someone that would need to receive blood and IV lasix once a month. Coming from acute care I am very comfortable doing such treatments, but policy is we don't give this treatment on our unit. I believe the issue is that the staff has not been properly trained. I think that we should take these types of patients and was wondering if anyone else has any input before I approach administration regarding this matter. I don't feel patient like this need to take up acute care beds.

[clawrence]

Long-term care is a rapidly changing field, however it is a very closely regulated one. Many younger nurses I have worked with are eager to learn new skills and receive more specialized training. The nurses who have been in the field longer are still acclimating themselves to all of the changes which have taken place in recent years.

Your issues should be approached from several angles. You have highly specialized training and could approach adminstration by offering yourself as an educational resources. This would involve determining needs of the staff and facilitating outside resources to come to your facility. The second issue which should be determined is guidelines for staffing set by the state in regards to resident acuity and staffing for residents requiring more nursing hours. The third issue is to find out from administration their long-term goals for the facility and what the reimbursement is for different types of resident health care needs. All of these issues tie in together.