Group home Nurse

[blessedmomma247]

HI guys,

I am not sure if this is the right place or not to post here... I could not find a thread r/t group home nursing.

I recently accepted with a company that manages group homes. I will be the LPN for two homes, 8-10 clients total. Ages and diagnosis vary. This is a part time job and most of it is working from home with bi-weekly visits to the homes. I am continuing my full time job as a NOC nurse in a LTC. I have been doing this for about a month and so far I like it and I am feeling very challenged. This job is way way out of my comfort zone. I like working with a team, with other nurses. Yes, I have my RN that I can call for support and questions. But for the most part, I am on my own. I find it difficult to leave my LTC nursing at the door..those rules and regulations do not apply in the group home setting. The staff that cares for the residents are not licensed by the state I work in . Yes, they have training and have taken a course, but they are not CNA's or NA/Rs or even med techs. I have one home that is having a major staffing problem. They have poor attitudes, hate their jobs, and are very rude!! I had one client that has stress issues and will make himself vomit. On my first visit, I found him in his room, under confinement because he had an emesis after supper the night before. The house manager had told me its their policy to isolate a sick resident for 24hrs and put them on a clear liquid diet. After further research, I determined the emesis was not r/t to a GI illness but to a behavior. So I made some changes to prevent that from happening again.

I am working with the other nurses (its just 3 of us) and the clinical director to make some other changes as well. Like at least have TMA to pass the meds to help reduce med errors. Staff training and education to help reduce triggering behaviors.

I would love some other feedback !! TIA

[pepperisbest, RN]

I'm an RN working in similar setting as you do. Which state are you in?

The staff are bound by Danielle's Law, which means that if they see the clients in life threatening situations, they should call 911. Not all staff are rude and insensitive. State doesn't have monetary incentive for staff so we are often stuck with staff who are just warm body in the homes.

Something like that emesis should be followed up by an MD/ NP. Can you let the GH manager handle that appointment? How medically needy are your clients?

[blessedmomma247]

The house manager is supposed to making the appointments and arrangements for transportation. But there is one client who makes her own appts. The clients I am currently working with are wheelchair bound d/t paralysis (2) and one from a back injury. Most of them are able to make their own decisions and I have 3 that have dementia related illness. I have one young gentleman who has Prader Willi Syndrome and he is also wheelchair bound. All but one do have part time jobs. I did have the one patient seen by his primary re: his emesis.