Published Jul 13, 2011
skicoachrn
10 Posts
Thanks for reading this. I have recently been hired by the LTC and rehab center where I work per diem as an RN to do consultant work for the res care. I can't figure out what I am supposed to do exactly. I have a list of regs that I need to check compliance for in the charts, but piecing it all together has been really hard for me. Does anyone do this? Can anyone help me with organization and planning? I spent 3 hours there today looking over 2 charts to review.....there are 24 on the unit! I cannot spend 1.5 hours on each persons chart every 60 days and write my summary and suggestions on top of that! Does anybody have any advice for me?
Thank you!
I feel like I got suckered in to the job before I knew what it really entailed!
debRN0417
511 Posts
I have never done this, but in my experience what I have seen is that usually a consultant is the person who makes sure that the facility is providing the best care for the resident and ensures that they are in regulatory compliance. A lot of facilities have a consultant that does the nursing part, one for dietary, one for enviromenntal services, etc, and they all concentrate on their department to make sure they are following the regulations and facility ploicy. The nursing consultants assist the director of nursing with the nursing functions, do chart audits and mock surveys and also help with anything else that could be part of the nursing department. The consultant is the person who the DON can go to for help. Chart audits are a big part of it, but also making sure that the staff are following proper procedures is also important. The nurse consultants I have seen are the support for the DON to help him/her, know the regulations and be able to help the facility during survey with any issues that arise. Lots of times the consultants help the DON and support him/her with solving quiestions and issues that arise during survey and with the plan of correction if needed. I am not sure exactly what your job description entails, but if they have a list of regulations that you are to check charts for, then they want you to be able to go through the charts and make sure that there are no regulatory issues. They want you to look at the charts like a surveyor would and see if you are able to find things that could be deficient practice. In order to do this you have to be very familiar with the facility policy and procedures and the regulations. They probably want you to look for things like making sure the physicians visits are within the time frames they are supposed to be, orders are signed and followed through, labs done, MD and RP's are notified, MARS and TARS are completed, and anything that is documented is complete, accurate and followed through on, care plans are reviewed and revised when necessary, and a whole list of things that the surveyors will look for, but not only because the surveyors will look for it, but to ensure that the apropriate care is given for each resident. It is a big job. I have often thought that I would like to be a consultant some day...sometimes the consultant fills in for the DON and must be able to take over if the DON resigned or is out sick- in other words, can function an an interm DON if necessary. You have to look at the chart, and also look at the resident to make sure the chart reflects the accurate documentation and care that the resident is receiving...I hope this helps a little and doesn't freak you out, but this is based on the experience I have had with consultants.
CoffeeRTC, BSN, RN
3,734 Posts
YOu could be doing anything. Ask for a job description
DebRN0417 - Thank you for your response. It is odd that the facility hired me as I have less than one year of experience. I am not up to speed with regs at all and will have a TON of work to learn it all. I feel a bit directionless, and I am worried about the work load, but it will ultimately be good for my career I guess. I'd hate to fill in for the DON!!!
CapeCodMermaid, RN
6,092 Posts
I know the job market it tight, but why would you take a job without knowing what the job description is?
Once you get through the initial chart review, the ongoing reviews should only take about 15 minutes a chart. I try to attend care planning meetings as often as possible and review the charts then.
Please get a full job description. you don't want to be stuck doing something you feel you have no experience with or feel you are not ready to do!
Crap. I am already feeling stuck. I work in a small LTC and rehab facility, originally hired per diem as a new nurse, and have grown and learned a lot, but now I think they find me to be one of the hardest workers, and so are jumping on any opportunity to have me do more and more. I have started as the consultant for the res care side (capacity of 24) and it has taken me 6 hours to go through 2 charts. I have to create an audit form to follow and try to get faster. The administrator wants me to make up for missing reports from the last 6 MONTHS!! I do not think it is possible, so I am giving him my first report from May and June. I cannot believe how much work it is, and I wonder if I am being too conscientious. I have a list of the regs I am auditing for, but even so, there are sub categories and tangents to follow if I see a red flag somewhere. I cant fathom going through each chart in only 15 minutes. That would take superhuman speed of attention to detail. I am kind of freaking out. The director called me today and asked me if I want to assume the MDS coordinator role too.......I have only been a nurse for 1 year now (a bit less). One side of me would rather look at charts all day than do some aspects of patient care, so maybe it will be a good fit. I figure for the first report for res care it should take me 1 hour per chart (maybe less after going through the first 12) and 2-3 hours to write up my report. 27 hours of work for every 60 days. Does that seem right?
pixie120
256 Posts
Look for and update all the assessments, fall, skin, pain, smoking, nursing, AIMS, psychoactive, behavior,... careplans bring forward with dates... Make a list of the assessments needed, and done, give that to your DNS.