I just got a job in LTC

[Blackcat99]

I have been gone for 3 years. I know the first few weeks will be hell. Any advice will be appreciated. I heard that nowadays that you have to knock on the door and cannot go in the room unless one of the patients in the room verbally says it's OK. So if your patient can't speak and the other patient is in the bathroom with the door shut no one will give you the verbal OK for you to enter. So do you just skip that room and try later? What do you do?

[CrunchRN, ADN, RN]

3 years off? Sweet.

That other thing sounds nuts!

[Blackcat99]

I heard that entering a room without getting a verbal OK is a violation of the patient's right to privacy and if a state inspector catches you it is a violation. Is this true?

[CapeCodMermaid, RN]

I always knock and usually say HELLO as I walk in the door. Honestly most residents aren't going to say Stay out! I've had to tell more than one surveyor over the years to knock before going in to a room.

[Blackcat99]

That's good to hear. I just got hired and they have these computer classes that I have to take for the new job. They are saying in these on line classes that no you may not enter a room unless you get vebal permission first and that visiting hours for LTC are now 24 hours a day. Since I haven't been in LTC lately, I thought I better find out how things have changed in the last 3 years. Are visitors now allowed 24 hours a day at LTC? Anything new and different that you can think of that has changed in the last 3 years? Thanks to all.

[CapeCodMermaid, RN]

We allow visitors 24/7 unless the visitor's presence causes trouble or if they are annoying the roommate.If YOUR classes are telling you to get verbal permission before you enter the room, you should.I'm not sure what you're supposed to do if the person is really hard of hearing or demented.

[Blackcat99]

I was told that these computer classes were required by the state. I am thinking though that they are not really practiced in the "Real world of LTC" I am thinking I would never be able to complete a medication pass because I wouldn't be able to get in the rooms of the demented or hard of hearing clients who would not be able to hear me knock. OK. So the part about visitors 24 hours a day is true. Thanks

[artsmom, BSN, LPN]

I do the same as CapeCodMermaid, knock, say hello and walk in, my pts dont mind. Our visiting hours are also 24 but it isnt usually a big deal. The visitors are normally only if someone is passing away, and the family needs to be there. Good luck to you!

[LTCNS, LPN]

I always knock and say the resident's name and let them know I am the nurse, and am there to give them their meds. or do a procedure if the resident is alert and oriented. If the resident is cognitively impaired, I knock, say hello and walk in, then let him/her know what I am about to do whether he/she can comprehend or not.

[amoLucia]

On 11-7, things are a bit different ... we KNOW that knocking is expected but the reality is we'd all be still be at the first door awaiting a response. I try to verbally "KNOCK, KNOCK" but it's still a problem.

[cienurse]

I have found that most surveyors are very reasonable. Knocking and saying hello as you walk in is an acceptable practice, unless the resident is on the phone or having a family visit, most of them don't mind if you do as above. We do have visiting hours 24/7 but it usually doesn't present a problem. If a family member is disruptive, loud, rude, or anything else in between, they are asked to leave. That's a rare occasion but mostly its families of residents who are passing and we like to put those residents in private rooms when we know the end is coming to allow for privacy for family members. We have also moved roommates to other rooms if they allow to accomodate families with dying residents. But mostly, common sense prevails-if a resident is not available, you can go to another room and try back later.