I started a Per Diem RN position and was surprised to learn that none of the patients wear ID Bands. The accepted method of patient identification for medication administration is (1) a Photograph from the Med Pass Book (no computers here) or (2) to "ask the aides" who is who.
The most prevalent diagnosis in this population is dimentia and many patients cannot tell you their own names. So I'm wandering through the dining room with a photo in one hand and medication in the other. Or, after dinner, I'm trying to identify patients as they wander through the hallways. The Med Pass typically takes the seasoned nurses on this floor from 6 to 7 hours.
When I asked why the patients wear no ID Bands I was told that it had nothing to do with HIPPA but rather, it is a matter of "Patient Dignity" and that the bands get wet in the shower.
Eventually I will get to know all the patients but in the meantime, is this safe? And, is it standard practice?
I have heard that "this is their home, do you wear name bands in your home" reasoning for the no name band policy. It struck me that it was made up by a bunch of desk jockeys that have no idea that they are putting patients in danger. It is one of the reasons I also worked for a week in LTC and then fled.
I'm one future "desk jockey" who thinks it's poor logic. While a LTC facility is home for its residents, the fact remains that it is a different type of home for people with different types of needs from the average homeowner. In a communal home setting where residents frequently need a wide variety of medications, it just seems as though it's asking for dangerous mistakes not to have a more reliable system than a possibly outdated photo book. Now, I have no experience working in one, so I'll defer to those who do; however, I do think this would set off alarms in the heads of those desk-bound folks responsible for risk management in such facilities!
BTW, oramar, I love your sig file! I think I have that whole movie memorized.
Specializes in Hospice/Mental Health/LTC/Home Health.
It's actually really common in nursing homes to not have ID bands because they don't want an "institutionalized feeling" just as I just got a PRN job a an assissted living facility and we aren't aloud to wear scrubs, just business casual. Which I think is an OK idea but I like scrubs and not having the possibility of getting poo or pee on my normal clothes.
BTW, oramar, I love your sig file! I think I have that whole movie memorized.
When my son was a teen he also had the movie completely memorized. I had to listen to his reinactments all the time. I have said it before, if I am feeling down I just have to watch it again and before to long I am laughing. PS Many years ago we had a vote on the funniest movie ever on these boards and it was a solid number one.
When my son was a teen he also had the movie completely memorized. I had to listen to his reinactments all the time. I have said it before, if I am feeling down I just have to watch it again and before to long I am laughing. PS Many years ago we had a vote on the funniest movie ever on these boards and it was a solid number one.
Okay, now I KNOW I'm in the right kind of place. :D
We have pictures in the MAR as well and they dont always look like the person in reality. I remember thinking to myself last week a pic in the MAR looked nothing like one of my clients. I would not have been able to ID him from it. I walked right past a resident the other day and went to her room to give her meds. The Nurse orienting me told me she was right there in front of me. I am going from one client to the next in minutes. It gets very hard to keep track when skipping back and forth thru the MAR . I dont like this style, but every nurse I oreint with does it because they know everyone. For me to remember the clients it would be easier to go in order and move down the hall until I can place a client with a bed number. I guess its just the way my brain can remember things.
You will get to know everyone...until you do rely on the photo, or ask an aid, "Is that Mr. Smith/John Smith?" If that aide is new and doesn't know, say, "Oh, that's okay, I'll ask Rachel the other aide over here."
But it is funny...I work overnights, and when I see some people dressed in the morning I have to squint and think for a minute, "who is that?" But I know what everyone looks like at night.
No, it is not safe. Never mind two identifiers. Patients look much different from night to day, so unless they have day and evening pics, I don't like them. On that same thread, people's mental status changes from night to day. So at 8am you may trust that Mrs. Smith knows who she is, come 7p at night, Mrs. Falls may think she is her roommate, Mrs. Wild. Patients need name bands. I once cared for a patient that would tell people she didn't know that her name was MaryAnne Trebonoski. In fact, it was not. Nor nothing like that.
We don't even have pictures with our emar computer system yet. Good thing I know most of the residents but if you're new there it would be very difficult. I don't think putting ID bracelets at a LTCF is necessary but pictures would be helpful.
TDCHIM
686 Posts
I'm one future "desk jockey" who thinks it's poor logic. While a LTC facility is home for its residents, the fact remains that it is a different type of home for people with different types of needs from the average homeowner. In a communal home setting where residents frequently need a wide variety of medications, it just seems as though it's asking for dangerous mistakes not to have a more reliable system than a possibly outdated photo book. Now, I have no experience working in one, so I'll defer to those who do; however, I do think this would set off alarms in the heads of those desk-bound folks responsible for risk management in such facilities!
BTW, oramar, I love your sig file! I think I have that whole movie memorized.