DON passing trays in dining room

Specialties LTC Directors

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  • Specializes in ICU, ER, MS, REHAB, HOSP ICE, LTC DON.

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Specializes in LTC.
Diet is in the MAR, but it does not mean you have to take it into the dining room. The nurses should know all the diets and make sure the proper diet is given. If not the MAR, a paper, audit tool, memory, whatever...the meals should be checked and we should know how to accomplish this.

Thats what toydemon was implying. That the MAR should be checked BEFORE giving the tray to the resident. I know some of my residents diets. We are a small facility. I know whos a diabetic, who is low fat, who needs to eat more etc. But to check it amongst the MAR then give the tray to the resident just is making more work for us.

Specializes in LTC, Hospice, Case Management.
Thats what toydemon was implying. That the MAR should be checked BEFORE giving the tray to the resident. I know some of my residents diets. We are a small facility. I know whos a diabetic, who is low fat, who needs to eat more etc. But to check it amongst the MAR then give the tray to the resident just is making more work for us.

Agreed. There should be some sort of dietary card with the tray and the dietary manager should be responsible for making sure this matches the MD order - that is why there is a manager in that department.

Nursing then should be responsible to make sure the diet card and the actual meal match. Crazy to think you have time to match to the MAR & absolutely impossible to think everyone is just going to memorize the diets!!!

Specializes in LTC.
Agreed. There should be some sort of dietary card with the tray and the dietary manager should be responsible for making sure this matches the MD order - that is why there is a manager in that department.

Nursing then should be responsible to make sure the diet card and the actual meal match. Crazy to think you have time to match to the MAR & absolutely impossible to think everyone is just going to memorize the diets!!!

The residents diet is shown on the meal ticket which is on the tray. They are pretty good with the low sugar/low fat so that's not our prime concern. Lots of times dietary screws up the consistency. So we always find ourselves correcting that.

Specializes in LTC, Hospice, Case Management.
The residents diet is shown on the meal ticket which is on the tray. They are pretty good with the low sugar/low fat so that's not our prime concern. Lots of times dietary screws up the consistency. So we always find ourselves correcting that.

I was just happy to express that we agree on something - Yeah!!!! :heartbeat

susanthomas1954

195 Posts

Specializes in Assessment coordinator.

One DON I knew took to taking away the med cart keys from all the floor nurses until all the trays were served. It worked. The nurses and aides got those trays passed like lightning. Everyone in admin, including the administrator and assistant admin takes a shift in the one of out three dining rooms, and when we don't the quality drops dramatically. restraints are left on, people are reclined in geri chairs, the CNA;s chatter among themselves, help themselves to some food, etc. A dining room is an experience, giving those of us who do assessments very valuable insights into behaviors, preferences and socialization. Meds are second to meals, meals are what everyone looks forward to, demented, debilitated or just homeless and down on their luck.

morte, LPN, LVN

7,015 Posts

One DON I knew took to taking away the med cart keys from all the floor nurses until all the trays were served. It worked. The nurses and aides got those trays passed like lightning. Everyone in admin, including the administrator and assistant admin takes a shift in the one of out three dining rooms, and when we don't the quality drops dramatically. restraints are left on, people are reclined in geri chairs, the CNA;s chatter among themselves, help themselves to some food, etc. A dining room is an experience, giving those of us who do assessments very valuable insights into behaviors, preferences and socialization. Meds are second to meals, meals are what everyone looks forward to, demented, debilitated or just homeless and down on their luck.

Nobody would be getting my med cart keys without counthing narcs!

Specializes in LTC.
Nobody would be getting my med cart keys without counthing narcs!

My first thought when I read the first sentence. Our new DON has it drilled into our heads to never ever ever hand over our keys to anybody, not her, not the head of the company, not the DEA, not anybody without counting first for any reason. And I think of her every time I walk away from my cart and realize its still open and I better lock it before leaving.

Blackcat99

2,836 Posts

I was always told how very important it is to give prn pain meds as soon as possible. I really resented the fact that my LTC patients had to wait for one hour until after I got back from the dining room before they could get their prn pain medication.:mad:

RNLew

8 Posts

Nursing is YOUR department, and your MDS nurse and ADON are yours to manage. I agree you need to be in the dining room, but not IN PLACE OF your charge nurses. You should have a nurse there whether you are there or not, and on the days you are there in the evening, you should come in later that morning. But in MY building, I expect nursing managers to be in the dining room at least 20 minutes each day. Its for me to decide who does what meal, not my administrator. Sounds like she has hijacked your department.

But, in her credit, your presence in the dinning room is vital in my opinion, and should not be looked at as taking you away from your work, after all, what is our work? How can you manage weight loss if you aren't consistantly in there? I don't go every day, and don't stay an entire meal usually. What I do is have my other nurse managers on a schedule to be there and I come when I can, which is usually 4 times a week. I prefer to catch the end of the meal vs passing trays so I can load up on the supplements and alternatives for my weight loss residents.

(disclaimer... All of the above should be prefaced by "in my opinion")

NurseGuyBri

308 Posts

Specializes in LTC, Education, Management, QAPI.

At my 120 bed facility, we have 1st and 2nd lunch, 1st and 2nd dinner. This cuts the work pretty well. Our first lunch is restorative - our Restorative aides assist in feeding patients. Our second lunch is for those patients that have much more ability to feed themselves or close to it. That way, the lunch/ dinner times take only 30minutes and we have more assistance during the lunch (first lunch) when its more needed. I am the ADON, and I absolutely love feeding residents, and I love coming in on the dining room when not expected. I will not, however, do it every day. That's not to be mean or hateful, but I'm so busy all the time- I work 10 hours a day as well and have enough to do!

pixie120

256 Posts

What? Did you really not read the original post before typing this reply. The DON should not be required to work 12 hours a day every day just to pass meal trays. It's not about putting work off onto someone else...it's about not being physically/mentally possible to meet all the needs all of the time - that's why we staff buildings for 24 hours. Call lights are "everyone's" responsibility, by your logical it would seem that the DON must stay after dinner to answer call lights as well because after dinner they are gonna need to use the bathroom.

OP..in my facility a floor nurse is assigned to supervise the dining room. All department heads are handed the calendar at the beginning of the month and we all sign up to rotate thru all 3 meals. At the very least, I would insist that your other nursing supervisors take their turn in the DR as well. They can always come in later on those days.

Yeah, when I was a CNA, I would have been insulted that my DNS was passing trays,..and as a manager, we shared meal times duties thruout the management staff, we all pitched in. I have a good friend who says this (RN) to her staff "I can do all of your job (CNA) but you cannot do mine,,,: food for thought, she toilets their residents and then teaches them to do their job so she can do her RN work. I find it funny that in some buildings, the DNS can apparently do all the work, answer all the questions, and then.... get thrown under the bus for not completing all of her/hiswork, funny how that works huh? Neither one of us works in the building because as RCM's, all we did was admissions, and discharges, our floor nurses refused to participate in the admission process, and management let them refuse.

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