Don't state surveyors know that med nurses (and other nurses for that matter) cannot possibly do everything the job entails? That it is impossible for one nurse to pass meds to 25+ plus patients within the 2 hour window "by the book"? That the facility basically puts on a show once a year when they arrive?
I especially feel for CNA's. Its bad enough to be on the bottom of the totem pole, so to speak, as far as pay and "status". Its such a difficult job, especially when there are so many patients to care of in an 8 hour period. What makes the department of health think its okay or feasible for one nurse to care for so many patients?
It almost makes me sick...it really takes a special and strong person to work in LTC's for many years. Okay...rant over!
Not that i mean i dont give them, I just give them late for example 8:00 bp meds and seizure meds are given within the time frame and I comeback for those glucerna and vitamins later. We all know 50% of medpass in ltc are vitamins. Sorry if i misinterpret
Thank you for clarifying that entry. I was thinking you had some chutzpah to brag.
That is a pretty harsh title for this thread. I'm wondering why all long term care facilities are considered to function the same but I don't typically see other specialties discussed with such a blanket statement. I'm sure that some ICUs, med surg units, or OR's are better than others but ALL LTC's are a joke?
I know there are facilities who function the same whether state surveyors are in the building or not. I know this because I work in one of them and I'm sure there are others like mine that are great places to work and provide quality care to their patients.
One day I will get tired of defending my chosen career but I'm not quite there yet. So I will continue to let people know that not all SNFs are horrible places and there are many positive things that happen there on a daily basis but unfortunately it is the negative things that are typically publicized.
LTC made me want to kill myself. Not only do you have to do everything mentioned above, but you also have to pick up slack of other nurses not doing their own jobs.
Couldn't agree more! I try not to pick up the slack, but sometimes it's hard not to. For example, the EMAR states that a PICC line dressing was changed today, and while administering next IV dose, I assess the site, and see a date from a week ago! Ugh, that makes me want to scream. Sure, I will then take time to change the dressing for the patient's sake. First offense, I give the previous nurse some slack, but if I see it the second time, it's a reportable to the DON... As for missed skin checks, I do not pick up THAT slack, just do the ones due today on my shift, and the DON can go to hell on this one: oops, go scream on the one who missed skin checks yesterday.
That is a pretty harsh title for this thread. I'm wondering why all long term care facilities are considered to function the same but I don't typically see other specialties discussed with such a blanket statement. I'm sure that some ICUs, med surg units, or OR's are better than others but ALL LTC's are a joke?
I know there are facilities who function the same whether state surveyors are in the building or not. I know this because I work in one of them and I'm sure there are others like mine that are great places to work and provide quality care to their patients.
One day I will get tired of defending my chosen career but I'm not quite there yet. So I will continue to let people know that not all SNFs are horrible places and there are many positive things that happen there on a daily basis but unfortunately it is the negative things that are typically publicized.
I am with you on this one. OP, very bad title. Posting that an entire nursing specialty is a joke should be viewed as an offense. Pick your wording better next time.
Thank you for clarifying that entry. I was thinking you had some chutzpah to brag.
I was worried.
Sorry for that one, like I said worse comes to worse, when I know its going to be one of days I try to finish every paper works to be done in the am, and i know i wont be finishing my med pass on time so i give the major ones on time and comeback later for the vitamins etc.
Yikes, wouldn't it be easier to call the Dr and get the "unimportant" ones discontinued.
This.
When I worked at a particular LTC, I got unnecessary BP checks and meds discontinued; it helped out the residents and the nurses; and the residents labs and BPs were fine.
That is a pretty harsh title for this thread. I'm wondering why all long term care facilities are considered to function the same but I don't typically see other specialties discussed with such a blanket statement. I'm sure that some ICUs, med surg units, or OR's are better than others but ALL LTC's are a joke?
I know there are facilities who function the same whether state surveyors are in the building or not. I know this because I work in one of them and I'm sure there are others like mine that are great places to work and provide quality care to their patients.
One day I will get tired of defending my chosen career but I'm not quite there yet. So I will continue to let people know that not all SNFs are horrible places and there are many positive things that happen there on a daily basis but unfortunately it is the negative things that are typically publicized.
I wish I could like this a thousand times. Thank you my fellow LTC nurse for this.
Our facility does not have a two hour time period to give meds. We now have AM, Midday, PM, and HS meds. This makes giving the meds more manageable. AM is 7-10:30 (hour before and hour after), Midday is 12-2:30 (hour before and hour after), PM 3-6 (hour before and hour after), HS 6-10:30 (hour before and hour after).
This how my facility does it and I have 12 residents max
When I worked at a particular LTC, I got unnecessary BP checks and meds discontinued; it helped out the residents and the nurses; and the residents labs and BPs were fine.
We get some that add BP checks for all BP meds. If its a med that's been used a,while with no adverse effects, then by all means, DC. If new or dose change, BP for short term (2 wks). One of few meds that I feel always needs a check regardless is a pulse for digoxin
Last year I had TWO units probably 25 times, which added up to 50 or so people, depending on how full they were. You can't take care of 50 people properly.
Last year I had TWO units probably 25 times, which added up to 50 or so people, depending on how full they were. You can't take care of 50 people properly.
If I did the math correctly, that's about 9 minutes per resident for an 8 hour shift. :/
amoLucia
7,736 Posts
I was worried.