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!
After you learn the meds your residents take and you learn the safe shortcuts, then the med pass is the least of your duties/worries...I could give my meds with the MAR closed...the constant interruptions is the most difficult part. Learning to multitask like no other and still trying to maintain some patience with ******* residents and their families. Sometimes the families are the worst. It isn't a hard job, but it is 2/3 of the time very stressful. They are a "joke" in some sense of the word. They "clean house" once a year to take care of business and keep their doors open. The rest of time staff is overworked and underpaid. Residents suffer and management doesn't care.
Oh, and I currently have 27 residents by myself. I usually work 3-1130, but have been know to pick up 7-3 and 11-7 shifts. 2 CNAs most of the time, but can be just 1 on a very bad day.
Really? You want to judge all LTC nurses from your experience with your own facility's unit? Of course we check BGs and of course we give O2. I might mention the times residents were sent to hospital and returned with Stage IIIs because maybe hospital nurses did not know about turning, etc. Basic nursing.
Our policy is a 2 hour window. If you are beyond that 1 hour after, the Quick MAR computer system requires you to enter a reason why you are late. If the state were to check my reason I entered they would wonder why everyone was in the shower during every med pass. Sometimes paper charting is much more nurse friendly.
I can't believe after all this time that for pts requiring crushed meds, that docs have not ordered liquids instead.
From working in pediatric PDN, I learned that suspensions/compounds are far pricier than their "typical" (and able to be repackaged) solid forms. You can order it, but whether or not insurance/Medicare will cover is the real question here.
Liquid ABT and vitamins/minerals shouldn't be a problem to request for house supply, particularly if you have GT residents.
Specializes in LTC, Assisted Living, Surgical Clinic.
After you learn the meds your residents take and you learn the safe shortcuts, then the med pass is the least of your duties/worries...I could give my meds with the MAR closed...the constant interruptions is the most difficult part. Learning to multitask like no other and still trying to maintain some patience with ******* residents and their families. Sometimes the families are the worst. It isn't a hard job, but it is 2/3 of the time very stressful. They are a "joke" in some sense of the word. They "clean house" once a year to take care of business and keep their doors open. The rest of time staff is overworked and underpaid. Residents suffer and management doesn't care.
You think LTC nurses are held to a low standard? I think they're led to impossibly HIGH standards, and are expected to provide the best care with the most limited time and resources available!
We have pill packets and the packet will describe the pill for example saying "purple oblong 53" or "white round 525" so you don't mix them up. I still prefer popping pills out though and it was easier that way.
All I can say is THANK YOU to those defending LTC. I laughed at the one person who thinks that once a year management feeds people and answers call lights for surveyors. I am not sure where that is but as a Director of Nursing all the nursing staff, nurse managers and myself, feed people, answer call lights, and take people to the bathroom every single day we work. Maybe I run a different ship because I worked the floor for many years in the nursing home and many times if the DON does not participate in care or make nurse managers do so then they did not previously work the floor. At least that is what I have found in my experience. Every area of nursing has its good and bad points but I do not appreciate people knocking long term care if they have no or very little experience in it.
I have never worked long term care as a nurse, but that is where I started as an aide. I loved it. It was that experience that brought me into nursing! I do private duty home care, as that is a better fit for me. (I am not a good multi-tasker!)
I also have the experience of caring for my Mom in a nursing home. I came in and did her regular AM care, because we both liked it that way. There were some battles that I just didn't fight. For instance, I brought in stretchy sheets for her bed, along with soft, smooth denim draw-sheets that didn't wrinkle and could be used as pull sheets. I kept her supplied with washcloths and personal wipes, and I did her personal laundry.
The aides were responsible for replacing Mom's oxygen tank as needed. But they did not always have access to an oxygen wrench, probably because someone pocketed it. So, I bought 9 or 10 wrenches of the proper size when they were on sale. I kept one on her wheelchair, another hidden in her closet, one in my bag, and handed out one to each of her aides.
Most of the aides were great, and the nurses were somewhat harried, but kind. I understand that nursing home nurses have a HUGE amount of work, and time management skills can only take you so far. Yet, the nurses in that nursing home seemed to do it, most of the time. I think we had one of the good homes!
xxMichelleJxx
269 Posts
Yup and I no longer do it at all lol. Glad that I left LTC. I'm much happier.