I'm Sooo Confused

[Emily0]

I have worked in this SNF for twenty years, have done multiple jobs,desk, QA, sup, desk again ect. I recently took over MDS in Oct 2011. I have done the care plan assessments for years. Mds is new. I've read the manual, watched the CMS videos, searched the web but still have much to learn. My DON has done MDS's for twenty years with 2.0 but only worked here for 4 years as DON. I recently had to do a sig change on a resident which she said was a mess. I admit there were some errors. I left off a DX of Aphasia and didn't code clinical assess for pressure ulcer risk. She highlighted my errors like skipping staff assess on an interview but I did a resident interview, couldn't code the staff one, highlighted restorative nursing when we don't do that, there were many like that. This resident is commercial insur and she said I didn't put in her minutes. I had just asked her 2 days before, just to make sure, if I had to do a 5 and 14 day on this resident. She said no. Later she said I should have put them on the sig change. She admits she's not up to par with the 3.0. but it's driving me crazy telling me something one day and then changing it the next week.

BTW, DON did a correction on my sig change and she left of the DX of Aphasia, so I had to inform her of that before she closed the MDS!! Then she accused me of checking up on her work. I was only looking to see what corrections she made to learn from.

Thanks for letting me vent

Emily

[Bella'sMyBaby]

Don't you love it when others are telling you how to do your job?

I feel for you...the 3.0 is different than the 2.0...much more to learn.

And why is this DON nosing around in your dept?

Who is supposed to be training you?

Who is supposed to be doing the assessments...what's the policy?

Do you have a corporate consultant to turn to with questions?

Who are you under...Administrator or DON?

I think you need some clarification.

And BTW, you have every Right to see what "Corrections" others are making to your MDS Assessments...

[Emily0]

And the answers to your questions are..

The DON is training me..sigh and she be my boss. Normally we get along pretty good. 24 hour position and one day other duties.

I do the MDS, assessments,care plans, matrix roster, cna care card updates, risk mgmt, falls, I'm sure theres a few I forgeting but I'm familiar with those just not all at once.

It a small 40 bed family owned facility. Nice, nice place. No corporate. I really like the job but feel like a yoyo between what she says and knowing what the manual says and what I read here. I'm thinking of taking an online class to get more claification. I've asked for a detailed job description of what is and whats not my responsiblity. It hard to walk away from the desk after 20 years and watch two new nurses mess up all my systems but Administration doesn't want me butting in.

I do plan on speaking with the Admin to let him know what it's like on my side of the fence.

I've picked quite a bit coming here and reading the other posts and probably will have alot a question myself.

Emily

[andy3k]

It is usually a good idea, if you have any questions or lingering doubts related to MDS, to contact your state MDS RAI or automation coordinator. It is their sole job to educate facilities (and others) on MDS issues. Please use them as a resource because that is why they exist. Helpfulness and knowledge of state MDS staff may vary by state. They are all listed in Appendix B of the RAI Manual.

[CapeCodMermaid, RN]

I used to 'nose around' in the MDS department to make sure the MDS nurses were doing their jobs and doing the MDS correctly. Technically they reported to the ED but since she was clueless about MDSs and I was a former MDS PPS Coordinator, it became part of my job as the DNS to check the MDSs. It's a good thing I did, too, because more than 50% of the time, the coding was wrong.