CathRN 4,794 Views
Joined: Jan 15, '05;
Posts: 148 (32% Liked)
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go to Florida's state page, google florida regulatory services for nursing facilities
www.cms.gov then appendix p, pp and q. PP is the regulations (tags), P is the survey process, and Q is the Immediate jeopardy appendix
SHOULD you be in trouble? I would say no. WILL you be in trouble, unfortunately, probably.
I was in the ED with my mom, who was curled into a ball because of pain and nausea (mom is a cancer patient). The nurse couldn't get her port to flush, hadn't drawn up the pain meds and zofran. I said, "here, please, let me do it." Fixed the port while the nurse drew up the meds. The nurse's response: Thank you so much for helping me! I feel so bad! I have family members all the time in the hospital who often know more about making long term IV's work than any of the nurses, especially in oncology. They do this all the time.
I would have started the IV too, after asking the staff if I could. If they say no, then they better get one in STAT or I'm making a huge stink!
Try State Surveyor jobs, lots of travel, but easier on the body, but it is stressful. How about home health, hospice or MDS coordinator for a nursing facility? Weekend RN supervisor for nursing facilities, home telephonic case management, the possibilities are only limited by what you desire.
Actually, I would cite it as Neglect. They are neglecting to provide proper care for the resident by refusing to use the lift. They are also neglecting to follow the plan of care.
For the posters who didn't know what SOC was, you can go to www.cms.gov and type in OASIS, and it will take you step by step on OASIS. In Texas, there are seminars everywhere that you can go to for OASIS training as well.
Oh my, it seems like I'm OCD and share traits with most of the posters here. Even though I don't work in the hospital setting, my brain sheet is a MUST! I can't function without it. And yes, I catch a lot of "flak" about it.
I am a new DON, previous surveyor and investigator. I'm very upfront and blunt. I also had one of "those" family members which every other sentence was "I'll move him (her husband who was very pleasantly confused Alzheimer's) to another facility. I would ask her if she wanted me to notify his physician to get a transfer ready and when would she like to pick him up? (He was total care). I felt that it was my responsibility to back my staff. She would yell and scream at them and I would go to his room and ask "What's the problem here?" I can hear you in my office and you cannot under any circumstance other that he is actively dying raise your voice to my staff. Of course, she would get mad.
She also got mad when I self - reported when she slapped her husband, yes, an investigator came out and unsubstantiated, but from that point on, she made an effort to be a little more pleasant.
When I shipped him out on day to the ER, she made sure that he was transferred to another facility at my urging that the other facility was closer to her home and she wouldn't have to drive so far and since this was the facility he was at originally, wouldn't she be happier there?
I tried to kill her with kindness, when that didn't work I set hard boundries and make sure they were followed. It worked for us
I take with me the fact that my very first code was my mother, even though they (there were multiple times over three months) were successful, I always wondered if we should have let her go. Even though she survived 13 years after a heart transplant, she was never the same.
I take with me walking in to view mother's body for the first time at the funeral home, there was a strange woman in mother's clothes and in mother's casket.
I take with me holding my dad in my arms, begging him to stay with me while we waited on the ambulance to get to the funeral home. And I take with me that I held my dad in my arms as he died.
I take with me the numerous patients that called me their "angel". And the lengths I went to in order to see that they were kept comfortable.
I take with me the patients that I sat at bedside and held their hands as they left this world when their families couldn't take the final moments.
Most of all, I take with me my memories of nursing over the years, the good, the bad and the ugly. For everyone of my patients, they all taught me and helped form me into the nurse I am today
www.cms.gov. That will take you to the main webpage. On the right upper side there is a search box. There you can type in Appendix P, which is the survey process - what the surveyors look at and why; Appendix PP which is the tags; and Appendix Q which is the Immediate Jeopardy information.
If you need any help, message me.
As a new DON and former surveyor, www.cms.gov. I saved mine to my Ipad under IBooks. Download appendix PP (the regulations), appendix P (the survey process), and appendix Q (the Immediate Jeopardy guidelines). In the regulatory (appendix PP), the bolded type is the regulatory language, when it reads "a facility MUST" that is exactly what it means, there is no leeway. Then read the guidelines, that may help you in staying away from a tag. A must read is the appendix Q, that could keep you out of an IJ
As a state/federal investigator, I have seen this all too often. And yes, I do call IJ's when this occurs.
I am definitely two people. Maybe even more than two... xD
I get told by my patients quite frequently how refreshing it is to have someone who really cares. I bend over backwards to get them anything they need and 99% of what they want. I always try to make time to talk, I'm friendly, I'm patient, I'm personable, and I'm highly organized. I am also very perky - I had a manager tell me it was refreshing to see someone around with so much positive energy, and that I was a great influence on the rest of the staff.
When I get off work, I'm a total sarcastic people-hater. It's funny how I can sit and politely listen to a patient talk when they're upset for 20 or more minutes, but I will absolutely be rude as all get out to people in the mall, on the roads, etc. I seriously have zero tolerance for the masses outside of the job. I get told often that I am really evil and sarcastic. I think I use up all of my perky and my people skills at work, and there are absolutely none of either left for when I walk out of the hospital. I also am a very messy housekeeper.
I once had a patient at the hospital I was working at the time, new admit, got vitals and admission data, started her IV fluids and she asked me to pray with her. I did and one of her visitors asked me if she could pray for me. As she held my hands and started her prayer, she began to tell me things about my life (and no, I had never seen her before in my life) and then she anointed me (yes, that was a surprise). But what a peaceful encounter, that was years ago and it still stays with me.
I forgot to add that I did speak with the attending physician and he said to go for it! He told me years later that he appreciated they way I treated his patients, that his patients and/or family would tell him that they enjoyed having me as their nurse. That was a heart warmer.
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