Oh boy

[Gigi72]

New admit from another facility. Admit nurse does not put orders in . Sack full of meds sent with res from other facility. Still no MAR. Do you log in all those meds when you have no current orders on the MAR nor med list to compare to ? What about narcotics do you log those in or not ?

[rpsychnurse]

That sounds like a poorly done admission! Usually we have med orders before the patient even gets to us but if we don't I will get them from the on-call doc. I wouldn't give anything or enter anything without orders, personally.

[downsouthlaff, LPN]

Wow you meant to tell me that your debility has a designated admit Nurse and your having to do all this ? There's a problem right there. I'm an LTC Nurse/LPN and I can tell you that I've done at least 40 full admits when I worked evening shift.

I've gotten admits from the local hospital, from there home, and in some circumstances such as yours, other nursing home facilities. It's just not gonna fly with me if a patient arrives with a sack full of medicine. No no. Very unprofessional and just down right lazy.

I would have called the nursing home they came from and asked for a copy of there current MAR or POs (preferably updated MAR). If the patient was coming to the facility under the services of the same physician I would have transcribed all the orders to my facility according to policy because nothing is changing but scenery here. Same doc same orders. Just slap those puppies in and log the meds in Narcs included.

Even if they were coming to the facility under a different physician our policy still tells us to copy orders from the previous facility and new MD will review and make changes on rounds. But personally I wouldn't just leave a new admit in the facility with no orders or anything like that. You can always call your DON/ADON nursing supervisor for advice in situations like these.

Admits are very lengthy and require one heck of an effort by a floor nurse to complete. Good luck to you I feel your pain.

[Gigi72]

It's the RN super who is supposed to do the admits. And this admit came from another facility diff doc. RN got the mar faxed to her but never put orders in and left the bag full of meds at the desk. LPN was on the floor passing meds for 20 + res.

[downsouthlaff, LPN]

Wow you mean they actually have RNs who complete admits ? Wow ! I would come on for an evening shift and as an LPN be expected to admin meds to 38 residents, complete all routine charting, and orders, and complete a full new admit on s full resident. That facility sounds like a dream job !

[hawaiicarl, BSN, RN]

Tag and bag the meds send em down to pharmacy to sort out.

Cheers

[CapeCodMermaid, RN]

Tag and bag the meds send em down to pharmacy to sort out.

Cheers

This is a SNF....I'm guessing there isn't an in house pharmacy.

I would have called the facility the patient came from and asked for a 3 page referral-it's a regulation at least in Massachusetts. If I didn't get one, I would have called and asked for the DON at that facility.

As for the nurse who didn't enter the admitting orders, I'd have a 'friendly' chat with her and remind her of the policies.

[suzw]

It's not a competition, you know downsouthlaff. There are no prizes for being the most overworked. ;-)

[CoffeeRTC, BSN, RN]

So does this resident just sit in their room and what??? Yikes! At the very least orders should have been put in for the resident.

A full admit takes at least 3 hours to complete and that is when you have all the information and the resident is alert and able to sign things and answer questions...we are still paper charting.

Who sets up the admission? They should have got the basic information from the last facility. Med list and H & P, face sheet info, recent labs. I'd be on the phone to the other facility asking them to fax that info STAT.

how can one nurse do 40 admits in a shift?? How big is your facility??? We try to have a "desk nurse" to do the admits. One admit and working the cart might be doable, but anymore than that is crazy. BTDT and have the Tee shirt!