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hibiscus6 BSN

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hibiscus6 has 39 years experience as a BSN and specializes in SNF/LTC, MDS.

hibiscus6's Latest Activity

  1. hibiscus6

    Why doctors never write diagnosis for their prescribed pills?

    It’s a regulation (at least in my state) in SNFs that every medication must have a diagnosis. Since that regulation doesn’t apply in hospitals or other settings, both sides can become frustrated. Hospitalists and other doctors aren’t used to being asked for diagnoses, and SNFs don’t want to get a citation for being out of compliance. My facility has a form for follow up on questions re new admissions’ orders, including a section where we list each med needing a diagnosis. We give this to the provider who is caring for them in our setting. We are now lucky enough to have an in-house NP/MD team who see every patient, but before that we would fax it to the provider (and we got to know which providers would give the diagnosis, and which expected us to write in the likely diagnosis so they could just sign it).
  2. hibiscus6

    Yes, I'm Vaxxed But...

    In my state influenza vaccination has been required for health care workers in hospitals and SNFs for several years in an effort to protect the patients through herd immunity. A consequence of exercising the right to refuse the vaccine in this state is the loss of ability to work in those settings. Consequences of exercising the right to refuse the covid vaccine include loss of opportunity for employment in certain jobs, along with increasing one’s chances of illness and the knowledge that one is helping to prolong the pandemic and endangering others.
  3. hibiscus6

    Do you ever feel undeserving to be called a nurse?

    Thanks for clarifying. Perhaps I was just in a quarrelsome mood when I read your post. Good reminder for me that part of respecting one’s colleagues is not jumping to unwarranted conclusions.
  4. hibiscus6

    Do you ever feel undeserving to be called a nurse?

    As a nurse who has worked in LTC for over 20 years, I have worked with a great many competent and qualified (and licensed) nurses who care deeply about their patients. I am sad but not surprised at your implication that LTC nurses are not quite worthy of their colleagues’ respect. I hope to see a day when we nurses respect all of our colleagues without exception.
  5. hibiscus6

    Long term care medical director is a jerk!

    Sorry your facility is having to deal with that. Perhaps your administrator needs to consider firing him for not fulfilling the terms of his contract (administrative on call) If you can find a replacement.
  6. hibiscus6

    There IS HOPE on the horizon!

    So glad for you! I too had a lot of trouble finding a job a liked and felt confident in early in my career. I have been an MDS coordinator for 20 years now and still enjoy it - always something to learn even after all this time!
  7. hibiscus6

    Barriers to SNF and ALF improvements

    I am an MDS coordinator so, I guess, part of “management.” Even so, I have been working in LTC for a long time (as a charge nurse before I got my current job). I am lucky to work for a company that is not a publicly owned outfit (no investors demanding dividends) with an owner who lives locally and seems to value his reputation. I believe that that the for-profit model of LTC is a huge impediment to quality of care. Every dollar spent on more staff is a dollar not given to a shareholder. There are currently state standards for LTC staff (at least in my state and I think in most) but they are absurdly low. My facility does not count administrative nurses in the staffing figures, but that probably varies by state. As someone else said, quality care takes time and supplies. There are no substitutes for those things. My suggestions to improve care: standards for staffing should be tightened drastically and health care companies should be non-profit in all areas (acute, LTC and ALF.) Also Medicaid really should pay more; in most states Medicaid pays less than it costs to provide care. And, from the perspective of my own job - the previous poster with 2 MDS coordinators for 240 beds - yikes! Huge workload for those 2 unfortunates.
  8. hibiscus6

    Don’t want to take care of people anymore...

    I am an MDS coordinator in long term care. I feel that I am helping people but I do not provide direct care; I spend perhaps 5% of my time in face to face patient contact. Long term care can be a good alternative to long term care (generally non-profits are better employers or - if you are lucky, as I am - a private company that values quality care).