signet123

Don't feel like a fool. This is a very common mistake. When Lantus first came out, I remember Doing this once or twice. Someone asked me what this new type of insulin was. I looked it up online and found out you can't mix it. The drug books on the unit were all two or three years old. Didn't have it in there. I had a patient last week. They said in report she bottoms out every morning at 6am. She hasn't been eating well for dinner. They said she was 25 that am. Please don't give her Lantus @ hs. Her 9pm accucheck was 72. I didn't give the lantus. Wrote down that she refused it. The next am her accucheck was 58. If I'd given the lantus, I wonder what it would be? I got yelled at by sup. She said I should've called doc and got order to hold.

I started working at a new nursing home recently. They have been orienting me to different halls. On the one hall I worked over the weekend, there was an intresting sight. This little old lady who speaks only Italian had a stuffed parrot. It was attached to the footboard of her bed. I was told her family bgought it in for her. It has some type of voice activated recorder in it. Every time she says something it will repeat it back. All the ladies in this four bed room have dementia. They are constantly calling out the craziest things. The parrot will repeat what's said several times. It is hillarious to go in there and hear this. At first I thought this might be a bad thing. Then the staff was talking and they say the ladies have conversations with the parrot. It may very well be comforting for them to think someone is listening to them. Even if it is just their own voice being played back. You always have those residents who are always calling out begging for an answer. Most times the staff will just ignore them. Maybe something like this could be helpful. I was wondering if anyone has any similiar experiences or ideas about this.

I'm an Lpn working in a local nursing home 2 days a week. I watch my son the rest of the time while my spouse works. My mother is a resident in the facility where I work. She went in there about a month after I started working at this place. This was about 18 months ago. At that time, I though it was a pretty good home. It's gradually gotten worse as time went by. My mother is a paraplegic for 35 years. She requires a Hoyer lift to get in and out of bed. She has all her faculties, but her body has just betrayed her. Paralysis and old age are a terrible combination. She's 73 now, but to look at her, you'd swear she was 93. She's told me more than a few times the CNA's have transferred her by pulling her on a towel. one person has also ran the lift when the rules call for two. They say they have to do this, because they're short handed and it saves time. My father used to go there and spend 8-10 hours a day with her. They never did this when he was there, only on the days he couldn't make it in. He contracted C-diff( which I suspect he picked up at the Nursing home). He has been ill for several months and doesn't drive now. Since he's not there and I can't get there during the week, they do what they want. They talk her into staying in bed many days. Telling her they might not have enough staff on nights to get her back in bed. Anything to get out and have a smoke. Some of them brag that they smoke 8 a shift. That's on an hour. She get's very fearful and they play on this. I've told a few of the cna's about this. I didn't go to management because I knew they would do nothing and I have to work there. Even though I work on another hall, it would cause problems. I know I was wrong not to report them. I have also looked the other way several times while working there. I have never covered anything up, but I have been aware of several things that were. This leads us to the incident. The other day My mother was being transferred with the hoyer lift. They said there were two CNA's present. She went out of the sling backwards and hit the floor head first. I honestly do not know how this could happen with two CNA's following proper procedures. One person on the lift, the other steadiing the patient in the sling. If the straps were not hooked properly, once you lift then 2 inches you would know. You could then put them back down. She was rushed to the hospital. She has a subdural hematoma and many bumps and bruises. It's a miracle she didn't break her neck. They say she will recover. I'm having her transferred to another nursing home when she's discharged. I called th Dept of health on them. They did an investigation. Surprise, they found nothing wrong. Management probably told them exactly what to write in their incident reports and nurses notes. i have seen this done many times. I went to the home today and got all of her belongings. I thought I was going to vomit just walking in there. I was supposed to work tommorrow. I'm quitting without notice. I doubt they want me there anyway after calling the state on them. I feel like working there all this time, knowing the way things were, I have been partly responsible for what happened to my mother. I used to tell myself, at least I was there trying to give the residents good care.

You definitely need more orientation time. I was almost exactly in the same position you are six months ago. It was very overwhelming trying to learn all the patients and their habits. How they take their meds, what treatments they have ect.. A few things I did do that were invaluable were. Get a resident roster. Next to each residents name I wrote how they take their meds. crushed, whole,w/ice cream.ect.. Then I made several copies in case I lost it. I left a copy in the top drawer of med cart and carry extras in my zipper folder. Another thing I did was come in early one day and look through the treatment book for my hall. I copied down all the treatments and made sure I knew exactly what they were. This saves alot of time during the shift. You still have to go through the book and check everyday when initialing. Some treatments change as wounds heal and new ones are added, but the majority are the same. I then went to my computer and printed a worksheet. This has all the info I need for the shift on one paper. Accuchecks,treatments, Skin assessments, tube feed i+o, MOM's, medicare charting(we have to chart on something different every day). I use half the back for taking notes at 3pm report and the other half for writing down what occurs on my shift. At the end of the night when I'm charting I just look at this paper. I keep these papers so I can look at them later. This helps mr figure out ways to do things better next time. This really has helped me alot.

I'm a new LPN working as a med nurse in a nursing home. I have this one patient who is very uncooperative. She is diabetic and gets accuchecks at 4 pm and 9pm. She gets Novolin N at 4pm as well as coverage determined by the accucheck. She also get 5pm and 9pm oral meds. The problem is she refuses to allow me to do any of this. When i first started working at the facility she did allow me to take her accucheck(under protest). One time it was 500. We had to call the Dr. The charge nurse told me to retake it prior to calling the DR. which I did. Since then she says that I stuck her 5 times and she won't let me do it again. I am a male nurse and I think she doesn't like men. She had a problem with a male CNA previously. This lasted for a month. She finally got over it. although she requests female only care for washing ect.. She has Depression and slight dementia with agitation. We have three halls on our floor. Each nurse passes meds to one hall. At the begining of the shift, one nurse does all the accuchecks. Usually the one with the shorter hall. If I do accuchecks this lady won't let me do hers and I have to get another nurse. I also wind up getting another nurse to give her insulin and her oral meds. Although sometimes she will take the pills if I have a female CNA stand in the room with me. They tell her to take the pills from me. This is really frustrating having to get a nurse from the other hall for everything. They are very busy and I get the feeling it's getting old for them. She also has taken to following me up the hallway in her w/c as I do my med pass calling me nasty names. I just ignore this. She will also tell other residents not to take their medication from me. I was wondering if anyone has any ideas on what I can do to make peace with this lady?