tinkertoys

tinkertoys

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  1. Med crushing

    I have a couple of patients who will spit out their meds without fail unless they're crushed finely, mixed in a little pudding, and then thinned with a supplement shake. I give it to them in their little med cup with a straw, adding more shake as nee...
  2. Ever provided hospice care to your own loved one?

    My heart goes out to you{{{:kiss }}} God bless you for you love and dedication. Your husband is a very lucky man to have you! Even though you are an experienced nurse, in this case, you're not a nurse... you're his wife. As hard as you try, you will...
  3. Vital signs? How often do you take them on your LTC unit?

    Our protocol is V/S Q shift x 72 hours for new admissions. After that, everyone gets a full set of V/S weekly. If a patient is ill or on alert for some reason, V/S q shift for at least 72H. Temp q shift if on antibiotics, AP and BP if appropriate fo...
  4. charge nurse dilemma

    I agree with much of the above posts... there may be a problem with perceptions that need to be dealt with, but the bottom line is that her patients are her responsibility. If the patient is c/o pain, it is her responsibility to assess and act on tha...
  5. Days off after midnights

    i'VE WORKED NIGHTS FOR THE PAST 7 1/2 YEARS, FIRST ON 11-7, THEN 7P-7A. USUALLY I WORK 3 NIGHTS IN A ROW, AND TO KEEP FROM TOTALLY LOSING MY FIRST DAY OFF TO SLEEP, I TAKE A NAP WHEN I FIST GET HOME. THAT'S ENOUGH TO LET ME GET THROUGH THE DAY, AND ...
  6. 12 Hour Shifts

    I work 12 hour shifts - 7p to 7a. My schedule is pretty set... on a 2 week schedule, I'll work 6 days out of 7 the first week, and the second week I'm off 6 out of 7, and the one day I work is usually either 7-11 or 11-7. That first week is really k...
  7. nurse staffing for LTC

    THAT'S CRAZY!!! There's no way one nurse can keep up with 92 patients. I'm assuming you're working 10p to 6a... The problem is most likely the universal misconception(even with people who should know better) that your patients actually SLEEP at night...
  8. Does your HN/NM cater to his/her dayshift?

    In our LTC center, we have a schedule for med administration,so we know at a glance what time meds should be given for each room. In general, we try to give all AM meds at the same time, so as to disturb the pt as few times as possible with meds. If ...
  9. hospice in LTC?

    I have just been told that LTC centers are being strongly advised to offer hospice for their terminal patients. This confuses me. First, I feel that we do a good job of supporting our end-stage patients and their families. We have MD's that work with...
  10. Anyone in Tennessee???

    Hi all! -- Great to see so many nurses from Tennessee!!! And Columbia State students, too! Graduated from that program 4 years ago ( Columbia campus). Have been working in Long Term Care since graduation, and love it! I'm originally from West Virgin...
  11. Nurse Practitioner in LTC

    We have recently added a nurse practitioner to our staff, and are having some problems. I don't think this was very well thought out prior to her hiring. The MD's are not really thrilled about having her here, and we, as nurses, are just not sure whe...
  12. Bowel Protocol

    At our Center, we try to have in place for our pts PRN orders for MOM 30cc qd prn, and fleets enemas qd prn. Our 3-11 nurse makes her BM list at start of shift, listing all who have been 2+days without BM. CNT's are aware, and mark off those who go ...
  13. Resident with hip fracture

    No, this is NOT the way this patient should have been treated!! She should have been examined immediately by her nurse to check for injury, especially for the possibility of a fracture, and the MD notified right away, with emphasis given to the patie...
  14. shift to shift report/staff assignments

    At our Center, we use cassette recorders, too. Each nurse tapes for their relief, and the Team coordinators tape a comprehensive report for the nurse following them. The TC listens to that tape, and the individual reports, and so has a good idea of...
  15. DNR? Why not?

    I, too, have had many patients who I felt should have been DNR, but were not. however, that is not our decision to make. The decision to change code status is not an easy one. It is one thing to say what others should have done. It is another when we...