tinkertoys

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...

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...

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...

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...

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...

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 ...

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...

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...

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 ...

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...

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 ...

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...

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...

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...

Our protocol is to give meds, THEN initial the MARs. I, personally, have a problem with that, in that it's easy to get side-tracked and forget to initial after leaving the pt. My personal preference is to gather my meds, make sure it's all right, the...

It is against regs to pre-set meds. I MIGHT be able to go along with gathering up the unit dose meds together for a few pts who get lots of meds that you have to search for (leaving them in their med drawer) ahead of time, but even that is iffy when ...

I just found out that one of my patients died today. She had been one of mine since her admission 3 years ago, shortly after I got my license. She had Myasthenia Gravis, had a trach, and used a ventilator (only at nite until recently). She was a very...

At our Center, our DON, ADON, and MDS Coordinator take turns with call M-F. On weekends, the staff nurses (RN and LPN) take turns with call, for which we are compensated. Our current attendance policy, which all staff members agree to at employment...

We recently purchased new pill crushers for all our med carts, called "Silent Knight". They work on the same principle as a door hinge. Just place the pills in the disposable plastic pouch,set it in the hinged area, and press down on the lever. The o...

Working in LTC, we have our share of "jinxed" rooms, ghostly sightings, etc. From time to time, the call light in a comatose patient's room would go off...middle of the night, no staff nearby, and light fastened securely to his pillow. We also had a ...

I've been working nights for almost 7 years, and I agree that it's important to schedule your work in blocks- it minimizes the amount of your off time lost to sleep. During your work stretch, don't eat or drink too much before bed. Make the room as ...

QUOTE: Heather27 No...it never gets "easier"...God forbid that there ever be a day when I don't feel sad at the passing of a resident. HOWEVER...I always remind myself that this is what I DO..this is what I CHOSE. I may be the last contact that per...

I chose to begin my career as an RN 3 years ago in LTC. I am constantly amazed that, even today, so many have the misconception that if you want to be a "REAL" nurse, you work in a hospital, and that LTC is for those poor souls who just couldn't cut ...

We do a computerized summary monthly on each patient, including addressing each issue of their care plan. 11-7 does this, and the MDS coordinator handles the quarterly, change-of-status, etc. We also do focus charting daily on our skilled-care patien...

I work an an extended care facility where all nursing personnel wears white. LPN's may wear white or Kelly Green lab jackets, RN's may wear navy blue or white. All nurses wear caps. As irritating and inconvenient as it may be, I earned my cap, and we...