nursespike

Depending on the facility and acuity..There is never a "typical day"..there is however the same old atypical day:D As an RN (ADON, soon to be DON)this is how my day does: To work between 7 and 730am Check lab box Check units for staffing, make quick rounds Address any night shift concerns:rotfl: Draw any labs left to obtain, Follow up on labs from day before, Check report for past 24hrs, Check Pain log for reports of any uncontrolled pain, 8am-Call MD with any concerns or need for orders after review Check telephone orders and review charts for documentation or notification, Finish unfinished notifications:clown: Review new admission charts Update cardex with any new information 9am- morning meeting and department head meeting 10am- follow up from morning meeting Still waiting on MD call back..... Handle family concerns, Prepare any discharges Do meds and organize charts for any admissions (1 to 5 in a day) Work on any reports due (QA) Back up assessments for staff nurses, IV meds/central line meds Still waiting on MD to call..... And whatever else pops up or out or falls off or breaks... 4:30pm...MD calls back..lol...not really, usually I have already spoken with them 2 or 3 times by now.. 5pm...pray nothing happens...sneak toward the door Stopped by multiple family members... RUUUUUNNNN!!! This is my atypical day:roll . The staff nurses days vary as well...usually, report, meds, treatments, meds, documentation, report....along with all the other interuptions that go with these duties..not necessarily in that order. It's not easy ...but I wouldnt trade it for anything..except maybe CHOCOLATE! I agree that whatever facility it is do some research on it first...it makes a difference.

It was very similar at this facility when I first started out..the pager drove me NUTS! It was an expectation of staff that when there was a call out...tag, youre it...after the pager "broke" it was never replaced and the staff got educated on how to use the phone and the call list to help find replacements or actually problem solve before calling me or the DON. Now they call for clinical issues mostly, which I dont mind. We are accepting more and more high acuity patients..you guessed it...with the same staffing "challenges" (pts with TPN, Hickmans w/ antibiotics...throw in some behavioral issues..and voila!)...I dont think there is a such thing as "long term care" anymore. Management isnt bad, you have to have limits and I always remember what it was like working on the floor, and treat others with respect- no matter what their position. Anyways...I think we have digressed...lol...there is no such thing as a "restraint free" facility

I did too..I am currently an ADON which also includes Director of Pt services, unit manager, infection control, restraints....and the "when you dont know, ask me" person...under the DON who gets the credit...recently accepted DON position at "local competitor"...turned in notice and got instant exclusion from upcoming company events..that's okay..I still feel good about what I do..I cant change the world..but I wont let that world change me. Just keep moving up to make a difference. I would like to go back to school again...just not sure when.

Hey..I got a lunch bag:lol2: ...I know...but I do love it...one day things will change, hopefully..

I still agree...I think I was trying to say the biggest "challenge" is the staffing issues...never seem to be enough...agree completely.

I agree...but for as long as I can remember there have always been staffing issues no matter where you are at...LTC/SNF seem to be chronically short handed in one way or another due to state laws and nurse/staff to pt ratios/greedy hands, but unfortunately it is very difficult to see or use as an excuse for not toileting, even though it is- if that makes any sense:uhoh3: In the past few years I have come to call it "challenged"...at least it sounds a little more positive...lol

"Ditto" with Suebird..We have a similiar rule...but nursing judgement is nursing judgement. If your assessment indicates a problem that cannot be fixed in your facility, then they need to be sent out.

A good toileting plan often helps too...hipsters have been proven to help prevent hip fractures...if you can get the patient to wear them

New here ...interesting and double edged topic. I currently run the restraint reduction team at the facility I work for. The development of this "team" was done to keep track of and review all patients that had any sort of restraint/device in use. We review psych meds as well or any other med that can contribute to falls. We do not always do reductions, and I ALWAYS have to do a monthly report (for QA). We will never be "restraint" free, that's not our goal, but we won't be using restraints for the wrong reasons either. It sounds like you need to educate alot of people...start small...start a review committee...educate, educate, educate. You are going to have falls, sooner or later. The results of misused restraints are far worse than a fall and could result in the death of your patient. If you start a review committee, at least you will know who has what and why. You can ensure that all documentation and education is in place on the chart (therapy review, SS issues, behaviour issues, etc.). This way if you have an annual survey and they pick up on heavy restraint use you will have everything in place. Hope this helps..