sunfire1725

I have worked in LTC for 5 years and have never once been bored. I have admissions to do, Dr. rounds, phoning MD for orders, med pass for 30 residents, supervising entire facility, IV's to hang, IV pushes to administer, dressing to change...I think I would welcome the chance to be bored one time. Many days I leave after my shift has ended thinking how over worked I am. At my facility we have only the amount of staff working that the state says is needed for the amount of residents. I never will understand why the state feels it is safe and ok to have one nurse for every thirty residents.

I am an RN Supervisor at a LTC facility. Right now we have 114 residents, All supervisors were I work have a floor assignment with about 30 residents ( feeding tubes, numerous blood sugars, dressings, and many hospice) and are responsible for the other 114 residents in the building the other LPN's and CNA's. Going on rounds with the MD three days a week, calling the MD for new orders, admitting and discharging residents, sending to hospital. Finding coverage for all call offs, mounds of paperwork, charting, dealing with family members, and basically everything and anything that can and will happen. I would love to work in a LTC facility where the Supervisor did just that supervise. I once heard one of the MD who does rounds here make the comment that we are like a miniature hospital and not LTC because of the accute residents we have been getting. In accordance with the law at my facility there has to be an RN in the building at all times.

I have also seen nurses signing for all their meds given and treatments at the end of their shift, I have never seen the RN's doing this, only the LPN's. I thought maybe that was the way they were taught to do it in school. I know that when I went to school we were not taught how the meds should be signed out. So I always checked the MAR and the med and then signed it out, but I found that this wasn't correct. The post about putting a dot for a reminder makes sense to me, but I don't have enough time to finish passing meds and treatments with signing for and it when it is popped from the blister pack, let alone going back and signing when the meds are actually taken by the resident. It seems like I would never get done with passing meds to 30+ residents, treatments, dressing changes and supervising the whole facility. So to be clear the legal way to sign meds out is to dispense them and sign after the resident has taken them? The way I do it, if I get called away from my cart ( which happens all the time as a supervisor) I can lock up the med cup and I know where I left off in the MAR because my initials are not present. If I don't sign for them and get called away, how would I know where I left off?

I had my yearly PPD at work lastnight ( I work in LTC) at 11:30 pm and at 8 am this morning I had a red,raised area and my DON said I need a chest xray. I have a lot of concerns. I know I could just be infected with TB germ or have active TB, my concerns. What about my family and any other people I have been in contact with? Will I be able to continue working if I have just been exposed? If I have active TB how long until no longer contagious? About 9 months ago a resident was admitted and after a week we found out that she had TB, we were eventually told that there was no risk to the staff, could this have been when I was exposed? and if so, why hasn't other staff been positive? Would my employer be responsible if I had active TB? Thanks for all who respond.

I also feel your pain. My doctor recommended me to wear New Balance 608 shoes at work with my insoles that I had to have made for me. I've had all the cortisone injections that I can have, and surgery but still have times were my foot is killing me from PF. When it gets so bad that I can't take the pain, I get a medrol dose pack and that seems to help me for awhile. I don't know what else to do at this point, my surgeon said he may eventually have to do surgery again. I have scar tissue that is making the release of the PF not effective. I know there are times that I want to crawl in a bed at work and have someone take care of me..>LOL. I hope you find something that works for you.

I've only been a nurse for 3 years and I also have chronic PF, and I started having trouble after working only 1 year as a nurse. I had surgery 9 months ago, but still having trouble. Now when I have flare ups, I take a medrol dose pack, and I am much better for a month or so, well...I can walk and almost get through my 12 hour shift without to much pain. Good luck!

What is the procedure for collecting post void residual? Do you let the pt. urinate and wait about 15 min. and then straight cath for residual?

This sounds normal to me. We have 104 residents right now where I work. If we are lucky we have one nurse and 2 aids to every 26 residents. Most of the time we work with less because we have alot of call offs. I am the supervisor on my shift, have my med pass, and treatment to do, call the Doctor, look up labs and phone them in, handle call offs, and numerous other things that come up during my shift. It's crazy!! Just this last week, I had 2 nurses call off for my shift, and we could not get any one to come in so that left only 2 nurses working. I have 3 residents with tube feedings, numerous on IV's and too many to count that are diabetic. I had my first real anxiety attack. Is it hard to keep nurses and cna's in LTC facitllities? We seem to be in a constant shortage of staff.

We I work we have been having trouble with nursing staff, not enough! We have calls offs almost everyday, and just the other day there were only 2 nurses in the facility for 105 residents. There should have been 5, but we had call offs, and could not get coverage. We have 2 MDS nurses who never work the floor when there is a shortage, I find this highly unfair..they work all daylight, 40 hours a week. All the other nurses are working overtime. Shouldn't they have to work the floor if were short, after all they are nurses too.