cactusj

We have had liberalize diets for a while and they have worked well with routine sliding scale. Our FNP has decided we are starting the carb counting. Our Med nurses are so busy now with everyone on numerous meds and vitamin supplements, I worry about a mass exodus of LPNs. So many of our diabetics are very elderly with many comorbidities including dementia of varying types and the latest trends I have been reading on is to not hold these people on a tight Blood sugar. We have only had 2 out of the 48 with an elevated A1c in the past 3 months. Just really trying to see how many LTCs are tightening up on the BS in this manner. I can see it being good on the Rehab side but on the LTC side??? Thanks for all the comments so far.

Do you trust your CNAs to really LOOK at each tray and decide if they ate 1/2 of the 1/2 cup of corn,, etc or do your nurse check them herself? How do you figure in the chips, candy bars etc that they get from the snack machine and food family and friends bring in unknown to u?

Are any of you doing Carb counting versus sliding scale insulin? We are about to start this and have lots of concerns as to meal percent actually ingest by the resident, who monitors the percent eaten of each food and who counts the carbs and figures the formula for the insulin. Any help will be appreciated. We have appro 110 residents with 48 diabetics.

the emergency medical treatment and active labor act (42 u.s.c. 1395dd, emtala) is a united states act of congress passed in 1986 as part of the consolidated omnibus budget reconciliation act. it requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. the emergency medical treatment and active labor act (42 u.s.c. 1395dd, emtala) is a united states act of congress passed in 1986 as part of the consolidated omnibus budget reconciliation act. it requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay.

Have any of you ever been through an EMTALA Survey and if so what were they looking for , how long did it take to get the results and were there any fines involved?

Yes, you are right. It's the COMPLETE admission assessment. We are a 6 bed ED--rural, where 1 RN and if she's lucky, 1 LPN--no tech, no admission clerk, no triage nurse plus all 6P tp 7A calls are routed to Er for transfer to patient rooms or the appropriate person--not to mention, it's like any other ED with lots of non-urgents who demand instant attention plus oue share of urgent to emergent. Gets very mindbogging. You comments are so greatly appreciated. Now on the other hand the med-surg unit runs a census of 2 to 14--(we have NO specialities-peds,OB, Ortho, CCU etc--these all have to be transferred) and run 1 RN, 1 LPN and 1 CNA--are often sitting at desk wrapped in a sheet! We are all paper no computer forms!!

How many of the ED's do the floor assessment on the patient before sending to their room. I mean the entire head to toe and psychosocial. I am really interested in Mississippi Rn's but would love to here from all. how do you work it in and not delay triage/medscreen or treatment on ED patients. Just wondering.