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Hospice, LTC, Rehab, Home Health
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FLArn has 20 years experience and specializes in Hospice, LTC, Rehab, Home Health.

FLArn's Latest Activity

  1. FLArn

    What's With the "Poop"?

    Perhaps in the past when they lived together in the same home, either hers or the family home, dear old Dad used the bathroom just before dinner (or maybe she just has a bowel fixation). Either way, I would have the CNA take him to the BR on the way to the dining room since daughter is there an hour before that should take care of the problem. If he doesn't want to "try" before dinner, have the CNA remind him that this way he'll get to eat a hot meal.
  2. FLArn

    Moral of the story: Never give IM injections?

    @nightowl If I am reading the original post correctly the OP took 2 other staff with her to restrain the agitated patient so that she (the patient) would not move unexpectedly causing the OP to accidentally stab someone else. No one got an accidental stick.
  3. FLArn

    rescue meds...or not.

    I am so sorry you had that experience and kudos to you for attempting to advocate for your patient. The thing to always remember is that "we" hospice are guests in the SNF and must play by their rules. Sometimes trying to educate staff that what they are seeing are the signs of the very end of life and the patient is in extreme distress may get them to try and get an order to use from the E kit. Remember that use of the Ekit in SNFs is not as simple as opening the kit and signing out the meds. It may involve a hard copy signed script from the MD to the pharmacy if not an actual phone call to the pharmacist from the MD. Also most states prohibit or strongly discourage the use of psychotropics for ANY reason so the SNFs simply do not stock them in the Ekit. (Sorry, Dr X that's not in the Ekit. What would you like to order instead?) Unfortunately the presence of hospice patients and their special needs are simply not addressed in the regulations that determine care in the SNFs.
  4. FLArn

    morphine pumps

    When possible it is good to have a PICC or Port if the patient has a longer prognosis (weeks to months as opposed to hours to days) so as to minimize the number of venipunctures needed. But it is entirely possible to infuse Morphine via PCA in a peripheral line, it is even possible to get effective relief from a subqu site. I've seen all of the above used effectively.
  5. FLArn

    Medication Adm in FL

    I never found that it took that much extra time. Also the one time I tried to "save" time by mixing the meds, they congealed into a horrible thick glob in the plastic cup so I had to discard the whole mess and repour the meds; then I had to order replacement doses for all of them. So much for time saved. I don't remember what the meds were since this was very early in my career.
  6. FLArn

    Medication Adm in FL

    And when the state surveyor is following your med pass. (Actually I always gave each Gtube med separately and never gave meds - e.g. Tums, cough syrup - without an order because your patients' or families will rat you out in a heartbeat and never know they've done it) " What do you mean I can't have a Tums? You gave me one yesterday!":facepalm:
  7. FLArn

    Should we teach unlicensed caregiver . . . . .

    I have taught many skills to FAMILY caregivers who are willing to learn, however, I would never attempt to teach nursing skills to unlicensed paid caregivers. That is an entirely different matter legally. Family members may learn whatever skills are needed to provide care but HHAs, CNAs etc are limited by state practice acts as to what care they are allowed to provide. If you are uncomfortable or unsure what can or can not be taught to paid caregivers, contact your education department or risk management.
  8. FLArn

    Facebook: Should I Just Give in and Join?

    I love my facebook for the free games! It is a great free stress buster! Posting anything private or work related...not so much!
  9. FLArn

    Comic relief...

    OP, On going back and rereading your post and your follow up comment, I will say that if your intent in the post was to highlight your immediate reaction to the way you were set up by your co-workers, I can see where looking back on your initial statement would be humorous. That said, I still feel your co-workers showed a decided lack of good judgement in this whole episode.
  10. FLArn

    Comic relief...

    I hate to be "Debbie Downer" but I find it very disturbing that a) your co-workers found this so amusing that they thought it deserved an audience, b) that your co-workers care so little about his privacy and dignity as to make him an object of amusement to others, c) that you felt this to be amusing enough to post under the title you chose. Finally I find it amazing that you all have so much free time to indulge in this foolishness. If I had been your charge nurse, all involved would have received a verbal warning. Rant over.
  11. FLArn

    Atlanta hospital dress codes

    Once you start your clinicals you will find that there are things on your clothes and shoes that you will NOT want to wear your uniform/scrubs/shoes ANYWHERE else. In fact, you will want to get out of them as soon as possible. Also (at some point in the future this may be more important to you) items that are used only for work are tax deductible.
  12. The skilled area is the section of the facility where the patients who are having PT,OT,ST and skilled nursing care IV ABT, etc. usually immediately after having a stroke, MI, or surgery for knee/hip replacements, CABG etc. They are usually in the facility for only a few weeks. This is the "money making" area of the facility as opposed to the residential or long term side which is the stable (reasonably so) patients who live there indefinitely. The skilled side is today's equivalent of yesterday's hospital med/surg floor. We get people on the 2nd or 3rd day postop. There could be IV's, Trachs/vents, TPN, traction, BiPap/CPap and these patients are more acutely ill and require frequent assessments.
  13. FLArn

    Atlanta hospital dress codes

    Yes, white shoes are the norm. However, they don't always have to be duty shoes. I have been able to wear white athletic shoes most of the time. But that said, I would get good duty shoes they are worth the investment and you can wear them after school for as long as they last and it will save you buying new shoes when you have to get the uniforms in the color you need.
  14. FLArn

    Need help with insulin ordered

    Correct. Think of the 70/30 like a base amount and the R is a fast-acting to cover a spike in the blood sugar.
  15. FLArn

    Noc Nurse perspective...

    My only real complaint was the fact that all mandatory meetings are held in the afternoon. Sorry but your 2 pm is my 2 am. So you probably won't see me. However if I don't show up I get dinged on my evaluation and get a lesser or no raise, but woe to me if I show up for work too tired to think and am just plain unsafe. The classic no win situation!
  16. FLArn

    Need help with insulin ordered

    Look up 70/30 in the pharmacology book. That should give you the answer you need. If you still have questions after that, please come back. You need to at least try to find the answers first. The information will stay with you better if you find it yourself.

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