Nursing.capps

I have a question I would like input on, please and thank you. I have a client whose random blood sugar is 204. When it comes time for lunch do I remove the whole wheat roll from the clients lunch that is already pre-measured, low fat, low sodium and diabetic approved USDA food program lunch that our adult daycare uses? The client has no orders to do so. I'm being told that this is nursing judgement that we should remove the roll. I personally say that the diet is already approved for a diabetic and also the whole wheat food item helps to regulate the clients blood sugar later in the day. Any suggestions are sooo appreciated.

Thank you. This is very helpful.

Thanks everyone for your replys. The client is 80 years old can not walk only stand to pivot for transfers. I just feel uncomfortable leaving 4 rails up. I usually do 3 so he can help himself with bed mobility. I know nursing home and home care are very different. Just didn't know if all rails up at home is viewed the same as all rails up in a facility. These days you have to be so proactive yourself to protect your license in a world where people are sue happy. Thanks again.

HI, have a question. Home care client has a hospital bed. If I use upper and lower side rails with this client, is that the same as facility nursing where all side rails are considered a restraint. I do private duty home care 12 hour night shifts. There are no orders concerning side rail usage. The family don't care if we use them or not. The case manager just told me to do what I thought needed to done to keep the client safe. I know in facilities where I have worked prior to this job it is considered false imprisonment. Am I doing wrong by using full upper and bottom side rails with this client?

Hi, hoping to get some words of wisdom. I have been a nurse for years. I have experience in hospital and nursing home but not in the past 16 years. The last 12 years I have worked adult day and private duty home care. So now I have an opportunity to work in the back office with a MA and the doctor. I am nervous and don't really know what to expect. My interview was basically "your hired". I know they have had some turn over in their office nurse the last few years. So I am wondering if I am walking into an office with attitude. I am concerned with the work that will be expected. I will have 2 hours of orientation the day the Dr is out doing nursing home rounds. This 2 hours is to cover the medical records training as I have no experience there either. So sorry for this long rambling post. Any insight that could help would be greatly appreciated. Thank you.

Hi Kentucky, I'm from western Ky just out side of the Paducah area. I love it here. Originally from Lansing Michigan. Been in Ky for over 24 years. Went to lpn school in Murray and rn school in Paducah. Great Schools. To all the nursing students here I say be strong you will survive. To all the nurses here I say thanks for sharing a profession that I love.

I worked in med-surge for 7 years and tired of it, I worked in long term care and tired of that. tried my hand at home care, md office and ambulatory care. Now I work for adult day care sevices in which we specialize in alzheimers disease. I love it. That is why I love nursing. So many areas to work, learn and explore.

Hi, I just got hired on a med-surg floor and start sept 11. In my interview they told me that they utilize team nursing. It will be me (I'm a rn) one lpn and a cna. we will have typicaly 8 patients together but on a bad day we could have up to 14 per team. I know I will do all iv's, assessments, emergency's, and the lpn will do all po meds and assist me with admits and discharges. the cna will do hands on care and vital signs. that is how it was explained to me. I have yet to work so I am anxious to see how it works. What scares me is the bad days when we have up to 14 per team. that sounds way too many to me. I have not ever worked an acute care med surg floor. I have always worked long term care. In long term care we did a form of team nursing. I would be charge for 35-60 pts depending on what shift. I would have some one to pass po meds. Then we had cna's that did all adl's for the residents. It would be very busy for that many but it worked. however, in ltc they are usually considered stable. I do have my worries about team nursing in med-surg. So I to would appreciate any other posters with this type of experience to shed some light and ease my anxiety. thanks.