KlareRN

The state of Indiana has passed a new scope of practice for QMAs. Under the new guidelines; a QMA can administer G-Tube meds, do glucochecks for BS, and some more critical dressing changes. In the facilities I go to- we are leaving it up to the fac...

Hi! All states have their own "state regs" that you have to follow within your state- and EVERYONE has to follow the "federal regs" throughout the US. Some states have taken some of the federal regs and expanded them or given more specific requireme...

I am currently working as DON in a facility similiar to the one you are working in. We keep the same staff on our dementia/alzheimers unit to help reduce confusion for our residents. Out on the other 2 halls- the C.N.As rotate every two weeks (on pa...

I have worked in management in long term care for several years and every facility I have worked in has the same policy: If a person is not a DNR- you are to initiate CPR and you send them out 9-1-1 no matter how you find them unless: -Obvious lividi...

We have a gentleman in one of our facilities that has a diagnosis of alzheimers dementia. A couple of weeks ago he started to grind his teeth. He does it almost constantly. We gave him gum...and it worked for several days. But now he either "pocke...

I agree with sunnygirl- you probebly will not find it anywhere else. There is alot of skepticism about it in the medical field. It is an ulcer that grows quickly during the dying process...alot of changes happen quickly when the body is shutting dow...

lpnga- I was not going to respond to your post but I cannot just let it go. First- I agree that the alphabet soup behind your name is not a mark of intelligence ("who is smarter than who") but there are some things that you need to understand. The ...

At the facilities I consult in we use low beds, bed and chair alarms,baby monitors, and motion sensors. If you choose a baby monitor- make sure that you do not call it that. The state may cite you for a dignity issue. We careplan them as "Adult So...

I am with you Tex- there is not much to read here anymore. In the facilities I go to- Medical Records do the ICD-9 codes. I have heard of the MDS co-ordinator doing them too. I guess whoever has the most time LOL!!!

I agree with everyone else here. Wait it out. The tenure for a DON in LTC is about 18 months- many times much shorter. The problem is that if you leave- odds are pretty good that you will end up working with her again anyway. I have learned that ...

Aot of mixed feelings here...so I have to give mine: (I will take alot of flack for this)- It IS this womans right to smoke it she chooses. I have been involved in cases with ombudsmen and the state board of health over pt. rights. I had a 39 y.o. ...

ktwlpn- You are the kind of nurse most of us would like to clone to work on our dementia units. Too many are too quick to pop a pill than to take the time to be human. I agree that if a person doesn't want to be in bed at 10pm; let them be up. In ...

I agree with prn nurse. Be sure you have all the details...How did you find out about her pay? Did she tell you or has it gone thru several people (at an increase of 50c per person??) I have experienced situations where nurses have inflated their ...

ACNORN- Thank you for telling it like it really is but be prepared...you are bound to get alot of flack for what you said. The truth is- staff nurses say "that is why you make the big bucks" not realizing that our hourly wage is usually about half o...

I am not frightened to defend myself...what I am is frustrated. Some nurses just continue to justify their poor behavior. Remember I never said ALL call-ins were avoidable. What we are talking about here are nurses who have abused more lenient att...

I agree with Susanmary. Walking rounds report gives the oncoming nurse the opportunity to see what she is dealing with. (I would not accept a unit/hall without actually taking a walk thru it to make sure it was not a mess, IVs needing changed, etc.)...

We also use the "if you call in sick on the weekend you are required to work the next weekend" policy. The catch is that the staff are informed upon hire that when they work the following weekend- it is on the shift where they are needed most- not n...

I agree with bandaidexpert. Most facilities in northern Indiana are having the nurses sign a "Master Signature Log". (Our pharmacy supplies our forms). A rubber stamp is used to stamp the back of each MAR/TAR sheet that says "See master signature ...

I have read two different views about the white uniforms- especially in dementia settings: 1. The whites cause behaviors because it makes the environment appear sterile and institutional- not warm and fuzzy. 2. The whites cause a decrease in behavi...

I am in northern Indiana (about 125 miles north of Indy). I think the pay here is pretty good. In long term care- LPNs right out of school can start at $16.00-$18.00/hr. Shift diff is usually $1.00 for 2nd and $2.00/hr. for third. Working a weeken...

The state surveyors are now asking for "proof" that agency staff have been oriented. They especially want to see that agency staff know things like where fire extinguishers are, crash carts, how to work the paging system in case of an emergency, how...

You never know what parents are thinking!!! These are two I heard when they were grown: 1. Minnie Davenport (nicknamed "Loveseat") 2. William Wallet (nicknamed "Billy Billfold") I also knew a girl who was named Shannon Shanyn (first and middle)...t...

I work with several long term care facilities in northern Indiana as a consultant and am just wondering how other states are coping with their state surveys. Indiana has gotten to the point that very few facilities are able to clear a survey. Leve...

The gentleman that fell was a G tag- actual harm. It was this ONE resident that got us the tag. I was suppose to go to court two days ago- but it was settled out of court. Both myself and my assistant were to testify. I am no longer the DON- I a...

Every practicing licensed nurse should cover themselves with their own malpractice insurance. Facilities cover you while you are employed by them- but alot of times the lawsuits do not make it through the paperwork phase until you have moved on to s...