kdhnursern

You will do fine. In 1995, I graduated with my BSN, passed my boards, and went to work in a LTC facility. This was also my first healthcare job so I had no previous experience. I worked a combination of LTC, skilled, and Alzheimer's (locked unit back...

Skills charting is charting towards what Medicare patients have been admitted to the facility for such as CHF, hip fracture, ... whatever the skilled nursing is for. Charting should document daily skilled care which is required for Medicare reimburse...

CapeCodMermaid, this is great! I plan to present this to my DON to give to the staff at inservice. Thank you for sharing it!

I must love doing MDS's since I did them for a few years, went to doing dialysis for 5 years, went back to LTC for a couple years, and now have been doing MDS's for about 10 months again. It is interesting putting the whole puzzle together. An MDS Co...

Just passed my last AANAC test last night and can' wait to get my certificate. My company paid for the 3 day course, too, and I took the tests online. I think this was well worth their money. It's good to see the "whole picture".

Therapy is looking at the resident at his best for documentation. MDSs are coding them at their worst. If a resident is coded during the day as a 2/2 but on nights they are a 3/2 for 4 days during the look-back period, using the rule of three's, they...

I'd just like to see all the documentation that I need to complete my MDS in the chart! Just give me what I need and I'd be happy!

I don't know about Illinois, but in Kansas, we do not have Section F on our quarterly assessments. But when I'm doing the interviews, I do Section F for all MDSs only because it lets me keep up with their preferences and it's quicker just to do it th...

Our facility has received 2 software patches since Oct 1st. It has fixed some MAJOR glitches. But we keep finding more.

But you are still getting information only as good as the CNA. Ours do ADL sheets daily but it seems that the first person to code anything sets the stage. Everyone else just seems to copy what was put there the day before. So, if they coded it wrong...

Here is a good link for wounds: http://www.woundconsultant.com/files/Wound_Documentation_Tips_6.07.pdf This is from Wound Care Education Institute - which has a great Wound Care Certification program.

I fill out the AIMS, Braden, elopement, fall risk, pain, and side rails for every quarterly and add a 3 day bowel and bladder for annuals. The nurses doing the admits do all these and I use that info for the admission, 5 day, and 14 day. I do everyth...

Our facility recently wrote a policy addressing it. It's one thing to talk with friends on the phone. It's another to spread your feelings worldwide. There is always that old saying "Be sure to make your words sweet, tomorrow you may have to eat them...

Just started as MDS Coordinator again a couple weeks ago after being out of it for about 8 years. I remember the changeover to MDS 2.0 from the "Blue Bible". Guess I'll just "go with the flow" and learn again. At least the last two weeks I've felt l...

Started in LTC, tried Occupational Health 3 years, decided to go back to LTC because I missed the real nursing I had done there. Then I worked as a dialysis nurse for 5 years and have gone back (again) to LTC where I LOVE my job. "Just a LTC nurse" p...

Our 120 bed facility has 4 Primary Care Nurses- of which I am one- who each has 40 beds. We do the admits for our beds. We also do discharges, doctor rounds, faxes to doctors, liaison between doctors and families, .......etc. And I love my job!

Having one day that is skin assessment day and...OMG...finding 4 bruises, two open areas, a skin tear, and an abrasion that NOBODY saw before I assessed the residents. Then I get to fill out the wound reports, skin sheets, orders, TARs, POs, start th...

As a former dialysis nurse, my recommendations are: NEVER remove the dressing over an IJ for every shift assessment. Just assess for clean/dry/intact/complaints of pain/fever. IF the dressing should become wet during shower, THEN you can do a clean ...

Dakin's solution helps to separate the dead tissue from the viable tissue without damaging living tissue. Might be a good choice for your wound. Was used on eschar covered diabetic wound.

Dakin's solution is an older treatment for wounds made from household bleach, baking soda, and tap water. This can be made as full, 1/2, 1/4, 1/8 strength. It's been around since World War I to treat infected wounds. As recently as a month ago, I had...

It sounds like an antifungal powder like Nystatin powder, just use generic, would help the abdominal fold and place a clean, dry washcloth there to stop the skin to skin contact. Then, a low air loss mattress would help the pressure points. Then you ...

I had a resident who was admitted to the hospital and came back a few days later. Hospital transfer noted "red areas" to buttocks. Transferred back to facility per ambulance, a 10 minute ride. When I did her readmit skin assessment, I noted dark purp...

I have a resident who was quite the hunter and gun collector. The facility I work in is located at the edge of town in a beautiful valley with timber all around. After watching through his window this last month, looking out at the pond, he tried to ...

We just started using some new mats beside low beds that are beveled at the edges, only about 1 1/2 inches thick, and are not moved at all. They're made of some foam-type material that you can drop an egg from 3 feet and not break it (DON demonstrate...

Our staff wear beepers. When the call light goes off, it beeps the CNA. If it's not answered, it also beeps the CMA. If not answered, it also beeps the charge nurse. HEAVEN HELP if it's not answered , it also beeps the DON and administrator. Staff D...