shoreh2000

as a nurse consultant and an x-surveyor.....i disagree with giving our residents multiple medications....we....are so wrong as a society.....to treat what hurts with another pill....other cultures choose not to do that....and guess what.....they live a happier lives....our culture and practice in ltc has been to crush the 20+ pills....mix it with apple sauce....then shove it down a residents throat!!!!!!!.....what is the alternative???....get the resident involved in activities, social dining, assign a volunteer to them, offer them fluids, start a "happy feet" and walk and dance with them to the beat of spanish music, etc. we have a spanish speaking resident who was admitted with g/t, none verbal, depresssed.....guess what.....she has come along way....the other day she was dancing the salsa during our "happy feet" program....she out danced me and i am a very good dancer!!!!....and she is strating to speak english!!!....wow!!! i am just sooooo against treating our beloved residents as a garbage disposals and not a real human being!!!!!

as an x-surveyor....we always looked at psychotropic meds closely.....now with the new federal regulation changes with pharmacy tags....surveyors are looking really closely at all the meds and the justification for them....they are calling immediate jeopardy (ij) with the help of dhs pharmacy consultants!!!!.....what we need to do is to look at all the residents meds....assess the need for the meds....and keep on evaluating them....until the resident is almost drug free! look at all the time and money the facility would save....not to mention decrease in falls, incontinence, behavior, etc., brought about by polypharmacology!

relax.....don't be nervous!.....if you do get nervous....tell the surveyors you are and you need some time to think of the answer....then go to your superior and discuss the question with them!....you can't have all the answers! take it from me....i was once a surveyor!!!!

what a waste of time and money:angryfire :angryfire not to mention the many side effects....

i love what all of you have written. you guys have some great suggestions. lemon ice....wow...what a wonderful idea. my mouth is watering already. fish shakes :barf01: augh!!....but it worked...ha? as an ex-surveyor the department will look to see what the facility has done to bring the resident back to their prior level. if you have to give a resident ice cream before he/she eats the meals, do that, but please care plan it and let everyone know about this plan because the regulations says so.

what???....go out of the facility to get the resident's perscription filled???? in california this is not our practice. here we have 24/7 pharmacy available which delivers the medications as soon as possible. the facilities do have emergency kits which allows the facility to have access to oral and iv antibiotics, narcotic pain medications, insulin, etc. which is documented, sealed and then replinished by the pharmacy whenever opened. maybe you can bring this idea to your administrator and don's attention. it really does work.

as an ex-don and an ex-surveyor your dministrators practice is unacceptable . what needs to be done is that staff (especially the idt members) need to address the residents behavior. if you transfer the resident and don't take them back because they exceeded their 7 day bedhold and if the resident wants to come back and you still have empty beds, you can get cited. the problem is administrators and don's do not screen the resident prior to admission. they need to make sure they have enough trained staff to take care of the that particular resident. according to the federal and state regulations, if you accept and admit a resident to your facility, you better be able to take care of them.

what great ideas....buquets for all.

i second that. what a smart nurse!!!

hello guys i am an ex-surveyor (la county) and don. there is help for all of us. 1. staff need to be more proactive and be more informed regarding the regulation so they can make better decisions. 2. prioritize your work. 3. talk to your colleagues. communication is the basic component to good care. 4. ask questions. and, hold your don/administrators liable for making any bad decisions! good luck

Hi They just don't prioritize their work. If the staff (DON/Administrators) knew how to use the QI reports it would help the staff tremendously. And, if SNF's knew how to decrease their erroneous meds it would leave more time for hands on patient care. :-)

I'm an ex-surveyor (LA County). This practice is illegal. The reason for the 7 days a week RN coverage is because the LVN's are not allowed to assess the residents. They can only gather information for the RN. got to be an RN, 7 days a week, 8 hrs a day in the SNF. Eventhough you only may have 45 patients. :-)