longtermcarern

in my 25 years in the ltc field, I have only seen a couple of patients like this. In this day and age, no one should ever get this bad. Being tube fed, they had the ability to give her the proper nutrition she needs to help maintain her skin integrity so it surely must of been inadequate care. Has the DR had any labs drawn, albumin etc to make sure she was receiving the proper nutrition? We do need to keep in mind, it takes one shift of neglect, 8 hours, to start a decube. Kennedy ulcers can appear in under 8 hours. I have seen many a decube come from the hospital on a surgical patient. Just the time they lay on the operating table is enough to cause a decube in our most fragile people. the nursing home your patient came from should most definitly have an investigation from the state. Please do report them and keep us informed of the outcome.

Our individual sheets have an area for date/time, number of pills dispensed, signature and remaining pills in packet. so I always do it this way: 3/5/5 1800 one (1) longtermcarern twentynine (29) Our pills come in a packet of 30 so if I give one and there are 29 left I spell it out. each resident has there own packet and you can not borrow from resident to resident.

a couple years ago, I had the nurse who followed me change the numbers on the count sheet to reflect differently from what we counted together. When the DON called me I was able to remember exactly how many pills were left in a particular residents packet and she could see the numbers were changed so she knew I was telling the truth. The other nurse was let go, but a copy of that count sheet would of been a life saver for me had she not believed me. Now I put my numbers in a way no one could ever change them. I print the whole number on the individual sheet and fill the box on the other.

my husband works as a roughneck... that is oilfield term for working the floor of a drilling well. For the price of gas and oil you would think he would make big bucks but he hasn't had a raise in 8 years and he only makes 4$ an hour more then when he started in 1976.

follow the P&P for your facility exactly. in our facility, we flush between each med with 10cc, off for 1 hour before and after dilantin etc. every facility has their own policy and that is what the surveyors are looking for.

I paid $50 for my cardiologyII from a DR at our facility. The sales reps always give them to him and as he gets them he sells them to the nurses.

I have been using it myself for about 4 years now. 300mg tid for peripheral neuropathy. it worked good for 3 1/2 years, the last 6 months it takes up to 1 hour for the effect to start and only lasts about 4 hours. I think I need an increase in the dose or something new.

The second shot can be given one or 2 months after the first. You get a better response if it is one month. The studies I did when I was infection control nurse stated the the series could also be completed over an 18 month period. If you have a titer drawn and if shows the response I wouldn't worry about it. While most show a response after the series of three, there are some who require more. I had to have 5 :uhoh21:

As a child I grew up next door to a woman who stayed in bed all the time. She was a stepmother to my best friend and I often played over there. We each had a number assigned to us and she would ring the bell however many times depending on which one of us she wanted. There was nothing medically wrong with this woman she just chose to lay there, eat and get fattereach year. Something happened after a few years and she got up out of bed, dieted and exercised. She lost over half of her body weight and started living again. But the damage was already done and she died very young from heart failure.

I know just how you are feeling. I lost my 56 year old sister in Dec.97 and my 53 year old sister in Feb.98 from cancer that had mets to the liver. just 3 months apart. Keep focused on everything positive, I think it can be the most powerful medicine for your sister and you. sending positive energy your way~~~~~~((earle58))

The pay around here is the same or more then the hospital. A typical day? No such thing!! For instance on Tuesday of this week I started work at 3pm, took report on 20 patients, 5 with scheduled HHN treatments, 6 diabetics with scans and insulins, 1 new admit to assess and do new admit physical and orders on. Dr who came in during supper and wrote orders on 5 pt's, 1 pt who fell and hit her head, q 2hour neuro checks. 2cna's to help toilet, ambulate, feed and turn patients. By the time I did my 2 med passes, treatments, medicare charting, took 1 20 minute break, I felt lucky to clock out only 40 minutes late. Then last night I had a different set of 20 patients, all long time residents, only 1 HHN treatment, and only 1 insulin, the evening was slow and easy, got my breaks and punched out by 11:05. A no stress night!! Each shift is different and rewarding. been doing it for 25 years and would not consider anything else. I get up each day looking foward to going in and working with MY residents. On the other hand day shift positions are very rare in LTC and if 2 opened up at the same time, I would look for the worm in that apple.

It should be what ever the pt normal home routine is. If this person was in the habit of getting up everyday at 4am and taking their shower then that is ok, but to bathe a person at night just for the convenience of staff it is never ok, even if they have dementia.

Lantus can be given anytime. But if blood sugar is not controlled on it, it is probably not right for that person. Myself for instance. I was taking 82 units of lantus every evening and one night my dementia crept in and 20 minutes after I injected, I drew it up again and injected a second time. :imbar blood sugar was checked every hour for 5 hours and then every 2 hours for the remainder of the night and it never dropped below 200 all night. Went back to 70/30 and I have much better control now.

Have you looked at this site http://www.eldercare.com ?

We have therapy dogs come in to visit 1 or 2 times a month, our residents love and look foward to it. We have one lady with massive damage from cva that just comes to life with the biggest smile when they visit.