HeyHeyitsMaay

I work for a small hospice with a census of 30. We have a marketer with no clinical background who's pretty difficult to deal with. She tells me patients/families/everyone said or did things that never happened at all. For example telling me that doc...

Your patient is a male in his mid 60's with a hospice so of ES COPD and is dependent on 6L O2 continuous per NC to maintain sats at or above 90%. Comorbidities: morbid obesity, htn, poly substance abuse use disorder. Most recent hospitalization requi...

I just want to say that I was not a nurse when I came here and signed up in 2007. I never in my life thought I would or could become one. It was absolutely because of this place and the people here that I went from CNA to lvn to rn. I wish brian knew...

You'll do better than you realize. In Texas you don't have to be a LNFA to be an ED of an ALF. And it's a blessing for those of us working with you on the case mgmt. Side coming from SNF's because ALF's have had an issue in my area anyway of having t...

I was interviewed this past Summer for a DON position at another facility. I was the ADON and am now the DON at a very successful snf, but the team that I work with - even though they're amazing, they've all worked together for a decade and it's very...

I was sent to AANAC RAC certification training for 3 days this week by our consultant. Bear in mind that my facility usually has 50 medicare in the building and rarely goes under 40. We're down to 30 and my administrator is losing it. Last week I was...

Lol "nothing better to do." When you're DON of the year, when you volunteer to work so your floor staff can take breaks...even at night..when your first survey results in only 4 tags in one of the biggest citoes in the u.s. with notoriously ridiculou...

And this is why I refuse to go work for another facility. With a corporate office that supports this kind of abuse, no way in the world would I cooperate with treating my staff that way. I have had to be pretty stern because I don't ask for reasons f...

I did a test yesterday - and turned on a call light in a patient's room and then proceeded to stand in the bathroom and wait. All of our aides were in the dining room for lunch or feeding residents in their rooms. The nurses were on the floor, at the...

I work for a privately owned SNF with a regular PPD of 6. Even with a central supply clerk, dedicated unit clerk and incredible corporate support - the acuity and the expectations are so high along with turn over that I regularly want to quit nursing...

I'm on call again this week and last night, an hour after getting home from work I had to go in for a nurse who started throwing up and finish up her 12 hour shift. Once again, I don't mind. But I'm a mom - and to be quite transparent I've realized t...

I will say that we have an MDS nurse employed by our corporate office to travel through our facilities and she was recently put on TPAPN. The company had to remove her from her position due to the stipulations placed on her license. I know that my co...

Ours don't really help out with anything at all. I adore them and understand why they don't help out, their jobs really are critical. Reckon I just wish they were at least a little able to throw in every once in awhile.

Your facility and this issue sounds identical to mine. I reduced the issue to the typical 30:1 patent nurse ratio we're used to seeing in skilled nursing vs. the higher than ever acuity of the skilled patients we're accepting. CMS and state rules fo...

I have two LVN's in my facility doing MDS assessments. I complete initial assessments and sign and their assessments are consistently impeccable. We dont use our MDS nurses on the floor or in the on-call rotation because completion of their assessmen...

I work for probably the most amazing skilled nursing facility I've ever seen. We truly love our residents, rehab patients and staff with all of our hearts. I've been the ADON for about a year now and I'm having an issue with our evening shift. Our nu...

I love your answer Isis. I'm actually working on our administrator to get us something like CareRight Voice to help with ADL charting to make it easier on our aides. I can't stand constant reprimands their jobs working on the floor are already hard e...

I reprimand both nurses, med aides and cma's when I see this happening. Our culture in our facility is such that even our administrator, maintenance and house keeping answer call lights (and respond to the extent of their licensure or lack of it...th...

I graduated from my LVN program in 2009. One of the women who graduated with me was 60 years old. Ever watch the movie, The Rabbit Proof Fence? They showed that to us in my LVN program. Because of THAT MOVIE ALONE, I know that if it's what God put in...

This happened to me when I was an agency nurse. When management is using wisdom, for QA purposes they won't put you in a position like this without either having the on call nurse by your side, a unit manager on site to monitor your progress and be a...

The issue is that most places don't have enough staffing to cover health care needs. We're faced with initiatives like INTERACT that require advanced critical thinking skills of new grads who aren't even taught to make a bed or why it's a critical fi...

I did the exact same thing also! I lost an Ativan..it was so tiny and I even tore the trash on my med cart apart looking for it. Depending on the facility you should be o.k. I would offer to take a drug test and let it be a lesson that makes you impl...

In THAT case....AWESOME! I would encourage you to apply at one of the Grace Care facilities. Northpointe especially has incredible learning opportunities as long as you don't mind orienting as a CNA, then med aide before RN. Which is the policy for n...

I will tell you what I tell every other GN that I meet. If you have the opportunity to work in LTC/SNF, you truly should. It is arguably one of the hardest nursing specialties there is. Without long term care I absolutely would not have been able to ...

I'm trying to get my nurses to get in the habit of reporting most recent blood sugar for diabetics, last BM and last narcotic dose if applicable. These particular pieces of info help the oncoming shift tremendously and are key to avoiding some sentin...