CapeCodMermaid RN

Gerontology, Med surg, Home Health

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All Content by CapeCodMermaid

  1. CapeCodMermaid

    Patient Care Coordinator or Unit Manager...Advice Needed

    CapeCodMermaid replied to RNgrrl09's topic in Geriatric, LTC

    I say get a job description of both jobs with clear expectations and make your decision
  2. CapeCodMermaid

    LTC vs SNF vs SUBACUTE??

    CapeCodMermaid replied to superlivyRN's topic in Geriatric, LTC

    No. Subacute units are usually a dedicated floor or wing of a skilled nursing facility. Stay there is relatively short. An LTAC is LONG term ACUTE care...not sick enough for the hospital but not...
  3. CapeCodMermaid

    Advice needed problem nurse

    CapeCodMermaid replied to Confused DON's topic in LTC: Directors, Assistant

    Given what you've written and leaving out all the extraneous info about the administrator, I'd fire her. We have progressive discipline, but we don't have to go through all the steps if the...
  4. CapeCodMermaid

    Can they make me stay at the hospital without pay?

    CapeCodMermaid replied to myoglobin's topic in General Nursing

    I worked in a SNF as the assistant director of nursing. We got hammered by a huge, unexpected snow storm over a weekend. Theynasked me to come in since I lived close by. I was there for three days...
  5. CapeCodMermaid

    Nursing now vs. then

    CapeCodMermaid replied to SweetheartRN's topic in General Nursing

    I graduated in 1982 ...diploma from a hospital based program. We didn't graduate until we had done EVERYTHING at least three times so when we got to the floor for our first job, we had already done...
  6. CapeCodMermaid

    How to medicate chronic pain

    CapeCodMermaid replied to prettyinblu's topic in Pain Management

    I have a patient who takes dilaudid 24mg every 3 hours around the clock. She says the best her pain ever gets is a 4. She is a tiny woman but remains alert and able to do her adls. So 48 mg a day...
  7. CapeCodMermaid

    Ever been a patient and had a former student take care of you???

    CapeCodMermaid replied to jmqphd's topic in Nursing Educators, Faculty

    Think of it this way: you'll have the firsthand opportunity to see if what you taught stayed with
  8. CapeCodMermaid

    Working for Hospice?

    CapeCodMermaid replied to nurseontheway's topic in Hospice, Palliative

    I'm not a hospice nurse so I can't speak to what it's like to be one, but I am the DNS of a skilled facility with many hospice patients. We have contracts with several different hospices since the...
  9. CapeCodMermaid

    Do you think marijuana should be legalized?

    CapeCodMermaid replied to Blackcat99's topic in Correctional

    WOW...that seems to be a bit of an hysterical answer...chaos....drug lords over running the country:eek: There is no scientific proof that marijuana is a gate way drug. Everyone I knew in college in...
  10. CapeCodMermaid

    Does anyone LOVE Geriatrics?

    CapeCodMermaid replied to geekchic's topic in Geriatric, LTC

    PICC lines, mid lines, trachs , wound vacs ,tpn, what more "technical" things do you
  11. CapeCodMermaid

    frequent call in's or no shows

    CapeCodMermaid replied to nola1202's topic in Geriatric, LTC

    I have a list of per diem nurses and CNAs. Trouble is they never want to pick up a shift. Honestly I think there is a group of them who say they want to be per diem and end up at 4 or 5 facilities....
  12. CapeCodMermaid

    lpn as ADON?

    CapeCodMermaid replied to nd deb's topic in LTC: Directors, Assistant

    Again, it all depends on the state you work in. In Massachusetts, an LPN CAN NOT supervise an RN in any clinical area and since the DON must be an RN, the ADON who is often called to fill in for the...
  13. CapeCodMermaid

    Am I freak for charting meds as I pull them?

    CapeCodMermaid replied to Izzy11's topic in Geriatric, LTC

    She should be fired on the spot. This is a very dangerous practice. How does she know the med wasn't changed or
  14. CapeCodMermaid

    First job out of nursing school in LTC...any advice

    CapeCodMermaid replied to NurseM2011's topic in Geriatric, LTC

    anopenheart....it seems you have an open mind as well! Take your time...find your own way...don't let anyone else tell you to take shortcuts. It's a great place to learn new skills...especially time...
  15. CapeCodMermaid

    BSN or More Experience

    CapeCodMermaid replied to luvtosmile's topic in LTC: Directors, Assistant

    LOL...maybe you MEANT to say roll since you know most managers in LTC have to wear roller skates to keep
  16. CapeCodMermaid

    Documentation "No-No's"?

    CapeCodMermaid replied to elb252's topic in Geriatric, LTC

    "Attempted to remove central line prior to discharging patient, but patient ran off before it could be pulled. Caught up with patient in the elevator, and he picked this writer up by the shirt and...
  17. CapeCodMermaid

    Non-healing Wounds

    CapeCodMermaid replied to txdon's topic in LTC: Directors, Assistant

    Hospice or not, have you had the tube discussion? We had a man who wouldn't eat, couldn't have a tube, was on dialysis and we still got hammered by the DPH because his would got worse. You can do...
  18. CapeCodMermaid

    BSN or More Experience

    CapeCodMermaid replied to luvtosmile's topic in LTC: Directors, Assistant

    Can you work and do school at the same time? I've been in management for years without a BSN. If you really want a management position.....it's management ROLE not
  19. CapeCodMermaid

    Documentation "No-No's"?

    CapeCodMermaid replied to elb252's topic in Geriatric, LTC

    OMG.
  20. CapeCodMermaid

    Documentation "No-No's"?

    CapeCodMermaid replied to elb252's topic in Geriatric, LTC

    Trouble is, we meet psycho families EVERY day. And there are plenty of ads on television by attorneys urging families to sue the nursing home for a fall or a pressure ulcer or an 'unexpected death.'...
  21. CapeCodMermaid

    Documentation "No-No's"?

    CapeCodMermaid replied to elb252's topic in Geriatric, LTC

    I identify the other nurses by name in my notes:" Had family meeting. Daughter Janet Smith, RN Pat Wall, SW Jane Johnson, and administrator Mike Lamp present for the meeting." That practice makes it...
  22. CapeCodMermaid

    Documentation "No-No's"?

    CapeCodMermaid replied to elb252's topic in Geriatric, LTC

    Things are very different in the States where we get sued for all sorts of things. An incident report would only give more evidence that something 'bad' happened. Everyone seems to expect a perfect...
  23. CapeCodMermaid

    Documentation "No-No's"?

    CapeCodMermaid replied to elb252's topic in Geriatric, LTC

    Never write "Incident report done". Incident reports are INTERNAL documents which can not be subpoenaed. If you mention one in your note, however, it's fair
  24. CapeCodMermaid

    Documentation "No-No's"?

    CapeCodMermaid replied to elb252's topic in Geriatric, LTC

    It sounds obvious but if you chart you notified the MD about something, chart his response even if he didn't want to do anything. "MD notified that resident X's BUN was 70. MD declined any further...
  25. CapeCodMermaid

    Spoke with the manager and feeling less confident with care..

    CapeCodMermaid replied to sn543's topic in Geriatric, LTC

    Please don't tell the DON you talked about her here! I am the DON in my building and I don't tell the nurses that I post on this site. We all need a place to vent that is relatively anonymous. Your...