CapeCodMermaid RN

Gerontology, Med surg, Home Health

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All Content by CapeCodMermaid

  1. CapeCodMermaid

    PPS-Triple check tool

    CapeCodMermaid replied to lisalake's topic in MDS Coordinator Information

    OKAY- finally had a chance to attach the Triple Check tool here. I hope all y'all find it useful. TRIPLE CHECK CLAIM CERTIFICATION
  2. CapeCodMermaid

    Frequent Faller

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

    Do you use fall mats? That way if she does slip at least she'll sit on a soft mat and not the hard floor. Make sure you care plan the silky nightgown. I had a resident like that. The surveyors wanted...
  3. CapeCodMermaid

    New LTC nurse

    CapeCodMermaid replied to HurricaneCasRN's topic in Geriatric, LTC

    get good shoes! Great advice. Ask lots of questions from people who know more than you. Get to know the doctors...they love it when they are asked to do some off the cuff teaching (at least the ones...
  4. CapeCodMermaid

    New Nurse needs help interpreting labs, please

    CapeCodMermaid replied to nycNurse2b's topic in Geriatric, LTC

    It's not up to you to interpret the results of the labs. It is your responsibility to report ABNORMAL lab values the the NP or MD. Unless you have specific parameters from each doc on how abnormal...
  5. CapeCodMermaid

    Dilemma: FORCED to float to med/surg - advice please!?!?!

    CapeCodMermaid replied to anndoodle's topic in Geriatric, LTC

    59 residents for one nurse on 3-11? Ridiculously unsafe. I have to staff to census and acuity, but that is too many residents for one licensed
  6. CapeCodMermaid

    How to approach this?

    CapeCodMermaid replied to Meraki's topic in Geriatric, LTC

    Facilities must have a grievance procedure. Ask what their procedure is and fill out the
  7. CapeCodMermaid

    Heel care for the geriatric patient

    CapeCodMermaid replied to toptastic's topic in Geriatric, LTC

    We use skin prep on intact heels and pressure relieving mattresses. If the heels are boggy, we use heel floats or if the patient says no, pillows. In Massachusetts we use the Norton Plus score....on...
  8. CapeCodMermaid

    Low Census...and LOVING IT!

    CapeCodMermaid replied to qestout's topic in Geriatric, LTC

    Hmmmm....who cares about the nurses? I can't tell you how much time in my day I spend defending the nurses, the need for increased staffing, arguing with admissions about taking residents way too sick...
  9. CapeCodMermaid

    Am I freak for charting meds as I pull them?

    CapeCodMermaid replied to Izzy11's topic in Geriatric, LTC

    Pour chart and pass or pour pass and chart. Either way is correct as long as you are consistent. I've always popped, initialed, and handed out the meds. If they refuse I go back an circle. Never rely...
  10. CapeCodMermaid

    UPHD's

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

    If the resident goes to the hospital, you lose money. It's that simple. All studies show that residents do better overall when treated in a familiar environment so it's best for them to be kept where...
  11. CapeCodMermaid

    Nursing Budget

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

    Call all your vendors and play let's make a deal. Honestly you have to be pushy to get them to cut costs but if you shop around you can save from 5-10%. Take a look at wound supplies. I worked in one...
  12. CapeCodMermaid

    I'm embarrassed, but can use some advice on time management

    CapeCodMermaid replied to nlk96's topic in Geriatric, LTC

    One good source of information is your pharmacy consultant. He or she should be able to give you the up to date regs in your state. We don't keep the insulin in the fridge once it's opened. Some old...
  13. CapeCodMermaid

    Low Census...and LOVING IT!

    CapeCodMermaid replied to qestout's topic in Geriatric, LTC

    I'll probably get flamed but here goes: how do you think the facility makes money? It's by having the beds filled and making budget. Y'all like raises. Where is the money going to come from if the...
  14. CapeCodMermaid

    hired as RN consultant to res care

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

    I know the job market it tight, but why would you take a job without knowing what the job description is? Once you get through the initial chart review, the ongoing reviews should only take about 15...
  15. CapeCodMermaid

    Interview Tues, leaving ICU for LTC

    CapeCodMermaid replied to kimmersRN's topic in Geriatric, LTC

    Not to burst your bubble, and I, for one, like it when nurses with experiences elsewhere come to a skilled facility, but....... you'll have just as much charting to do in a SNF, just as many...
  16. CapeCodMermaid

    DNS is an LVN??

    CapeCodMermaid replied to ChargeNurseAmy74's topic in LTC: Directors, Assistant

    In Massachusetts, an LPN or LVN can NOT be a director of nursing or director of nursing services. Whatever initials you use, the job is the same and to be a DON or DNS you have to be an
  17. CapeCodMermaid

    Admitting a new patient.

    CapeCodMermaid replied to WittySarcasm's topic in Geriatric, LTC

    Tell the hospital you need a typed discharge summary with a list of medication orders. In Massachusetts, if we don't have a discharge summary, we can send the patient back to the
  18. CapeCodMermaid

    Has Mr Peabody been here with his Way Back Machine?

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

    I've already started polling the residents. So far they are all against
  19. CapeCodMermaid

    State~!

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

    Deb, I fear you are the exception, not the rule in
  20. CapeCodMermaid

    Weekend Supervisor in LTC Interview

    CapeCodMermaid replied to surfnbeagle's topic in Geriatric, LTC

    The push now is to treat residents IN the facility if they get sick. Sometimes it's just easier for the staff nurses to send them to the hospital because they have 20 or 25 other residents to deal...
  21. CapeCodMermaid

    My resident died yesterday. What should I have done differently?

    CapeCodMermaid replied to NN2BVE's topic in Geriatric, LTC

    If the patient didn't have a DNR order, this nurse HAD to call the code. It isn't up to you or me to decide who to code and who not to. If you don't attempt every measure you can be sued for...
  22. CapeCodMermaid

    State~!

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

    It would be illegal in this state, highly unprofessional, and suspect if a DON was offered a job by a state surveyor during
  23. CapeCodMermaid

    Help

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

    Since on the whole they were so troublesome, I think he has stopped
  24. CapeCodMermaid

    Help

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

    The nurses were not in a union. This particular owner thought the way to fill nursing hours was to import nurses from the Philippines., give them a place to live and a contract they were supposed to...
  25. CapeCodMermaid

    State~!

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

    I might suggest that if someone had helped/supported the DNS all along, she might not have been burned