CapeCodMermaid RN

Gerontology, Med surg, Home Health

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All Content by CapeCodMermaid

  1. CapeCodMermaid

    LTC

    CapeCodMermaid replied to Courtneyrn9317's topic in Geriatric, LTC

    I've been in the business since the late '70's. I've been a DNS for the last 10 years. Stress is a way of life. Things aren't going to change and every year CMS comes up with more and more...
  2. CapeCodMermaid

    A bunch of hypothetical questions about DONship

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

    What isn't good on your resume are a lot of short stays at various places. Bad facilities can be turned around . THAT looks good on your
  3. CapeCodMermaid

    Risk Managers

    CapeCodMermaid replied to CoffeeRTC's topic in Geriatric, LTC

    Check on line. I stole a Falls excel spreadsheet that's excellent. I think you could modify it to make one for skin tears or other
  4. CapeCodMermaid

    Difficult Resident to Pass Meds. Advice?

    CapeCodMermaid replied to Newgurl17's topic in Geriatric, LTC

    Even people who have been deemed incompetent have the right to refuse
  5. CapeCodMermaid

    Crushing Oral Medications...New Regulation

    CapeCodMermaid replied to ltcnurse4u's topic in Geriatric, LTC

    CMS has backed off on this reg. They are re-writing it to say it's 'best practice'. We are taking a resident centered approach and will write orders and care plans to cover us crushing and...
  6. CapeCodMermaid

    Jtag!!

    CapeCodMermaid replied to ndragonfly's topic in Geriatric, LTC

    A DON can be fired for any reason at all. You could have 2 perfect surveys back to back and still get
  7. CapeCodMermaid

    Patient's "right" to abuse nurses...I need your opinion

    CapeCodMermaid replied to MsNewbee's topic in General Nursing

    No cognitively intact patient has the right to abuse their nurse. End of
  8. CapeCodMermaid

    Geriatric bruising and what to do

    CapeCodMermaid replied to iamoph's topic in Geriatric, LTC

    Facilities have wacky policies. I worked for a large company which wanted us to do a UA C&S after every fall. I argued against it. Sure, if they had other symptoms grab a urine, but many times the...
  9. CapeCodMermaid

    Agency Use? How Much & Staffing Solutions

    CapeCodMermaid replied to Chris Caulfield RN NP-C's topic in LTC: Directors, Assistant

    I'm not going to answer your questions one by one, but around here, no one uses agency. Facilities fill the holes in the schedule with managers and 'anyone in the building who has a license is...
  10. CapeCodMermaid

    Crushing Oral Medications...New Regulation

    CapeCodMermaid replied to ltcnurse4u's topic in Geriatric, LTC

    It is against every regulation to hide medications in food--applesauce, pudding. You're forcing someone to take meds when they clearly don't want them. Even someone with dementia has the right to...
  11. CapeCodMermaid

    Crushing Oral Medications...New Regulation

    CapeCodMermaid replied to ltcnurse4u's topic in Geriatric, LTC

    It's not your management forcing this on you. It's CMS. The state surveyors don't have any input...they do what they're told from their bosses. This is one of the stupidest regs I've seen and I've...
  12. CapeCodMermaid

    Desperate for advice

    CapeCodMermaid replied to nursegup's topic in Geriatric, LTC

    Shame on your DON. She should make time to speak to you. I've run huge buildings. If I was busy, I'd ask the staff person to come back later in the day, but I always made
  13. CapeCodMermaid

    Geriatric bruising and what to do

    CapeCodMermaid replied to iamoph's topic in Geriatric, LTC

    Care plans do NOT need an MD order. However, the doc is supposed to be in agreement with the plan of care. As the DON, I expected the nurses to investigate every bruise. If there was an abdominal...
  14. CapeCodMermaid

    Timeline for a bruise

    CapeCodMermaid replied to iamoph's topic in Geriatric, LTC

    I can't help you find a source but personally speaking I've had a bruise last for longer than 2 weeks and I'm not that
  15. CapeCodMermaid

    Wall of Shame

    CapeCodMermaid posted a topic in LTC: Directors, Assistant

    My facility is getting a new DON (I just quit). I've heard at her last facility she had what she called a "wall of shame" on which she would post pictures of nurses who had made mistakes. I am...
  16. CapeCodMermaid

    Crushing Oral Medications...New Regulation

    CapeCodMermaid replied to ltcnurse4u's topic in Geriatric, LTC

    It's not just YOUR company. It's supposed to be a dignity thing. I had a surveyor ask me if I took MY meds while I was eating. I replied "It's not about what I do. It's what the individual resident...
  17. CapeCodMermaid

    What do nurse managers and clinical directors actually do?

    CapeCodMermaid replied to poopylala's topic in Nurse Management

    They might be delegatable tasks, but chances are there is either no one to delegate to or anyone you try to delegate these tasks to would do a half ass
  18. CapeCodMermaid

    Showers in nursing home

    CapeCodMermaid replied to Vonique's topic in Geriatric, LTC

    The DPH is really looking more closely at care plans so we make sure ours are reflective of each resident. A good care plan has saved me more than once from a
  19. CapeCodMermaid

    Showers in nursing home

    CapeCodMermaid replied to Vonique's topic in Geriatric, LTC

    Back in the day before twice weekly showers became common place, all the residents would get a thorough bed bath twice a day. I had a 96 year old woman come up to me and ask "Mermaid, do you take two...
  20. CapeCodMermaid

    Is This Becoming Standard?

    CapeCodMermaid posted a topic in Geriatric, LTC

    I've been working in nursing homes for more than 20 years. The patients are getting sicker but the staffing has remained the same. I ran into a former co-worker who told me at my old building they've...
  21. CapeCodMermaid

    What do nurse managers and clinical directors actually do?

    CapeCodMermaid replied to poopylala's topic in Nurse Management

    What kind of word is responsibigies ? As the DNS I am responsible for all 150+ patients, 100 staff--everything they do and don't do. It's a very stressful life...been on call 24/7 for the past 10...
  22. CapeCodMermaid

    Is This Becoming Standard?

    CapeCodMermaid replied to CapeCodMermaid's topic in Geriatric, LTC

    I know, or think I know, a lot more than I feel comfortable posting here. But, a few key players have been walked out and a few others have quit. Rumors float around town that it's for sale, but God...
  23. CapeCodMermaid

    Employee Motivation

    CapeCodMermaid replied to LTCEducator1966's topic in Geriatric, LTC

    I worked in a building that used Relias. It's not a very good program. In the first few classes I looked at, I found several mistakes. It's all just part of the companies trying to cut down on nursing...
  24. CapeCodMermaid

    Offended a coworker

    CapeCodMermaid replied to Possum_RN's topic in Patient, Colleague Relations

    I worked in SNFs as the director of nursing. Everyone is responsible for answering call lights and especially responding to alarms. I have seen nurses walk three times around the unit looking for a...
  25. CapeCodMermaid

    Calling patients by "pet" names.

    CapeCodMermaid replied to dbabz's topic in Patient, Colleague Relations

    I was recently in the ER as a patient. EVERY person who came in my cubicle called me Mermaid. They didn't ask what I preferred. They all just assumed it was okay to call me by my first name. They were...