CapeCodMermaid RN

Gerontology, Med surg, Home Health

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All Content by CapeCodMermaid

  1. CapeCodMermaid

    Dispensing meds from a punch card?

    CapeCodMermaid replied to Brady29's topic in Geriatric, LTC

    Our punch cards have a different color strip on the right side which is supposed to remind the nurses to reorder the med. We start at the top left hand corner and punch consequetively....especially...
  2. CapeCodMermaid

    Bait and Switch?

    CapeCodMermaid replied to Natkat's topic in Case Management

    When I was a home health nurse, all the nurses were called Case Managers. We were responsible for deciding what services the patient needed and for how
  3. CapeCodMermaid

    Time management, Patient ratios and Moral turpitude in Rehab/LTC

    CapeCodMermaid replied to cyc0sys's topic in Geriatric, LTC

    I don't know where you work but MassHealth does not reimburse at that high a rate. We lose money on most long term
  4. CapeCodMermaid

    Skilled Notes

    CapeCodMermaid replied to Isitpossible's topic in Geriatric, LTC

    I don't miss paper at all. The progress notes are so easy to read. You don't spend unnecessary time trying to decipher the handwriting--although with some of the notes I've read, it might be better to...
  5. CapeCodMermaid

    Does nurse have to review recaps or can any staff?

    CapeCodMermaid replied to Sheshe11's topic in Geriatric, LTC

    I'd be happy for the help. If they are the third check and are signing that the orders match I don't see a problem. Is there a history of med errors using this
  6. CapeCodMermaid

    Does nurse have to review recaps or can any staff?

    CapeCodMermaid replied to Sheshe11's topic in Geriatric, LTC

    Are you just checking for completeness? If you can read you can see if all the holes are filled
  7. CapeCodMermaid

    Time management, Patient ratios and Moral turpitude in Rehab/LTC

    CapeCodMermaid replied to cyc0sys's topic in Geriatric, LTC

    Oh puhleeeze. Lack of a moral compass? Get over yourself. I've been in the business for years and have seen all the changes good and bad. The staffing ratios are not good but it's due to the...
  8. CapeCodMermaid

    coworkers constantly checking your charting

    CapeCodMermaid replied to MNNICU, RN's topic in General Nursing

    Please don't loose it. Lose it if you must but don't loose it. Part of my job is doing chart audits. We need documentation to prove that we are giving skilled care to our patients. Too many notes I...
  9. CapeCodMermaid

    Public Health Called Me At Home

    CapeCodMermaid replied to Guest 973412's topic in Geriatric, LTC

    If the DPH is in your building doing an investigation and they want to talk to you....you talk to them. If you're not in the building they will often call you at home so you don't have to come in....
  10. CapeCodMermaid

    What Is the Problem???

    CapeCodMermaid replied to CapeCodMermaid's topic in Geriatric, LTC

    It makes the nurses too task oriented. They pass meds and do treatments without having a good grasp on lab results or MD
  11. CapeCodMermaid

    Building-wide burnout

    CapeCodMermaid replied to notanumber's topic in Geriatric, LTC

    Do all these non-nursing tasks generate overtime for the licensed staff? Years ago I ran a very busy sub-acute unit. I asked for a unit secretary and was told it wasn't in the budget. I spent the next...
  12. CapeCodMermaid

    How much sats should a patient with COPD sit at?

    CapeCodMermaid replied to Nursemaxim's topic in Geriatric, LTC

    It's hard to tell what she meant. Personally, I think you should go by your assessment of the patient and not rely solely on the number on the pulse ox. The hard and fast rule of no more than 2 liters...
  13. CapeCodMermaid

    Falls!!!!Falls!!!!!Falls!!!!!!

    CapeCodMermaid replied to texas tea's topic in Geriatric, LTC

    We never move someone who doesn't have full range of motion. Too dangerous to the patient and the staff. Call EMS. They are trained to do
  14. CapeCodMermaid

    Falls!!!!Falls!!!!!Falls!!!!!!

    CapeCodMermaid replied to texas tea's topic in Geriatric, LTC

    It's been my experience that 15 minute checks or hourly rounds do little good in preventing falls. Many thing can happen in an hour. We should always try to find out why the resident fell. In this...
  15. CapeCodMermaid

    Falls!!!!Falls!!!!!Falls!!!!!!

    CapeCodMermaid replied to texas tea's topic in Geriatric, LTC

    Alarms do not prevent falls any more than writing interventions in a care plan does. People are going to fall. Every surveyor likes things done their way. I've been in the business forever and have...
  16. CapeCodMermaid

    Have you ever worked through a agency?

    CapeCodMermaid replied to whslee01's topic in Agency Nurses

    None of the agencies I've worked for whether private duty or Medicare/Medicaid facilities ever wanted a specific amount of experience. As with any place you work, some are good and some are horrible....
  17. CapeCodMermaid

    DON position...great opportunity, or career suicide?

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

    I'm not sure how much you think you should be making. You have very little experience in long term care and the DON is not an easy position. It's all consuming if you do it correctly so if you don't...
  18. CapeCodMermaid

    Being assaulted by a patient

    CapeCodMermaid replied to Sjade's topic in General Nursing

    I'm sorry this happened to you. It seems facilities take even the worst behaved patients with no clue how to really deal with
  19. CapeCodMermaid

    Questioning a doctors order

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

    I don't know where YOU went to nursing school, but I was taught to ask the whys starting on day one. We are not sheep blindly following
  20. CapeCodMermaid

    Long Term Care Nursing is Lame

    CapeCodMermaid replied to purplegal's topic in Geriatric, LTC

    You're lame.... Very
  21. CapeCodMermaid

    New DON, seeking advice

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

    Ah, a pot
  22. CapeCodMermaid

    When do you throw in the towel and call it a wrap?

    CapeCodMermaid replied to lilura's topic in Geriatric, LTC

    The latest and greatest around here is: Pick up your pay stub or we will cancel your direct deposit and they actually do it. So
  23. CapeCodMermaid

    Charting has to be done no matter what?

    CapeCodMermaid replied to Blackcat99's topic in Geriatric, LTC

    Since patients should be sleeping on 11-7 it would be difficult to assess them in order to write a note. Split the work between days and
  24. CapeCodMermaid

    What Is the Problem???

    CapeCodMermaid replied to CapeCodMermaid's topic in Geriatric, LTC

    HERE is one of the problems: I got called to do dining room duty today even though I run the busiest unit--we had 6 admissions today. I told the ADON it was a sh*& show because I was in the weeds,...
  25. CapeCodMermaid

    Charting has to be done no matter what?

    CapeCodMermaid replied to Blackcat99's topic in Geriatric, LTC

    There must be a skilled note at least once a day after the first 72 hours. If the day shift didn't document, the 3-11 shift should. Document what YOU did, what YOU saw. Not what happened on another...