CapeCodMermaid RN

Gerontology, Med surg, Home Health

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All Content by CapeCodMermaid

  1. CapeCodMermaid

    Catheter Policy

    CapeCodMermaid replied to punkdmm's topic in Geriatric, LTC

    Make sure you know the diagnoses we can use for catheters. We always remove them at 6am and include in the orders: DC catheter. If no void in 8 hours reinsert catheter. Saves you a call to the MD who...
  2. CapeCodMermaid

    "My Nurses"

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

    I'm a DNS is a SNF. I always refer to the staff as 'my nurses'. It's not being possessive as much as being protective of them and how they are sometimes treated or spoken to or talked about by the...
  3. CapeCodMermaid

    Toileting program

    CapeCodMermaid replied to litbitblack's topic in Geriatric, LTC

    I've been a nurse for a long long time and honestly I've never seen anyone whose bladder was really retrained through a bladder retraining program. These are old people for goodness sakes. If they're...
  4. CapeCodMermaid

    Foot Care

    CapeCodMermaid posted a topic in Geriatric, LTC

    I went on a foot patrol today since I had some concerns with the way my residents' feet are being assessed. I took off one woman's sock to assess her heels, and dry, dead skin flew out and landed on...
  5. CapeCodMermaid

    Antipsychotic Focused Surveys

    CapeCodMermaid replied to cgalloway's topic in Geriatric, LTC

    Call your pharmacy consultant. He/She would know the
  6. CapeCodMermaid

    Directors covering open shifts

    CapeCodMermaid replied to RainRN1's topic in LTC: Directors, Assistant

    I ran a very large, very busy SNF. I did everything for my staff from helping with tray pass to toileting residents to making beds to staying late every Friday to enter orders into the computer for...
  7. CapeCodMermaid

    Directors covering open shifts

    CapeCodMermaid replied to RainRN1's topic in LTC: Directors, Assistant

    In my area, all facilities are having trouble recruiting nurses which is odd since the hospitals aren't hiring new grads. The facility is beautiful and has a great reputation in the community. New...
  8. CapeCodMermaid

    Reporting unsafe care

    CapeCodMermaid replied to lmccrn62's topic in Geriatric, LTC

    Start with the Director of Nursing by giving her concise examples of what you think is unsafe care. If she doesn't listen or you think she's not going to do anything to remedy the situation, go to the...
  9. CapeCodMermaid

    Double Shift

    CapeCodMermaid replied to Adele_Michal7's topic in Geriatric, LTC

    I used to do 3 or 4 doubles a week. Was the manager from 7-3, passed meds from 3-11 and came back the next day. It wasn't fun, but the pay checks were. I was young then....in my 40's. Couldn't do it...
  10. CapeCodMermaid

    Oh boy

    CapeCodMermaid replied to Gigi72's topic in Geriatric, LTC

    This is a SNF....I'm guessing there isn't an in house pharmacy. I would have called the facility the patient came from and asked for a 3 page referral-it's a regulation at least in Massachusetts. If I...
  11. CapeCodMermaid

    How to respond when residents say "I love you" (in a family way)

    CapeCodMermaid replied to Live.Love.Nurse.♡'s topic in Geriatric, LTC

    Maybe it's because I'm getting to be the age of some of the residents but when they say an I love you, I tend to say it back-especially if they have dementia. It doesn't hurt anyone. It certainly...
  12. CapeCodMermaid

    Diabetes management in LTC

    CapeCodMermaid replied to kfostercma's topic in Geriatric, LTC

    What a wonderful medical director!! Just be aware that many stable diabetics are put on sliding scale insulin in the hospital because they have some sort of infection or are on prednisone. Try to get...
  13. CapeCodMermaid

    Diabetes management in LTC

    CapeCodMermaid replied to kfostercma's topic in Geriatric, LTC

    How old is she? The docs around here and in the world of academics don't think HgB A1C should be kept to the same numbers in older people. The theory is we tend to drop our blood sugars at night...
  14. CapeCodMermaid

    RN - Crushing medications

    CapeCodMermaid replied to DDdove's topic in Geriatric, LTC

    Most places I've worked have policies that read: flush with 30 ml before the med pass, 5ml flush between each med, and 30ml after the pass. Someone needs to do an EVIDENCED based test on this to see...
  15. CapeCodMermaid

    Diabetes management in LTC

    CapeCodMermaid replied to kfostercma's topic in Geriatric, LTC

    Do these elders really need a sliding scale? If the MD or NP addresses the basal insulin needs, many of the sliding scales can go away. It's not a good way to manage insulin dependent diabetics. It's...
  16. CapeCodMermaid

    Directors covering open shifts

    CapeCodMermaid replied to RainRN1's topic in LTC: Directors, Assistant

    I was just thinking the same thing. The last 3 jobs I've discussed with recruiters have the expectation that the DON will push a cart daily and perform the duties of a DON. I've been in the business...
  17. CapeCodMermaid

    SigmaCare

    CapeCodMermaid posted a topic in LTC: Directors, Assistant

    Is anyone using SigmaCare for their EMARs and ETARs? We are starting training next week and although I am excited about the prospect of EMR, I am a bit uncertain of how everything will really work. My...
  18. CapeCodMermaid

    Skilled nursing facility helped.. !!!

    CapeCodMermaid replied to Zesikajia's topic in Geriatric, LTC

    I've been working in SNFs and LTC longer than some of you have been alive. It gets more difficult by the day. Reimbursement has not increased at the same rate as acuity. We are expected to do more...
  19. CapeCodMermaid

    AMA discharges

    CapeCodMermaid replied to jdub6's topic in General Nursing

    In most SNFs leaving AMA means you don't get anything....no meds, no 3 page referral, no follow upbooked...zip. Sometimes that's enough to convince someone to stay. Most times not. Personally, I think...
  20. CapeCodMermaid

    I Made an Absolute 'No-No" Mistake :(

    CapeCodMermaid replied to frustratedRN16's topic in General Nursing

    I don't think it was the same surveyor but one walked in to a place where my friend was the DON because the family called and said their grandma wasn't getting the correct IV fluid (by the way, they...
  21. CapeCodMermaid

    I Made an Absolute 'No-No" Mistake :(

    CapeCodMermaid replied to frustratedRN16's topic in General Nursing

    We have many standing orders but Benadryl is not on the list. It's on the Beer's list and isn't a good drug to use in the elderly. I've had nurses medicate residents without orders then call the MD...
  22. CapeCodMermaid

    Is it okay for RN to ask recovery patients not to swear?

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

    I do not usually drop the f bomb. However, I recently fractured a bone and had diverticulitis. I was in sheer agony...far worse than child birth. I warned the nurses before they moved me or tried to...
  23. CapeCodMermaid

    Nurses smoking weed?

    CapeCodMermaid replied to bunnynurse's topic in General Nursing

    Quote from juanitarn I think marijuana is a crutch. I hate to think I am being cared for in the hospital by persons who need a crutch. Marijuana is not only illegal in most states it is...
  24. CapeCodMermaid

    Med pass 55+ residents and med error

    CapeCodMermaid replied to Newnursey86's topic in Geriatric, LTC

    The DPH in Massachusetts would disagree, but you have to get through the med pass any way you
  25. CapeCodMermaid

    Med pass 55+ residents and med error

    CapeCodMermaid replied to Newnursey86's topic in Geriatric, LTC

    I wouldn't rely on straws sticking out of the MAR. Suppose a demented resident decides to take them? Or the book falls on the floor? And since most facilities are or are going to be using EMR, it's...