CapeCodMermaid RN

Gerontology, Med surg, Home Health

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All Content by CapeCodMermaid

  1. CapeCodMermaid

    Meds due at shift change

    CapeCodMermaid replied to zieglarf's topic in Geriatric, LTC

    Surely your facility has a policy you can
  2. CapeCodMermaid

    Which nurse called it?

    CapeCodMermaid replied to garciadiego's topic in Geriatric, LTC

    Our advanced directives can get pretty specific: DNR DNI No hospitalization No feeding tube No IV In reality, I've never seen one in which the resident was just a Do Not Intubate This is the precise...
  3. CapeCodMermaid

    It's Wrong! (A night shift perspective)

    CapeCodMermaid replied to Sixtyseven's topic in Geriatric, LTC

    " Much easier for them-try undressing and fighting to put a LOL back in bed " a LOL???? please don't be demeaning...she's not a LOL...she's a grandmom or a mom or a sister or a
  4. CapeCodMermaid

    How Much Orientation is Normal?

    CapeCodMermaid replied to flashpoint's topic in Geriatric, LTC

    Where to begin? Never do anything from memory. Things change rapidly so you can't rely on what you did yesterday. That certainly doesn't sound like a proper orientation even for a not so new nurse....
  5. CapeCodMermaid

    starting an antibiotic

    CapeCodMermaid replied to strawberryfields's topic in Rehabilitation

    Why are you treating for 10,000 colonies? We usually don't treat unless it's over 100,000 and the patient is
  6. CapeCodMermaid

    Getting More Residents Up and Walking Once Again

    CapeCodMermaid replied to MARY HARROUN's topic in Rehabilitation

    I dislike Merry Walkers...never saw a good response from one. Most residents have Med B....get a rehab eval, set up a plan, and have the restorative aides carry it out. We had one guy who was always...
  7. CapeCodMermaid

    It's Wrong! (A night shift perspective)

    CapeCodMermaid replied to Sixtyseven's topic in Geriatric, LTC

    We would never wake someone up to catheterize them...ever. Talk to the DPH about the ridiculous med times. We were cited once because we didn't give Prilosec when the manufacturer said we should. We...
  8. CapeCodMermaid

    19 Patients, 4 PEG, 2 Trach, 3 Major Fall Risks, 1 Wanderer, Seriously Want to Quit

    CapeCodMermaid replied to lifelearningrn's topic in Geriatric, LTC

    Thank them for the experience, give a two week's notice, and start your new
  9. CapeCodMermaid

    Advice for a new grad on sending patients out to ER?

    CapeCodMermaid replied to Cynnie24's topic in Geriatric, LTC

    If your facility doesn't provide information on it, look up INTERACT 3. There is an SBAR tool to help you collect your thoughts and be ready when you call the MD. Know what you want before you call....
  10. CapeCodMermaid

    1 hour window on med pass times...

    CapeCodMermaid replied to elimayrn's topic in Geriatric, LTC

    Everything we do is a risk versus a benefit. We give synthoid at 6 on an empty stomach because it's absorbed better. We give most everything else whenever...the benefit to the resident of living a...
  11. CapeCodMermaid

    1 hour window on med pass times...

    CapeCodMermaid replied to elimayrn's topic in Geriatric, LTC

    Daily is once a day. If the patient wants their daily med at 11 am fine. If they want it at 4pm we would write 'give daily at 4pm'. It's a shame that the med pass seems to be the be all and end all at...
  12. CapeCodMermaid

    1 hour window on med pass times...

    CapeCodMermaid replied to elimayrn's topic in Geriatric, LTC

    Without instruction? Our docs write "Lasix 20 mg by mouth daily". Daily is
  13. CapeCodMermaid

    Help, I hate my job

    CapeCodMermaid replied to TiffTiffRN's topic in Long Term Acute Care

    An LTAC is NOT an ICU. The med surg nurses around here complain if they have more than 6
  14. CapeCodMermaid

    1 hour window on med pass times...

    CapeCodMermaid replied to elimayrn's topic in Geriatric, LTC

    A medication scheduled for 9am can be given any time between 8am and 10am and be in compliance. Facilities, at least in Massachusetts, set the med schedule, not the pharmacy, not the doctor. Our once...
  15. CapeCodMermaid

    Telling "STATE" you don't have supplies....

    CapeCodMermaid replied to nervousnurse's topic in Geriatric, LTC

    It IS the floor nurse's responsibility to tell whomever does the supplies that they are in short supply. Not every facility has a supply
  16. CapeCodMermaid

    question when doing my assessment

    CapeCodMermaid replied to guereb07's topic in Rehabilitation

    Yes. You must monitor for the 14 days. She might improve if it is a UTI. You need to have a decline in 2 or more areas in order for it to be considered a sig change. Pity the woman is becoming more...
  17. CapeCodMermaid

    HIGH fall risk resident

    CapeCodMermaid replied to guereb07's topic in Rehabilitation

    All studies show that alarms do NOT prevent falls. Find out why he's getting up: wet? hungry? bored? sore bum? There is usually some reason behind the behaviors. Enlist the help of the activities...
  18. CapeCodMermaid

    No fleets! The sky is falling!

    CapeCodMermaid replied to garciadiego's topic in Geriatric, LTC

    Your aides give Fleets? Mine aren't allowed to. Our protocol for no BM in 3 days: Night shift gives Milk of Magnesia (unless contraindicated). If no BM Day shift gives suppository. If no BM Evening...
  19. CapeCodMermaid

    Narc Count Disaster

    CapeCodMermaid replied to bluegeegoo2's topic in Geriatric, LTC

    Cheaper or not, it's ridiculous for nurses to have to count ANYTHING that comes from a bottle. We have enough to do without all this. Sounds like a potential diversion. I've worked in places where the...
  20. CapeCodMermaid

    Advice for a new unit manager in LTC

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

    As a former unit manager....get a plan of your own to stay organized. Make sure the systems that are in place are being followed-falls, weights, pharmacy recs, doctor visits. As far as not being held...
  21. CapeCodMermaid

    LTC has changed-How do you give out 5pm meds now?

    CapeCodMermaid replied to Blackcat99's topic in Geriatric, LTC

    Stupid rules are meant to be broken? Do you want someone interrupting YOUR meal? Probably not. We have lots of residents who request to have their meds with their dinner...so we write the order that...
  22. CapeCodMermaid

    chiropractor employee taking blood pressures

    CapeCodMermaid replied to sam1971's topic in Patient, Colleague Relations

    A low paying job is far better than none at all. Perhaps this is the best job this individual could get. There are fines and jail time for impersonating a police officer or an army officer. There...
  23. CapeCodMermaid

    Advice about liability insurance?

    CapeCodMermaid replied to xiaobear007's topic in Geriatric, LTC

    It's never too late to get coverage. It's worth the peace of mind to know you're
  24. CapeCodMermaid

    Unavailable meds

    CapeCodMermaid replied to Pat_Pat RN's topic in Geriatric, LTC

    Seems silly doesn't it? The hospitals are always sending us patients whose MARs state Med Not available. What good does it do to call the DON? Does she have an ekit in her car? We try to get the med...
  25. CapeCodMermaid

    Tikosyn

    CapeCodMermaid replied to CardiacKittyRN's topic in Cardiac

    The Pfzier web site has a wealth of information on