CapeCodMermaid RN

Gerontology, Med surg, Home Health

Member

  • Content

    6,092

  • Visitors

    66,244

  • Followers

    4

  • Likes

    290

All Content by CapeCodMermaid

  1. CapeCodMermaid

    Insulin adjustment

    CapeCodMermaid replied to Supercandy131's topic in Geriatric, LTC

    Holding insulin or giving a 'partial dose' are two different things. It's nursing judgement to hold insulin if someone's blood sugar is too low or they didn't eat. Then, of course, you would call the...
  2. CapeCodMermaid

    Should I find a new job asap?

    CapeCodMermaid replied to Kaysmom8's topic in Geriatric, LTC

    If you re-read what I posted, I didn't call you naïve. I simply pointed out that it is NOT necessary to check the vital signs of every resident simply because they are on a med that could lower their...
  3. CapeCodMermaid

    Should I find a new job asap?

    CapeCodMermaid replied to Kaysmom8's topic in Geriatric, LTC

    It is okay most of the time to give medications without taking vitals. Not every blood pressure med has a parameter. If someone is on short term antibiotics to treat an infection, I'd grab a temp on...
  4. CapeCodMermaid

    Should I find a new job asap?

    CapeCodMermaid replied to Kaysmom8's topic in Geriatric, LTC

    I'm sorry you work in a crummy building. I work for a company that values the residents above the bottom line. If someone has to go, they go, but we know it's better for them to stay where they are so...
  5. CapeCodMermaid

    Do you have to count lyrica at your LTC facility?

    CapeCodMermaid replied to Blackcat99's topic in Geriatric, LTC

    We count Lyrica because it can be sold on the street and used to get high....not because we are trying to make sure all doses are
  6. CapeCodMermaid

    Is most ltc short staffed?

    CapeCodMermaid replied to Nightowl_nurse's topic in Geriatric, LTC

    I've been in management for years..and worked the floor. I stay within the budget without being short staffed by
  7. CapeCodMermaid

    Should I find a new job asap?

    CapeCodMermaid replied to Kaysmom8's topic in Geriatric, LTC

    It's apparent from many of the comments here that all y'all don't have a full understanding of the climate we're in. Heard of ACO? Hospitals are going to be penalized for readmitting patients with one...
  8. CapeCodMermaid

    SNF who provides supplies?

    CapeCodMermaid replied to NC29mom's topic in Hospice, Palliative

    Do I live on another planet? Most room and board charges for someone on hospice are paid by Medicaid, not private pay. We don't charge separately for incontinence supplies. Our hospice providers are...
  9. CapeCodMermaid

    Pronouncing Death

    CapeCodMermaid replied to lumbarpain's topic in Geriatric, LTC

    I don't call the coroner or the ME's office for every death. I would call if the death were from a fall in the facility or if the resident died within the first 24 hours after admission--unless they...
  10. CapeCodMermaid

    Admissions people

    CapeCodMermaid posted a topic in Geriatric, LTC

    I know everyone has a job to do, but I've just about had it with the admissions people in my building. One of them sent me a text, about me, meant for someone else and it wasn't very nice. The other...
  11. CapeCodMermaid

    New ADON

    CapeCodMermaid replied to june2009's topic in LTC: Directors, Assistant

    The best way to foster team work is to BE part of the team. Many times people who get promoted forget what it is like to be on the units doing the work. Help when you can but don't let anyone take...
  12. CapeCodMermaid

    Is lying the new norm?

    CapeCodMermaid replied to Hoosier_RN's topic in Home Health

    I've never heard of such a thing. I do the interviewing for my facility for most licensed positions and wouldn't think of doing that. I have, on occasion, asked someone who came in to interview for a...
  13. CapeCodMermaid

    Is most ltc short staffed?

    CapeCodMermaid replied to Nightowl_nurse's topic in Geriatric, LTC

    Oh please...short staffed by design? I don't know where all y'all live but in Massachusetts and especially in MY facility, we take staffing seriously. People call out. I can't force them to come to...
  14. CapeCodMermaid

    Should I find a new job asap?

    CapeCodMermaid replied to Kaysmom8's topic in Geriatric, LTC

    It doesn't happen in a lot of places....never in any place I've ever worked would we have tolerated that. Maybe because I work in Massachusetts and we have the strictest DPH there is. Or maybe because...
  15. CapeCodMermaid

    Need expert advice on how to pass 39 patients' medication in a 2-hour time frame.

    CapeCodMermaid replied to OneMurse's topic in Geriatric, LTC

    There is no need to check a pulse on a resident on digoxin. We no longer automatically hold it if the AP is less than 60 since, as one of my former medical directors put it, they might need the extra...
  16. CapeCodMermaid

    Dilemma in LTC

    CapeCodMermaid replied to mars123's topic in Geriatric, LTC

    I love my job in LTC. I could work anywhere....I choose to work with elders and, these days, not so elderly rehab
  17. CapeCodMermaid

    New lpn working ltc

    CapeCodMermaid replied to Nightowl_nurse's topic in Geriatric, LTC

    Do you live in Maine? Is that why it's your priority? 35 residents overnight is more than doable. Make it clear that you are now in charge...age shouldn't have anything to do with
  18. CapeCodMermaid

    Need expert advice on how to pass 39 patients' medication in a 2-hour time frame.

    CapeCodMermaid replied to OneMurse's topic in Geriatric, LTC

    1. Have your pharmacy consultant determine if the patients really need all these meds. 2. Stagger the times...half for 8 half for 9 OR 3. Have the daily meds given between 6:45 and 11:45. No one ever...
  19. CapeCodMermaid

    New grad RN seeking first nursing job

    CapeCodMermaid replied to RetrieverGirl's topic in Geriatric, LTC

    45 residents over night on a long term unit seems very doable. You shouldn't be giving many meds on that shift. Go for your second interview. What can it
  20. CapeCodMermaid

    Documentation

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

    We tried that but the nurses weren't documenting anything useful so we had to go back to charting every shift with the hope that there will be enough
  21. CapeCodMermaid

    How does your facility do the following:

    CapeCodMermaid replied to TigerxLiLy's topic in Geriatric, LTC

    Our part time people are scheduled for between 16 and 24 hours a week. Our full time is considered to be 32 hours a week. Per Diems....I have some that work one day a week and some who work 5
  22. CapeCodMermaid

    Admissions people

    CapeCodMermaid replied to CapeCodMermaid's topic in Geriatric, LTC

    In theory, as the DNS, I have the final say, but if I say no and my case manager says no, the admissions people often remove the sheet with our comments on it and hand it to the administrator....
  23. CapeCodMermaid

    Documentation

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

    My facility is quite abit larger than yours. We run between 25 and 30 Med A and managed care residents. The nurses are encouraged to chart throughout the shift but they usually end up staying late. We...
  24. CapeCodMermaid

    How do I go about applying for this?

    CapeCodMermaid replied to Cynnie24's topic in Geriatric, LTC

    Things change quickly. I've interviewed people who were hired for 24 hours only to have a full time shift open up in a day or two. Send your resume' and cover letter to the
  25. CapeCodMermaid

    Confused with Charting

    CapeCodMermaid replied to ChampRN's topic in Geriatric, LTC

    Follow your facility's policy. Medicare rules...chart every shift for the first 72 hours then daily after that. No need for daily charting on residents who aren't skilled unless something