afteralltheseyears

afteralltheseyears

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All Content by afteralltheseyears

  1. Hourly rounding logs

    afteralltheseyears posted a topic in Geriatric, LTC

    Is anyone utilizing the practice of hourly rounding to assess the 4 Ps (position, pain, personal needs and potty) and if so do you have a log up in the room for staff to document it? This practice...

  2. CNA training program, manual

    afteralltheseyears posted a topic in Geriatric, LTC

    I am considering starting a CNA training program in my community. Where can I find a good training manual/curriculum? What is the ratio of LPNs to residents at your facilities?

  3. knowing how to maintain a PICC line

    afteralltheseyears posted a topic in Infusion, Intravenous

    Since proper maintenance of PICC lines vary depending upon whether it is an open or closed end catheter, how do you know how to care for it if the patient doesn't know what type of catheter they have...

  4. communication of PT recommendations to nursing staff

    afteralltheseyears posted a topic in Rehabilitation

    At your facilities--How do the recommendations of Physical,Occupational or Speech Therapy become part of what the nursing staff follows when giving care? Do the therapists give the recommendations...

  5. communication of PT recommendations to nursing staff

    afteralltheseyears posted a topic in General Nursing

    At your facilities--do the therapists (PT, OT or ST) give their recommendations to the Dr and the Dr then writes them as orders for the nursing staff or does your nursing staff follow their...

  6. Samples of Kardex or other communication tool

    afteralltheseyears posted a topic in LTC: Directors, Assistant

    We are interested in implementing some sort of a communication tool that will inform staff of care needs of specific LTC patients. I don't know what to call this tool but I envision it to be like a...

  7. flag outside room door so staff can be found

    afteralltheseyears posted a topic in General Nursing

    We are a small hospital with limited funds to purchase staff tracking technology (device that turns on a light above the room door so you can see when a staff member is in the room). Anyone have any...

  8. Staffing/NHPPD

    afteralltheseyears posted a topic in LTC: Directors, Assistant

    In my CAH right now, I have 18 unskilled, custodial-type patients who reside here (for the state they are categorized as unskilled swing patients but they are basically nursing home pts). In addition...

  9. Hourly rounding logs

    afteralltheseyears replied to afteralltheseyears's topic in Geriatric, LTC

    I'm shocked at the staffing ratios I hear on here-1 nurse and 4 aides for 60 patients. HMMM, if you do 12 hour shifts that comes to about 1 NHPPD. That sure doesn't come close to the 3.2 NHPPD that...

  10. shift report, CNA/pt ratio

    afteralltheseyears posted a topic in Geriatric, LTC

    In your nursing homes I'd like to hear how the change of shift routine goes. Specifically: who sits in on report--all oncoming nurses and CNAs hearing the same report from offgoing staff? OR nurses...

  11. kardex

    afteralltheseyears posted a topic in Geriatric, LTC

    I am a new DON in a critical access hospital that has 20 extended swing patients (nursing home type patients) who reside here. My specialty is ER and I have no experience with LTC so am looking for...

  12. kardex

    afteralltheseyears replied to afteralltheseyears's topic in Geriatric, LTC

    We are the only hospital in our state that has been given the designation of CAH with extended swing patients who permanently reside here (in other words-we have 20 nursing home patients in our...

  13. kardex

    afteralltheseyears replied to afteralltheseyears's topic in Geriatric, LTC

    I wanted to add: to whoever said they love Kardexes I say AMEN. I'm an old nurse too and Kardexes were what we used to give report with and I guarantee nothing important got left out of the report...

  14. kardex

    afteralltheseyears replied to afteralltheseyears's topic in Geriatric, LTC

    Thanks so much for all your feedback. The system that exists here is alittle flawed I think as the RN on duty keeps to her ER/Acute care patients and has little to do with the LTC patients and the...

  15. kardex

    afteralltheseyears replied to afteralltheseyears's topic in Geriatric, LTC

    Sorry, I'm not explaining my thoughts well. The care plans in use now are ones that have been "copied and pasted" from a care plan template. I don't think they are very meaningfully personalized...

  16. kardex

    afteralltheseyears replied to afteralltheseyears's topic in Geriatric, LTC

    Good question. Like I mentioned, there are 19-20 residents. They are cared for by 1 LPN and 2 CNAs. What is a good ratio of nurse to patients that will allow adequate time to do care planning and...

  17. does DKA or HHNKS always accompany high blood sugar

    afteralltheseyears posted a topic in Diabetes, Endocrine Nursing

    Had a patient who had blood sugar in upper 700's but didn't show the textbook s/s of DKA or HHNK syndrome. Does a patient with a very high blood sugar always have DKA or HHNKS? My situation that led...

  18. giving oral meds to skilled fighters

    afteralltheseyears posted a topic in Pediatric

    I'm looking for tips from nurses who deal with this all the time--how do you get small children to swallow liquid meds when they are not on board with that plan of care? Some kids fight so much I'm...

  19. rural er dr wants experienced er nurses

    afteralltheseyears posted a topic in Rural

    Our rural hospital has a nearing retirement-aged dr who is probably putting in his final years of practice here. Because ER has been his practice specialty and he's reportedly worked in some...

  20. Failing to carry out a stat order in timely manner

    afteralltheseyears posted a topic in Emergency

    I made a mistake in deciding to send an admitted patient to the medical floor (from the ED) and have a stat admission order carried out there rather than seeing that it was done in the ED prior to...

  21. Failing to carry out a stat order in timely manner

    afteralltheseyears replied to afteralltheseyears's topic in Emergency

    Stargazer, That was how I was thinking. The room assignment to the med-surg floor had already been made (based on the admission orders) so I didn't believe the dr planned on using the ABGs for...

  22. does DKA or HHNKS always accompany high blood sugar

    afteralltheseyears replied to afteralltheseyears's topic in Diabetes, Endocrine Nursing

    If ketones are being spilled in the urine and the serum ketones are elevated will the patient always be acidotic or might there be a certain amount of buffering the body can to do prevent acidosis?...

  23. Failing to carry out a stat order in timely manner

    afteralltheseyears replied to afteralltheseyears's topic in Emergency

    The orders were written by the admitting Dr (not the ED Dr) and were admission orders.....so my interpretation was that because the patient was relatively stable the orders could (and even should) be...

  24. Failing to carry out a stat order in timely manner

    afteralltheseyears replied to afteralltheseyears's topic in Emergency

    I appreciate your input HiHoCherry-O It was alittle over 30 minutes between the time the order was received and the specialist came in and cancelled it. I hadn't thought of the time it might take...

  25. Failing to carry out a stat order in timely manner

    afteralltheseyears replied to afteralltheseyears's topic in Emergency

    I appreciate the responses. The suggestion to contact the admitting resident to clarify what should be done where would have been a good thing to do. I am an experienced RN (28 years), just attained...