ChainedChaosRN

Anyone have any information on Kennedy terminal ulcers? I was only able to find this info on it during a search: http://Http://www.kennedyterminalulcer.com The first I've heard of it was today at a joint provider meeting. With very little info giv...

I'm a DON in a 160 bed facility and I did away with monthly summaries. I too found them redundant and not helpful. The patient is reassessed quarterly or with significant change. I'd rather have a nurse doing a several daily quality nurses notes...

There isn't any tags for ADON's. There are no specific citations for DON's or Administrators but some tags fall under administrative. The facility is cited. Any position in a facility can cause a citation if the person errors no matter what depar...

Depends on the type of resident being cared for. Totally dependent with all ADL's will require more staffing, more independent less. Care levels and layout of a facility are big factors in ratios.

I might of missed it, but I didn't see anyone ask what the acuity of the patients on that 30 bed unit. Are they ambulatory? Mostly independent? Alert and oriented? I've worked in facilities which would have a unit designated for the primarily indepe...

I know this is always a hot topic here but I wanted to share a new policy set forth by my company this month. My company is a nation wide chain 300+ homes. In their new policy book it states that any employee found sleeping on company property is ...

Has psych seen the patient? Something to calm him down, it can't be a pleasant situation for him either, being that restless.

Hard situation. I guess my first question I'd ask is if the patient is competent, and deemed competent by a physician. If yes, advance directives should be in place prior to the tube being pulled. If she IS competent it is not the families decis...

Wow NightOwl, I haven't been on for a few days...what a weight on your shoulders. You handled it well. I wish I had you on my staff. Re: Incident reports, we IR everything, every bruise, lab draw or not as soon as it's noted, even if it is over 4...

LOL Night Owl...you made me choke on my water :)

I agree Night Owl, you can't tread softly. That's like covering a draining decub with duoderm and wondering in 3 days what the heck went wrong. Frankly I'm tired of having to continually keep "surprising" the 11-7 crew to see if they are awake and d...

Hi Rebel_Red, Please do not think I condone sleeping on duty..not at all. I've fired many for finding them sleeping on 11-7 shift. I and my nurse managers continue to spot check in the middle of the night. I just think putting your head down, k...

In our facility we keep a bag full of small bags on the double hamper (laundry and trash) tied to it. Laundry stocks the linen carts for each shift and unit: adding the briefs, some gloves and the small trash bags. We ask the CENA's to carry a cou...

Wow.. your surveyors are definitely out of control. I think you need to place a complaint to CMS about this.....or maybe your licensing officer? I've seen homes picked on....usually they are corporate chain homes. I think there is alot of politics ...

Hi Huq, Definitely it is...and I thought that was what we were doing? Kind of nice seeing the Geriatric forum coming alive...isn't it? When I first joined days and days would go by and no one posted here.

Hi Huq, I wasn't making the comment necessarily to you that if you don't sign it still goes in the file. It was just a comment in general. Many employees at first will assume if they don't sign it...it doesn't count. Regarding the speculation/as...

Even if someone doesn't sign their disciplinary action, it still goes in the employee file. I believe saying there is no such thing as privacy or confidentiality in long term care is pure speculation. Lot of facilities out there. If someone chooses...

One other thing I want to add because I've ran across this alot over the years. Is when I counsel or give disciplinary action...it's a private matter between myself and the employee. So very often I am accused of "You didn't write so and so up when ...

In my facility I only give attendance disciplinary actions on paydays. I follow the companies attendance policies for nurses and the unions for the CENA's. I do not have time to check the attendance book daily for 120+ employees for who is due f...

Hi LuvLife, I've seen people who don't "get it"..but I've never had anyone actually admit to it. If you are already considering taking a refresher course, do it. Read alot...not just nursing journals, read charts, read H&P's, read your s...

Thanks for the site...5 stars for us. Made my day!

I live in the Detroit area the wages at my facility for LPN's are $18 for new LPN's and $21 for experienced.

Knowledge and experience is the fastest way up. Be curious, ask alot of questions, watch someone with excellent managerial skills and analyze why they are different. Degrees will only get you so far and will not keep you there if you don't know what...

Thank you Catsrule...I appreciate the info :)

Definitely ask for a raise, it sounds like you are doing an excellent job! And they are all right about wanting to have at least one deficiency or it will trigger the Feds to come in and survey. Sheesh...when we finally got down to only 1 tag...it ...