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  1. Agreed! This would be a good item to take to Qapi and do a PIP about this.
  2. HELP! We use Relias for our education. Unfortunately, we do not have many computers for the staff to complete these on in the facility. I do have all of the modules in paper form so that there is that option. I'm also willing to hold mini classes and go over the material so that they do not have to spend the 1-2 hours on some of the subjects. No one comes. On the days that there are in-services or mini classes, I've tried to make sure that there is extra staff around to cover. Of course, this doesn't always happen and staff thinks it is a great time to call off. We also have let staff know that they can complete the modules at home and get paid for the time that they spend on them (some prefer this option) What are suggestions for getting staff to complete these modules on time? Our company rolls out new modules each month. Any suggestions?
  3. CoffeeRTC

    Please suggest topics for student presentations

    all great suggestions!!. How about the new trend in youger pts in LTCs? Totally different issues to deal with psych/ social..
  4. CoffeeRTC

    Understanding limited DNR

    I've been doing LTC for over 15 yrs and have never seen this. We have a facility form that is Yes, no or I don't want to make the decision now for CPR. Yes and no decision = start CPR. In the advanced directives they indicate what type of life saving therapies they want..blood, abtx, intubation etc. It is Yes or No cpr. Once we start CPR and the medics come, they continue...at the hospital then they can look at the advanced directives.
  5. CoffeeRTC

    Is this professional?

    Um...she needs a head band. If that is all that you have against her...........
  6. CoffeeRTC

    RN jobs with high amount of patient/family teaching

    Be surprised, but in LTC/ rehab there are tons of teaching opps. Diabetic care/ diet, cardiac care, rehab, adls. Most of our pts are short term and younger and are very uneducated about there new health problems when they come to us from the hospital.
  7. CoffeeRTC

    The CEO said WHAT!!!!

    Well..soon we won't need nurses in LTC. We now have a entire system set up that tells us when to call the doctor and what to do. Yes, it is a 10 page form that we have to fill out and a huge book of algorthims that tell us how to be a nurse. Neat, right? I can just check my brain at the door now!
  8. CoffeeRTC

    Ironic:No Healthcare for Nsg Homes

    The union employees at my facility haven't had benefits for years...Yeah, great union. I don't know how a facility that is part of a large chain can do this and expect staff to stay when the next place down the road can offer benefits and the next place can offer even better benefits???? A lof of our staff get some form of public assistance When the staffing gets real tight due to call offs or burn out illness or injury or dismissals...the moral gets super low and OT (either signed up or force OT gets high) the call offs happen. Work to many hours and make to much and you can loose your public assistance/ benefits. Horrible cycle...benefits = healthy/ happy employees
  9. CoffeeRTC

    Demanding resident-vent

    I've been doing this for years and have seen my share of demanding residents and super demanding not even gonna back down type of residents. I think we all have dealt with one of them or the families. I don't see a problem having a resident say that they will need another pain med in 4 hrs. I don't have a problem asking about pain every med pass (the 5 and 9) and even asking in between when I see them or are doing dressings etc.."Did that help?" Just about everyone gets a pain med and or sleeping med at hs med pass..I offer/ encourage and or they ask for it. A lot of times they might just be reminding the nurse about it because they do fall asleep (yes, people in pain sleep) and will wake up in more pain and have a tought time getting control over it. Chronic pain doesn't always mean sitting around crying or having sad face..alot of residents have learned how to deal with it and still live life. Now..following me around the cart, asking me evey five minutes, complaining that it isn't working all the time, telling me about every pain med that you are on, have tried or became allergic too...yes...I have that thought in my mind, but when they are due for it, they can get it. It is so much easier to plan, work with the residents, re assure them that they will get prns when asked or anticipate the need and ask them about pain rather than get upset that some one is a clock watcher. Beat them to the punch...they don't have anything left to demand (yeah...they come up with a next complaint/ demand) or complain about.
  10. CoffeeRTC

    Ativan...do i hold or give?

    Yes, yes, yes! This was a great answer. Remember, that the Fentanyl is probably just kicking in around the second day. If you hold it one day, you will still need to remember that maybe the next day when they are getting used to the new med, then they will need it or maybe he won't need it at all now that the pain is being managed..maybe a prn dose.
  11. CoffeeRTC

    In your opinion, how many pts is too many in SNF/rehab?

    Me, personally, I can handle 25 or so. On 3-11 we have 2 nurses and 50 residents. Most, if not all of mine, are short term rehab and are like the ones you all have mentioned above. Post op knees and hips sent to us on day 3 and some other short term rehabs. We also get a lot of complex wounds and iv therapy pts...some TPNs. I normally have an average of 8-10 diabetics with qid checks, coverage and lantus, labs, drains, etc. Most of the admits come on 3-11 too. Most of our residents are younger now too. With that comes different needs (customer service issues) and different psych issues. (I'd kill for my Long term residents that "just" have dementia....heck...I don't mind the hitting, spitting yelling ones either) As a new grad with little orientation....Yes.....this is a bit too much. I've been in LTC for years and started off with just the LTC residents..now that we've made a change to short term, more acute residents, I kinda enjoy the change. I couldn't see myself starting off in a place like this with the staffing like LTC.
  12. CoffeeRTC

    Facebook almost cost me my job

    Can't you set your privacy settings to only friends? That assumes that your friends are real friends.
  13. CoffeeRTC

    My health is suffering..vent I guess...

    I'm back on the wagon (aka Weight Watchers) because I'm sick of being tired and sore. I've got young kids with crazy schedules work and yada yada yada. I'm also fat. After you go to the doc and get a check up and maybe labs...start watching what you eat. I eat for comfort/ emotions and to feel full. Excercise...Yeah, I can kill people that tell me it gives you energy, but it really does. How does that make sense when you can barely walk, hobble around, have a back ache, headache and just no time? Excercise can be anything..it doesn't mean a gym. Walk to the corner of your street and back. What makes this different than the miles we walk at work??? Tons...fresh air, music or no music....it is a time to relax and un wind. Small little bits of increased activity do over time help with weight loss. I'll admit....the first week you won't want to keep doing it, but if you get past that first week.........
  14. CoffeeRTC

    Dining room vent.

    Um....sometimes people eat more when watching TV. We had the same issues..when food is sent back alot, they tend to get it right the firstime
  15. CoffeeRTC

    Silly family members, Trix are for kids!

    Is mom in a private room? We deal with these families by telling them that the roomate needs privacy / quiet time too. We have open visiting hrs too, but with respect for the roomate.