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Content by CoffeeRTC

  1. CoffeeRTC

    Documentation Inservice

    Does anyone have a great site or resource for an in-service? We have so many issues with even the basics. We use PCC so it is either a skilled note or nursing progress note. Oh, the things I've seen!! I was planning on doing a quick case study or chart review using a large screen and projector and projecting images of actual charted information and do a "what is wrong with this picture" and "what can we do better?" Any suggestions?
  2. CoffeeRTC

    Major shift in practice...

    Is it a skilled facility? What is the structure of the facility? How many nurses vs CNAs? Do you have 24/hr responsibility or is there a DON?
  3. CoffeeRTC

    Any way you could stay over and work a few hours

    Yep, they just negotiated a new contract with our new company. I'm soooo glad I'm not part of the union. It is insane. The longtime employees are comfortable with their rate and raises. A suggestion was made to increase the starting rate but they won't vote on it because they won't get an increase in their pay. They don't want new employees coming in and making a fair rate because they've had to work their way up to what they are making. ???
  4. CoffeeRTC

    Any way you could stay over and work a few hours

    This post screams our LTC staffing. What ruins it are the ones that love to pick up OT until they don't. I developed real thick skin and great avoidance of the "can you help out for a few hrs?" when I was part-time. Now that I'm full time, I just get pulled to the open shifts. Makes it real difficult to get my real work done. As a union facility (LPNs, CNA, Dietary and Housekeeping) we have a hard time attracting new employees because our starting rate is ridiculously low for those positions due to the contract. How about pay a fair rate to start with? We already have flexible scheduling and a decent working environment, but when you are working short due to call offs....no one except that one nurse wants to pick up. BTW, DON picks up tons of shifts (gets a bonus) and I will fill in. Its just insane.
  5. 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?
  6. CoffeeRTC

    Continuing Education --Getting staff to complete it

    Well....a good bit has changed in the last year! We are now owned by a new company that requires completion of Relias modules on a monthly basis. We do have more laptops and computers as we are almost fully EHR. We just need to get the EMAR in place! This new company relies heavily on Relias for the mandatory education requirements. I'm not 100% sold on this model. I lean to a more hands-on approach. I'm constantly hounded for the percentages of staff completion....it is all numbers on paper. I get it, because if it wasn't documented....it wasn't done and if it wasn't done...then you are not permitted to work. Nice in a perfect world, but we rely heavily on part-time and PRN staff and like most SNF...we are in a staffing crisis. I've been running contests or drawing for staff that gets their education completed on time and a bonus one for those getting it done at least a week early. This seems to help.
  7. CoffeeRTC

    LTCI surveys

    So, we just went through our survey. It was very interesting. A lot more in depth than the state surveys. A lot of information was shared and we got a great education on develpment of PIPs.
  8. CoffeeRTC

    LTCI surveys

    Has anyone been through a LTCI survey? Long term care initiative.org?
  9. CoffeeRTC


    Does anyone have a great website for these?
  10. i would write up a statement about this and include the statement from the other nurse who gave the med. Only the facts. The prn that you gave...was it ia narcotic? How does she have access to meds? I can see her argue that your PRN caused the sedation. This would then turn into a he sad, she said.
  11. CoffeeRTC

    Christmas Gifts For Residents

    What an awesome idea!
  12. CoffeeRTC

    McGeer's Criteria

    There are newer ones. Google McGreers 2018
  13. CoffeeRTC

    Getting orders noc shift

    This is not legal for a LTC facility. While the Dr. might be mad that a critical lab wasn't called in earlier, it still needed to be dealt with.
  14. CoffeeRTC


    I haven't done true sub acute in years, but 20+ seems like a lot. As far as the IV, why didn't the supervisor step in and call the DR? We've had our IV team come out to check the line and do the declogging/ de-clotting. If there was a med that wasn't given then it would be a med error unless the Dr was notified and you got an order to hold the med until IV access is reestablished.
  15. CoffeeRTC

    Time to prepare

    Thankfully, as SDC I share the same office as the DON. If she isn't able to screen new admits then I do. If there is an issue about education, equipment that is needed prior to admit then I say "no" to the admit. Right now, that seems to work. I'm happy to admit that we don't get any VIPs. :) We might get someone's family member, but they don't ask for VIP benefits.
  16. CoffeeRTC

    How do you deal with dizziness and syncope?

    Care plans!!
  17. CoffeeRTC

    Supervised smoking in LTC

    You must not work LTC? So, using the "if they can't wheel themselves" train of though....I guess they shouldn't be able to go to activities or the dinning room or heck...go out of their room if they can't wheel themselves? Sometimes going outside to smoke might be the only connection they have to feeling normal. To take it away because they cannot wheel themselves ??? I don't agree with forcing staff to assist with smokers (I'm a non smoker) but their needs must be met as long as they are a resident.
  18. CoffeeRTC

    Supervised smoking in LTC

    This is a huge hot button topic in LTC. Surveyors love to jump on this. First off, check what the facility policy is for smoking. Ours states that all smokers must be supervised by a staff member (even if they are independent in smoking). We have other residents that require assistance such as using the lighter. I am a non-smoker and cannot tolerate being close to the smoke. If I'm forced to take them out, I'm supervising the independent smokers from a few feet away. If it is part of your duties to take them out, what about switching with a smoker? Watch their assignment while they take them out? As everyone said above, most would jump at the chance. We don't permit staff to smoke with them but don't enforce that rule.
  19. CoffeeRTC

    Help me spend money!

    I just found out I have money budgeted for staff development! I think it is around $100 a month. I need to find the specifics. Give me some suggestions on things to purchase for teaching in a LTC setting. My dream purchase would be a manakin....
  20. CoffeeRTC

    Help me spend money!

    We get our Hospice companies to come in and do inservices for free! They even bring snacks!
  21. CoffeeRTC

    Help me spend money!

    Nope, but it is better than the $0 that I thought I had! What types of things are you spending money on?
  22. CoffeeRTC

    Girlfriend wants to help her dad die

    I would suggest a hospice consult. Why would his Sinemet need to be dc'd to be on hospice? I would think it would provide comfort and a better quality of life with the med.
  23. CoffeeRTC

    HIPPAA violation

    Are you in an LTC or Assisted living facility? Are you a supervisor on just your unit or could you be pulled to the other one to pitch in? That is the only reason i can see to have information on all of the patients. Could it just be a computer issue where alerts need to be turned off ?
  24. CoffeeRTC

    Staff Development Coordinators-what's included?

    Take infection control, call and workman's comp away and it might be manageable. We do limited IV push meds..solumedrol, and lasix are some. We do TPN but no go on the IV heart meds. Wayyyy to much monitoring. What type of chest tube is it? We have a few with Pleurex tubes. They are rather simple to manage/ teach.
  25. CoffeeRTC


    I haven't seen strick i/o in years. If someone is on a fluid restriction we record that. A new foley would get closer monitoring. In my experience, it is rarely done right anyway.