GretaRN

Hi all, last week day nurse hadn't changed drsg (scaly/mole) on resident back for 4 days, the drsg was dated..I did change and thankfully the mole was healing. I wrote in report book regarding this and the next day she told me he didn't want it changed although it was not circled in treatment book and she also said the third shift. well I asked the 3rd shift nurse who said she never changed it. I also let DNS know. I guess the point is should I have not wrote this in the shift report???? Thankfully the resident was ok and when I asked him if he refused he said no..

day nurse found this...she did take care of it...I wasn't there...she just wanted the 3rd shift to be aware of it happening........

Hi all, Last night.....I've been working in a wonderful small nursing facility for 3 1/2 months...I love it, people are supportive and the residents are loved and get phenominal care...that being said...I had an incident happen and was looking for some input?? I work 3-11 and the nurse I was relieving told me that two residents were wet/incontinent..excessive...I told her I would pass it on..the 11-7 nurse which I did and she kind of freaked on me..."they should have come to me I am here till 7:30am...the residents are up by 7:30.. they should have told me.... if they don't tell me right away I am not going to do anything about it...(the day nurse is the one who told me, she found the residents herself)..."they're putting the nurses against one another", "thats gossiping" on and on...needless to say she said this in front of 2 cna's who were waiting in the elevator with me...(they didn't know what the whole thing was about)when the elevator door closed and all was done they said "don't trust her for a minute she will get you fired"..I honestly felt like she was attacking me...I simply said I was just passing the message on...she has been there for a long time...I have been upset since, should I talk to DNS who is also great? Or should I talk with the day nurse who was on... I don't want to start any drama with this nurse...thanks for the advise...

Hi, I think you need to make your concerns known and ask for more orientation time. Good Luck!

Hi ALL, I have a question regarding meds and working 3-11. I recently did an orientation for second shift and am a little unclear on timing of meds. The facility uses PM and HS, we also have 5pm and a few 10pm scheduled as well. The nurse I was orientating with gave PM and some HS meds between 3:30 and 5pm. I did have to wake a few residents up for the HS meds the other night. My question is Is it safe to administer meds (specifically BP meds) that are scheduled BID to be given in the am and at 3:30-5pm times instead of am & pm. She also gave a med scheduled for 10pm (again BP) around 7:30. I was always taught 1 hour before and 1 after is allowable. Is this unsafe practice? Thanks

Thanks for your reply, sounds just like my place. I just have to wrap my head around the idea w/charting and what is acceptable to chart and not (regulations) We also call in other RN'S to do special care...I kind of feel incompetent when we do this because I am so used to do these things myself. I am still in the mind-set of skilled care....thanks again Fav!

Hi all, Question or a few...working in alf-dementia unit for 1 year now...there is a lot of "I hope their not writing that in the chart" by wellness director...example - resident resistant to care ,the resident required 2/3 girls to get her ready..When we have a resident on hospice we are not allowed to medicate w/morphine etc., they have a pca come in and they medicate...Why as a nurse am I there??? If I as a nurse do these things it is considered a nursing home... As an RN if a pt. condition warrants it "I" chart it..ex: if resident is declining and losing 3 pounds a week... I do an assessment etc. and chart it, vs as well. Well there is a meeting coming up for nurses re: charting next week...unfortunately many of our residents are incontinent and not really assisted living residents but they want to keep them as long as they can $$$...question do you think I should not be charting these things??? I guess its not a question. I know I am correct in doing these things...maybe I should start looking for another job? I do love my job and the residents but I feel even though they may be at the end of their lives sometimes we have to do all we can for them not just let them decline without trying to help and "chart" what we do for them and their condition...I did work a LTC and I know ALF are not nursing homes but I need someone to put these things into perspective for me...Thanks for the support.:redpinkhe Greta

since last post I have moved to an assisted living facility and LOVE it!:redpinkhe

thanks, I don't get to see her physician I only work part time, eves and every other weekend days,,, but will discuss w/unit manager who does communicate with him.

Hi, Have been in assist. living for 3 months now...love it...but one resident is on trazadone, she has moderate anxiety, is 70 year old w/picks disease. In the past she would wake around 6am and be anxious (packing things etc.) I believe she was on trazadone 25mg in am and hs. she also had 25mg prn q8hrs. In the last month they have increased traz. 25mg am, 50 at 5pm and 50 at 11pm. We provide daily documentation for the md since the increase. within the last week she hasn't been going to sleep until 3 or 4 in the am. waking around 7 or 8am. This morn she was very un-coordinated and putting glass into cereal bowl. I held the morning dose of traz. She seemed more coordinated after lunch and actually sat for an hour and a half watching movie...but legs and feet were moving... Previous to this med increase, the poor woman didn't even know what to do when handed meds (she puts them in cereal bowl-I was testing to see what she would do) . She frequently has things in her mouth: papers, bingo chips; she also has a hard time following simplist of directions... so we really have to keep an eye on her. She also eats and 5 minutes later is hungry because she doesn't remember eating...I feel holding traz. was the correct thing to do, I also checked on side effects of traz and she seems to have them also. Any advice out there? Thanks for the support.

Hi all, after working in LTC for 9 months I have recently taken a job in ALF: which I LOVE so far...question? when checking new med sheets for the month I have come across something which I would like some advice on example: original order: celexa 60 mg q day, the way it is written on the sheets states: celexa 40 mg give 1 1/2 tabs=60 mg Is this ok??? I was told that DNS wanted it this way... this is totally different that what I am used to, I am used to the order celexa 60 mg q day then on the script bottle it would be 40 mg tabs and it would say give 1 1/2 tabs.. I know alfies follow different rules, am I just confused going from one facility to another?????some of the med sheets are written like this... Input would be appreciated. Thanks all..

Thats what its all about!!! :)

what part of the cape?

Hi, definately do dosage until you are proficient at it...there is a test each semester. also A&P. I used the Saunders Review Book throughout it is great!

It sure does I don't think I could do it without the staffing I have.