davidndenise2001

:bugeyes:Does anybody know what an LPN can and can't do in Indiana without IV Certification regarding a PICC line? Also, does anybody know how to become IV certified in Indiana?

First off, let me sit the scenerio of prob #1. Res. is 99 y/o. Fell in room and fx r. hip. at nursing home about a week ago. Sent to lg. hosp. and they sent res. back saying surgery wasn't possible d/t heart being too weak. She was at hosp. for 2 days. The lg. hosp. set the hip and started lovenox. They didn't send her back to the nursing home w/no PT, OT, or ST orders. Just no weight bearing on r. leg. They didn't give res. an abductor pillow to put between her legs. They just put a pillow against the inside of her leg and wrapped it with a blanket. The order said to put demend on resident and change PRN. I got to work today and she was one of my res. The only thing we're following up on is that she has an antibiotic for UTI. Nothing about the fracture. Then I started working on the orders that I had received and there was an order that it was ok to get res. up in G-chair. Res. weighs almost 200 pounds. So, I went to PT and asked if they had or were going to eval and tx. res. They said they asked the dr. for permission to, but no reply so far. I showed PT the order to get res. up in G-chair and she suggested that I didn't get her up yet. I told my CNA's to leave res. in bed for supper, not to move her at all unless they moved the entire body at one time, and not to raise the head of bed unless she was at a 90 degree angle. I went in the res. room to give her meds and do an accu check. Res was sitting at between a 45 and 90 degree angle. Also, I had heard through the grapevine, that we were suppose to use a Hoyer to get res. up. Am I right or wrong that the res. doesn't need to be a Hoyer or in a G-chair until PT evals and decides that its ok or at least longer than a week after she feel and fractured it?? Gripe #2! My opinion of what I'm suppose to do as a patient advocate. If I see or hear something or someone not treating a resident right whether that res. is on my "hall", then my job is to stop the actions ASAP and go to higher athority whether the person doing wrong is my best friend or my worst enemy. Also whether it could make my life a living h*ll for the next umpteen weeks. I figure it doesn't matter who it makes mad, as long as that res. is beening treated like they should be. Right or wrong?

So far, knock on wood, I don't think I've done anything to dumb, that I'm gonna recall. :icon_roll I have heard stories about a few of my collegues. One nurse was getting ready to do an enema and had a CNA helping her. She forgot to instruct the CNA how to hold the bag of water and ended up w/a soap water enema on her head. Another nurse was calling the on call doc one night and instead of asking for Dr. Rector asked for Dr. Rectum.

After I posted the first post, I researched some. Couldn't find anything about long term effects. The pt. is 96 yr/old. Semi-mobile. She walks w/a wheeled walker at times. But she was given at least 2-3 doses of MOM and had to be "dug out" the other nite and had a LG! bm.

Maybe I need to clarify my question. I have done some research, but can't find anything. This person had the surgery a couple of years ago. She now is c/o not being able to poop. After being checked digitally, it's there just hasn't moved. She had been mag'd 2x's that I know of w/o any results.

I'm basically not taking the time to research my question, so I'm hoping somebody on here can help. Does Villous Adenoma of colon, with section removed, slow mobility of bowel movements?

I am pretty much assuming it is like this everywhere, but everybody knows what assume means. How many ppl feel like they get a day or two off just to turn around come back to work and have to clean up "messes" that have been left? Whether it's orders, labs, etc. I really don't figure I'm the only one.

We left a note for the DON because we aren't there when she is. Wouldn't a blood drug test show what and how much meds are in the residents system?

I was told by a CNA that another nurse had given a resident a pill from her own purse. The CNA wasn't 100% for sure that it had happened, but it had been spoken of by the nurse on one of their many smoke breaks. It supposedly happened on 3rd shift, so there is hardly anybody there to witness anything. I told the CNA that she needed to report it to the DON. It was her job, in my opinion, as a patient advocate. The resident is usually combative and yells all the time. The night after all of this supposedly happened, the resident was out like a light. Hardly a peep out of her. Well, I read in the mar and the chart where she had been given about 4 doses of ativan within the past 48 hours for aggitation. Everytime I've gave her ativan, it hasn't worked, so I quit giving it, so I was kind of curious as to why it had worked all of a sudden. The CNA also told me that that same nurse also states that she gives residents "a little extra" when the usual dose doesn't work. Has anybody else ever happen in their facility? This is a LTC facility - FYI. Is there anything else that myself or the CNA can do other than report it to the DON?:angryfire

I know I've read several postings about night shift aides, and it's like I'm reading postings about the facility I work at! I work at a LTC facility that has three "halls". We have one hall that is like assisted living, our medicare hall, and then our, what I call, full care hall. I've been bragging about how the night shift aides have been doing such a great job lately doing their bed checks, passing ice water, reporting anything unusual when they find it, etc. Well, the other night, an aide that had been off all weekend came in for her shift. There was myself and another LPN that was working at the time. Other than that there were 4 aides total. Well we realized that they didn't do their 10p bed check. We didn't give it much thought though, because evening aides had just got done w/their bed check about 9:30 or 9:45. Well as the night went on, we realized that the 2 aides on the "full care" hall didn't do their midnight bed check either. Like a few other postings I've read, we gave these 2 aides the benefit of the doubt that they were going to do them in a few minutes. Myself and the other nurse went on doing our duties - mainly passing breathing tx. The other nurse realized that one resident had an awful odor coming from her. She didn't say anything to the aides, because "benefit of the doubt" ya know. Well, at 0500 we started doing our early morning med pass and accu checks. We went in that room and it had an even stronger odor coming from it. The resident was soaking wet! We said something to the aides and they just mumbled something about she had gas all night and she always pee's that much. Well about 1400 yesterday, this all happened sunday night, I got a phone call from another nurse that was on duty, that I'm friends w/. She told me that her advice, since she has been there longer than myself or the other nurse I was working with, was to write them up and send them home if they're not doing their bedchecks when they're suppose to. If we were to have sent them home, the we would have had 2 aides total in the building and have to try to get ahold of somebody to come in and replace those holes at midnight. What should we do next time this happens?