sharlynn

My employer paid for the 3 day certification course. I passed the regular MDS part, but failed Medicare. The instructor actually said "I can tell those of you who only do MDS by the glazed look in your eyes right now". Needless to say, she was mot very helpful. Certification is not required by my company, so I am not inclined to have them waste more money!

We've taken MDS off the chart entirely. It was just too cumbersome. They are kept in file cabinets in a separate room. As for 3.0, it still has many problems in my opinion. The wound section leaves a lot to be desired, but then I'm a wound nurse. The D/C's are totally ridiculous! How can you interview someone who is already gone to the hospital! Are we suppose to hold the ambulance-"Wait, I have to ask him a few questions about pain before you go."?

On quarterlies, if you go to the last section under diagnosis with the drop down boxes and list the psych diagnosis first, it will clear it from the QI/QM. If you do that on the annual, it is autumatic on the quarterly too. It can be Psychosis, Schizophrenia, Paranoid State, but I've never had a Dementia diagnosis work.

I am an old nurse, but new MDS Coordinator. I have a question about the pain section. Sorry, I don't know the exact section, but it has No pain, Daily pain or pain less than daily and goes on to mild, moderate etc. I have been coding it as daily pain if a resident is on a scheduled pain med, and mild or moderate depending on whether it was a med like Tylenol or a narcotic. My corporate advisor recently came and she thought it was only for breakthrough pain. That would put somone with no pain at all and no meds in the same class as one getting Lortab TID. Is she right about this? She also said she could be wrong and to bring it up at our next corporate meeting. I've read the manual and didn't find anything like that. Thanks

Thanks! That gives me an idea of what I'd be in for! Now to decide if the extra pay is worth the responsibility.

I 've been offered the position of Medicare manager. Everyone tells me it's stressful, but no one can tell me why or what I would be doing. Anyone ever done this?

I tried it for leg cramps after reading about it in Dr. Gott's column. I just put the soap under the fitted sheet ( no baggy). The soap moves around in the bed. I can't swear that it helps leg cramps, but the only times I've had them since I started, the soap has manage to slip down the end of the bed into the blanket or on the floor:rolleyes:! I never heard of it for RLS, but now that I think about it, I haven't had that problem lately either.

My favorite is potassium.

Does she have sleep apnea? Just went thru this with my husband. When he finally decided to believe me and got tested, he was dropping to 64%!

Check with your state. Each state has different regulations. I was allowed to in NE as an RN. Not sure about LVN, though.

I agree! Actually , I once worked at a place that gave us a turkey. But otherwisw everywhere else, it's nada.

I've never worked anywhere that required an order.

I agree with doing what is best for you. For me, the third night is terrible. When I worked in ICU, I felt it was hazardous for the patient to have me as a nurse on the third night! I still prefer to work no more than two nights in a row. I can handle two nights with only about 6 hours sleep, but not three. Unlike others, I do not sleep that well in the daytime and catch up on my days off. I have a husband (a long term night shift worker who can sleep anywhere, anytime-grrr!), but the kids are grown and on their own. I couldn't do it if I had small children!

In general, when a blister develops it started 7 days before. Ask yourself " where were they a week ago". If the heel is kept offloaded and the skin does not break, the fluid will resorb and the skin will peel off like any blister. Howevere the discoloration is an indication of deep tissue injury and it may not be that simple. It is best to leave the skin intact if at all possible. Surgeons usually want to see what is underneath, and this just invites infection.

Good grief! A nurse educated in th e fifties would be in her 70's now. LOL

I also learned about this in nursing homes. It's great for any really stinky area, especially contracted hands on stroke pts.

I agree with Smokey.

Tegaderm is air and gas permeable also.

I was required to have them first in Nebraska after moving from a state that did not require them. When I returned to Arkansas, both had become compact states and I did not have to have them until renewal time.

When I lived in another state where CEU's were required, the area hospital gave free inservices to employees for CEU's. Those of us employed elsewhere had to pay to attend. It was pretty disheartening to sit there with employees who read a book, worked a crossword puzzle or gossiped through the whole presentation and then picked up the same certificate I had payed $35 to receive! At that time only half of the CEU's could be home study. Since I've moved they have changed that and you can do all home study. The whole thing was a joke.

so have i. also "no antibiotics per family request"

Wound Wash Saline is great! It is usually cheaper than bottles of saline (which should be discarded after 24 hours) and gives the proper psi.

Wow! In my opinion, 12 subacutes would be more than enough for one nurse!

Where I worked (past tense) it was 6:1 with one aide for 2 nurses. I've heard they've gone up to 7:1 since I left. It wasn't safe!

All I can say is "shop around" If you are in an area with several LTC's. Not all LTC's are like this. The last one I worked in, the Administrator and secretaries took the CNA course so that they could help out when staffing was short. Needless to say, I stayed there 10 years and only left when I had to relocate D/T aging parents. By the way, I Am one of those baby boomers you are talking about:rolleyes:!