Aspen1

In our facility, we would never allow an agency nurse to do an admit. Not because we think she can't do it, but because they don't know our policies and procedures very well, they don't have computer access to put in orders--it just isn't a good idea, for the nurse, facility or other residents.

You could be in danger of receiving and immediate jeopardy tag over this. You know the residents are volatile, altercations have already happened. Have any of these events been reported to the State? It seems to me that alternative placement must be found for at least your worst offenders. Is there a nearby geri-psych unit? We often us geri-psych to get their meds adjusted. But if their behaviors do not improve, alternative placement must be found. The safety of your unit depends on it.

I have a few on my Alzheimer's Unit that are tough to redirect. My best bet is to keep them busy all day, but especially starting around 2 PM. I have activites and programming going straight time. If that fails, and sometimes is does, I enter their world. I ask them to tell me about their home, their neighborhood, how long did they live there, where did they grow up? Any pets? Children? Who lives with them? What do they like best about their home? Did they garden? On and on until they move on. This usually works, but not always. Dementia is difficult to deal with, I know. You have to be able to handle repetitive questions. Another techique that is successful for me--get everybody singing. Old songs, hymns, silly songs, anything. They will all usually join in. Singing is uplifting. For the resident that wails, that seems a tougher situation. I don't have any ideas there, except hugs, if she will allow. I always think that these behaviors are a way of communicating, since their ability to effectively communicate is impaired.

My LTC facility hired a graduate nurse who will take her RN state boards next week. She is being oriented as a nurse already. I thought it was no longer legal for graduate nurses to work, that they had to pass their boards first. We are in Indiana. I have been unable to find an answer to this question elsewhere. Can anyone tell me? Thanks so much.