carol20lpn

In reply to Ipnerika, I must be doing something wrong!!!! I have been an LPN for 37 years and am making $28 an hour.......let me know where they start at $25!!! I believe the facility I am in starts around $18 for a new grad.

Wow......that was far more than I needed to hear.....makes you wonder doesn't it? This came to light yesterday when they lined up to fill out their absentee ballots...................VERY scary when someone that demented is going to vote for the president:nurse:

Does anyone out there know of a resource for more information on how to code the cognitive impairment "B" on the MDS? The RAI gives some info, but not a whole lot....we have a lot of people that are "ify" between moderate and severe impairment....thanks for any help. carol

Thanks Daytonitej. I have been a long term care nurse for 38 years......I appreciate your input, but as a long time care plan and MDS nurse, I want to help in any way that I can....remember, it is not about us, it is about the residents and if helping someone write a better care plan, I am going to do it.....sorry, that is just the type of person I am .

I hear what you are saying daytonite about care plans......I know nothing other than the "I" care plan process as the company I was with was doing them before PPS came into play. The company that I recently moved to was all electronic and everyones care plan was the same, they all had constipation, and a million other things that didn't allow you to imagine who that person really was.

I would love to help you out if I can......can you send me your e-mail address and I will forward to you some I care plans......you will not get stuck by the state or feds if you "tell a story"....so what if your resident wants to sleep 15 hours a day or have breakfast at noon....don't forget we are visitors in THEIR home so we need to do what they want....... What state are you located in also? Would love to help you if I can. :chuckle

Medical model care plans are for "diseases" or medical issues the resident may have, copd, dm, pvd, chf, etc. The "I" format care plan puts it into a story about the resident......I have dementia and copd. I am not able to wash or dress myself as my forgetfulness doesn't allow me to care for myself and I become very winded when I do much activity wise. I need help from the staff daily go wash and dress then you add a goal such as I will wash my face when handed the face cloth and cued then interventions. Hand me the face cloth, Cue me to wash my face. Allow me rest periods during my morning and evening care. on and on and on....... I "weave" into the nutrition problem with other issues like diabetes, chf, potential for dehydration, etc...... Hope that helps you

Packerm, if you can somehow be in contact with me, I can send you some I care plans.....of course you will meet resistance, it is something new!!!! Change is hard in the medical field, especially when you move away from the medical model of care planning.....haven't got a deficiency yet for care plans with the I format. carol:chuckle

hello, i would start by expressing interest to your director of nursing or your current mds coordinator, ask them if they need help in that department. that is how i started, have now been doing it for more than 10 yrs and have been a regional mds coordinator for a major company in the ne us. good luck.

hello, i hope this is a help to you. independant: you do absolutely nothing for the resident. they can go to the med cart and get a towel, etc. supervision: talk only, provide cues and reminders, no touching!!!!! limited assist: touching only, guiding arms, etc into sleeves, no lifting!!!!! extensive: bearing weight if only once during their shift. holding up legs to put on teds, lifting their legs up into the bed, lifting their head to adjust the pillow, bearing their weight during any part of care. total: pretty much they can't or won't do anything. a person that is "coma-like", severly demented, you do absolutely the entire process. activity did not occur: just plain , it did not happen, be it walking, locomotion, dressing (is in street clothes, not johnnies!!!!!!). i do constant inservices, put guides up over the computer charting area and call them on their errors via e-mail........i inservice late loss adl's the most, and just repeat the 4 areas over and over and hit the others randomly. good luck. cj

lovebuglpn i think that most of us go into nursing because we care. after being a nurse (lpn) for 38 years, i have become attached to many residents/patients. you just have to be careful not to let your personal attatchment get in the way of your professionalism. you sound like a good nurse and i am sure that you are able to keep the professional and personal relationship within safe limits. good luck in your career. cj :redbeathe:nurse::redbeathe:yeah:

hello! i have been an lpn for 38 (oh my gosh!) years. most of the time i have worked in geriatrics, long term care and rehab in the long term facilities. i have also done a bit of time as school nurse and a visting nurse. for the past 10 years or so, i have been an mds coordinator and am loving it! i have been writing "resident focused" or "i" format care plans for the entire time. i have no regrets in stopping my education at the lpn level. i have had many, many opportunities in my years and have been treated as an equal to the rns and in many cases and often been told that my experience places me far above many of the rns that i have worked with. as far as the money goes, right now i am making $26 an hour, have medical insurance paid in full for myself and my family, 401k and many other benefits. to all of you thinking of going on to get your rn, good luck to you in your endeavors. to the lpns "for life", keep up the good work. :redbeathe;):nurse: carol

Just wondering how you are doing in your job? I have been an MDS coordinator for 10+ yrs in long term care and I love it.......I am now in a 146 bed building and have all electronic charting.....no more paper!!!! Please let me know how you are doing. cj:nurse:

I don't write all new orders into the care plans.....it makes them too long and complicated. If someone for instance goes on coumadin, I add a problem for bruising/bleeding and then mention the med, labs, etc. I NEVER put in order changes for treatment, I use "treat any areas as indicated". I am not sure if you are using the "medical model" for care planning or doing the "I" format care plans......All I have known for 10 years is the I format care plan and have recently changed jobs and have converted 146 care plans from generic ECS (electronic charting system) to "I " or resident focused care plans. It is easier and much easier to follow than the computer generated ones. If I can be of assist, please write back. cj:yeah:

I am the only MDS coordinator in a 146 bed building with average of 27 - 30 Med A residents. I have a computerized system (ECS) so getting the information is easy, however, I am questioning the accuracy of the cna documentation. I am in line to get an additional 20 hours of help so I can devote more time to the Med A and get hopefully better reimbursement. Previously, I was the only coordinator for 96 beds, all paper process with multiple issues with printers as the paper had to be changed for every different form used, a real time waster. Hope this helps you. :nuke: