litbitblack

It is not easy to report a nurse to the board it is a lot of paperwork a I guess places don't want to mess with it.

It is what the residents wants no matter the facility policy. I would ask the facility if there is a policy stating how often and let them know he is reporting he hasn't gotten one and what staff said. Just because that CNA forgot doesn't mean the next one can not get him done. Bathing is a hygiene and comfort issue. Start with the facility.

I understand out of the facility 2r hours results in discharge assessment.

I am looking for others experiences with the dexcom use in nursing homes-specifically with family members monitoring them as well as staff. We have someone who is a brittle diabetic that prior to her illness used an insulin pump but now is no longer able to stay at home. The daughter is sooooo focused on her BS that she talked the doctor into a PRN sliding scale for a bs over 250 at any time. What has anyone elses experience been with cont. monitoring specifically in a nursing home.

So to followup after my original post. The scheduling person is awesome. Of course it took some getting used to and changing habits that we had gotten into but to not have to deal with the schedule is the best darn thing to have happened. She has the scheduling call Monday - Friday 24 hours a day and me and the DON alternate weekends to be on call. It has been a positive change.

Prior to COVID we were doing in person Care Plans every week. Now after doing telephonic ones for 3 years we do not want to go back to in person. Residents families have started asking about it (not ones that were here prior to COVID) and we have found it is easier to get the discussion completed in a shorter amount of time using the phone rather than having to encourage them to go because its time for the next family. What do you do at your facilities? I know when my aunt was in one they never called about the Care Plan. Is in person cp the norm and should I suck it up and go back to in person :(

check with your osbudsman.

Is there a new practice for double gloving for incontinent care? We received a tag for infection control incont. care and are doing inservices. Our sister facilities infection control nurse is educating her staff that they can double glove then instead of changing gloves just remove the 1st pair and they are good to complete the care. I find this wrong and am just looking to see what others are doing.

So Nov. 1st we were told we had to start completing Section GG on the MDS and next October is when Section G will be going away. I am in a private pay facility. We do not bill Medicare. Therapy is contracted out and they bill Medicare for their part. But state has said we have to complete it any way for date collection. We are a Dementia care facility. We mostly admit residents that are not discharging unless they go to the hospital and hopefully return. This thing wants admission info. ( they have been here 2 years) and a primary medicare diagnosis that it won't accept. So frustrating just for information collection.

I am an ADON at my long term care facility and sometimes feel used and abused LOL. And it’s probably my own fault because of a sense of duty. I have been there 14 years and just the last 3 have been adon. You are the administrative in charge when the others are out. On call can really suck at times. Other times you don’t get many calls. I’ve kinda grown to this position and didn’t start out in it. Some people stay in jobs for the benefits then retire and work where they always wanted to. I have some nurses that worked for the state till they retired then come work for us. I would really evaluate what you would be giving up vs what you would be getting. Fulfillment? Purpose? If your not feeling like your getting what you need there can you get it from a hobby or a class for something you have never done before. Just some things to think about.

I got in the habit of charting as I go so I rarely had to stay hover but yes you should get paid for staying

So I was informed today that the administrator is looking at getting a person to do staffing so the don and I do not have to manage it and take Calvin ect. At first it sounds awesome- but then I thought about it and want some opinions of those who may have already or are currently doing this. The company basically started as an independent living facility with a healthcare attached. 15 years ago a dementia facility was opened a few streets away. The staff have never been mixed and each facility have their own don/adon ect and the CNA’s do not float. It is set up different that we are. We have 85 staff in our nursing dept I don’t know how many they have. Last year she. We had to open the Covid unit they would not assist with staff . Now they are very extremely short handed and this staffing person thing comes up. Me and the don take call weekly Friday to Friday. We find staff change the schedule and the don does the schedule. With this staffing person it is being said that person would take call ins and be responsible for finding staff including pulling staff from our building to go over to the other one and vice versa. We have more staff because of the residents we care for and the way our suites are set up. We have been trying to open our other dementia suite that we closed for Covid so it seems we are over staffed when we are actually training staff to open it. I’m supposed to be positive LOL but I see red flags. Anyone else have experience with this type of staffing set up?

Honestly it has been a struggle. We are private pay so notoriously have a lower rate than others. We are the only one in town or I'll say in this area for of our kind and are managing to stay a float. We won't hire agency- just can't afford it. When we had to open Covid unit myself (ADON) and the DON worked the floor just as much as not. We just recently brought the minimum pay for CNA to $15 hr. but big company NH are giving huge bonuses and offer bonuses for working extra shifts. Our plus is the staff/resident ratio and the CNA's know that so it does help.

Are you able to run a monthly report on labs that are due?

We currently use an excel form to do our nurse/CNA schedules and manually mark the xxxx/ooo’s every month and it takes for ever. What are some secrets some of you use to make it easier. It is somewhat of a rotating schedule. I thought there might be a program or something that would self populate the schedule when you put the first day of the month in but haven’t been able to find anything that might work.