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.

Sadly I agree with this recommendation. But I also work in a private pay facility. I am the one that does the Covid testing for everybody and we have 43 out of 100 staff not vaccinated. Some of the comments from my vaccinated staff are that they are angry at the unvaccinated staff are not doing what they need to do to help keep people healthy. This mandate will not affect us unless it gives us stuff from other facilities that have to mandate it. vaccinated staff also talk about the ones who are unvaccinated that do get sick or still getting benefits for Covid pay because they’re out so what was the point of getting the vaccination in the first place. We still have too many people thinking that this is just like the flu, it’s not going to affect me, all the ones that are in the hospital are also vaccinated so what’s the point in getting the vaccine.

We have a admin staff meeting then a clinical meeting right after so the ones not involved in care do not get the patient info

Do any you have a sample neuro check form that was built within matrix

I see it as he gets paid for his position and it is his job. I have documented exactly what is said. They will cover their *** if *** hits the fan later on so you have to cover yours. I happen to now have an awesome medical director but have been yelled at for calling in the past. Even when I worked in the hospital and a doc told me not to call. I stated "Your on call and we have an order to notify of such and such. Good bye! " and hung up on him. I don't play. We are professionals and they don't need to act like they are above any one else.

My DON does our staffing and it is crazy. We have a separate COVID unit and staffing that has shorted us else where. We are set up where we can get some part time nurses to even just come in for med pass then have 1 nurse cover 2 halls. I am so ready for covid to be over. Plus testing twice weekly because of our county positivity rate kills us to because then they are out for 10-14 days.

The doctors do visit non covid patients so I could see this as a way to decrease exposure. Not really a benefit to the other staff though

We had been having very low numbers until recently then this last week had over 500 positives and the hospital is 75% capacity and had to open more covid beds. I work long term care and we managed to be COVID free until recently when a resident was sent to the hospital for what we felt was a prostatitis infection. His PSA was 12. He tested positive for COVID so then we had to test the other residents on that hall and there was 1. So then we opened our COVID wing. No a couple weeks later and short staffed, our medical director tested positive my DON is now positive and an activity staff is positive. We had 2 other residents test positive as well. The staff we were able to get to work on the COVID hall all work the same block, Our nurses are tired. And now the DON is out for 2 weeks..Such Fun.

I am the MDS coordinator/ADON for a private pay facility. We had to open our COVID unit for 2 of our residents. This unit is isolated from the rest of the facility with an outside entrance and has dedicated staff to work it so they are not able to work anywhere else and no one else can go in the hall or they can't go in the rest of the building. My question is.....How do we complete the interview part of the MDS for all of the disciplines that have to interview? Have someone else interview them and use their answers? This is the 1st we have had to deal with this...Thanks for the input in advance

I schedule 14 days after discharge from hospice.

I am interested in what some facilities are doing with thier staffing and people going out of town when there are hot spots. We initially had a travel ban. Texas also had mandatory testing so we had some refuse to take it and had to be off 14 days without pay. So the travel ban is somewhat lifted except you have to fill out a form and depending if your going near a hotspot you understand that you will have to self quarantine for 7 days then take a covid test prior to returning to work. Some are taking it seriously some are not and it’s messing with staffing. Ideas?