rnman99

That's a whole 'nother thread by itself. I might stop to help someone *after* the resident has taken their meds and I've charted them, but do not interrupt me while that cart is open, unless it's a code, etc. I've seen too many errors happen because someone stopped a nurse right in the middle of drawing up the meds, or while they were in the process of taking them to the resident. As an aside, when I hear griping about lazy nurses not helping their aides, when it's not warranted, I remind them that while I might be able to do their job, they can't do mine.

How many meds are there at 1700? No place I've ever been has had a huge med pass at 1700, mostly coumadins and sliding scale. Our BID meds were saved until 2000. Maybe they could shift times a bit.

That place sounds about as psychotic as the place I left a year ago. I stuck it out for 5 years, and felt like I was putting my license on the line every time I set foot in the building. If nobody else is going to have your back, and they can't get their collective %#^* together, then you need to protect your family, your license, and your sanity, and if leaving is what it takes, then it's time to go.

Sounds like something that got stacked on your writeup just to beef it up. When I was working the floor there was no way you could get the normal LTC med pass done in 2 hours.

If I had my MSN I wouldn't be doing MDS anyway. They don't pay me enough for the work I do and the education I do have...

I used to like 2.0. 3.0 not so much. The discharge assessments have basically doubled my workload, I have no help, and I feel like I'm a hamster on a wheel, trying to catch up and not get in trouble with the state and feds. I've applied for a nurse management position. I'm about burned out and ready to move on after this 2 year stretch.

Like I don't have enough to do as it is.

The three of us in here were wondering what would happen if we all turned in our notices all at once, if they don't get us some help. Right now I have 33 PPS by myself, I had 85 MDSs last month. This month so far I have had 15 full admissions. I have about given up on trying to make the other disciplines do their sections. This is getting really old.

This came from the government. You only assume the people who created this are smarter than you are...

Where I'm at, if it's an OBRA assessment, it goes into case mix, no matter if it's combined with a PPS assessment or not. If they're cut from MC on day 30, and stay in the facility, whatever medicaid RUG they had on their admission goes into the case mix. Once in a while, if we know a resident is going to stay long term, and they get cut from therapy early, we'll throw a quarterly in with the 60 day to establish a new RUG for case mix.

Remember, too, that therapy gets them nice and early when they're bright-tailed and bushy-eyed, and nursing gets them at the end of the day after therapy has inflicted their pain and torture and they're 3/3 for everything including eating. Most of them DO fluctuate depending on the shift....

I do all the PPS myself. PPS census ranges anywhere from 35-50 depending on the season. See my above post. We have 170 beds, my 2 cohorts split the medicaid and private pay residents, do care plan meetings, and the usual stuff. They stay busy. We have had a few residents that haven't had a 3.0 quarterly yet as they've had sig changes every time. We used to go to standup, work on call; I had the restorative program at one point, but it was getting stupid busy so we had them taken away. I'm supposed to have another person for PPS but the last hire we had was a total hoser and got fired so it's been just me. It wouldn't be so bad if we didn't have to do all those stinking discharges.

I wish my PPS census was 20... I'd make your coworker go to standup, though. I hated going to standup before 3.0 came out.

Don't know. End of Jan, my PPS census was 41. I had 90 total assessments; 24 full admits with CP and CAAs, 18 discharges. Plus the usual ancillary stuff they dump on us. I think we get dumped on no matter where we are anymore.

If your resident was discharged on day 15, you're OK. If not... I'm not sure. If you submit a 14 day after the discharge then you get flagged for out of sequence. Maybe you could modify the d/c and add a 14 day...