americanTrain

americanTrain

ICU, ER, MS, REHAB, HOSP ICE, LTC DON

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All Content by americanTrain

  1. Medical Specialty Unit in Long Term Care

    americanTrain replied to americanTrain's topic in Geriatric, LTC

    Yes they are always skilled, the difference is I have a separate unit for private suites, the dining is separate as is all the activities. We have a wonderful 8000 sf gym for rehab. The ones who...

  2. Medical Specialty Unit in Long Term Care

    americanTrain posted a topic in Geriatric, LTC

    Several larger nursing homes are adding Medical Specialty Units. ( MSU ) This is separate from Skilled Care but more advanced than Rehab where the focus is on quality indicators, outcome measurements...

  3. Medical Specialty Unit in Long Term Care

    americanTrain replied to americanTrain's topic in Geriatric, LTC

    mso819, sorry about the name mix up, it's been a while since I've been on here and they have added the color codes,

  4. Medical Specialty Unit in Long Term Care

    americanTrain replied to americanTrain's topic in Geriatric, LTC

    Thank you Bronze 2, I am really surprised I haven't gotten more

  5. experienced and empowered?

    americanTrain replied to confusedattimes's topic in Medical-Surgical

    Do what makes you happy, if they are begging you to come back, weigh out the pros and cons. As a nurse you need to be happy where you are. I drove a commute for 3 years and loved the job until a lay...

  6. Medical Specialty Unit in LTC

    americanTrain posted a topic in Long Term Acute Care

    Several larger nursing homes are adding Medical Specialty Units. ( MSU ) This is separate from Skilled Care but more advanced than Rehab where the focus is on quality indicators, outcome measurements...

  7. Supra Pubic Catheter Question

    americanTrain replied to jigi's topic in Wound, Ostomy, Continence

    Seems to me that the Urologist would have inserted a larger one, not smaller, which they usually do on intervals until the right size fits the stoma. Im not a Urology nurse, and if I'm wrong, I admit....

  8. What to manage a painful dry eschar?

    americanTrain replied to small_potato's topic in Wound, Ostomy, Continence

    Is this resident Diabetic? You may be looking at gangrene instead of

  9. Hospitals discharging patients to nursing homes with pressure ulcers-no documentation

    americanTrain posted a topic in Wound, Ostomy, Continence

    What's the deal with hospitals today, do they not get reimbursed for a hospital stay if the patients develops a wound? When I worked in Med surg, all wounds had to be documented on admission and...

  10. What to manage a painful dry eschar?

    americanTrain replied to small_potato's topic in Wound, Ostomy, Continence

    In our facility eschar is left dry and OTA, with offloading, LAL, etc. The eschar provides protection. Unless there is an underlying infection, which it sounds like may be the case with yours, with...

  11. Hospitals discharging patients to nursing homes with pressure ulcers-no documentation

    americanTrain replied to americanTrain's topic in Wound, Ostomy, Continence

    Christy, you are exactly right! I just wanted to hear it from another nurse. There is one particular hospital that refers to us, these patients become our residents and we are supposed to fix their...

  12. Hospitals discharging patients to nursing homes with pressure ulcers-no documentation

    americanTrain replied to americanTrain's topic in Wound, Ostomy, Continence

    OOPS! They did it again! Arggggg..... I really dislike some hospitals who want to say that LTC causes all the

  13. Returning to work and want to get into wound care nursing

    americanTrain replied to Momofbubbas's topic in Wound, Ostomy, Continence

    I agree with the others, get your certification in wound care. Im not sure with a BSN if you have to have the hours or can just take the class. AD RN's have to have 2 years of full time wound care...

  14. Cutting VAC foam

    americanTrain replied to islandnursemama's topic in Wound, Ostomy, Continence

    The first vacc foam fitting is the hardest for me, I measure the L,W,D of the wound bed and calculate in my head about how much I will need, I like to use a separate piece if needed the first time....

  15. How many residents can use safely care for as full time wound care nurse

    americanTrain replied to americanTrain's topic in Wound, Ostomy, Continence

    Bblessing2u , we don't have any of the charge nurses doing skin assessments or treatments, I do it all. Iam full time, so I really don't want to complain too much, but it takes a steady pace to get...

  16. How many residents can use safely care for as full time wound care nurse

    americanTrain posted a topic in Wound, Ostomy, Continence

    Iam a wound care nurse at a very large facility. I currently have 80 residents and growing. Iam interested in knowing about other nurses who have the same title. I have the responsibility for doing...

  17. Transitioning to Wound Care Nursing

    americanTrain replied to aab1964's topic in Wound, Ostomy, Continence

    Please read my thread " how many residents can a wound care nurse safely care

  18. frequency on RN visits

    americanTrain posted a topic in Hospice, Palliative

    At our company we have a policy that all patients must be seen by a nurse no less that 2 days per week if stable. I feel this is unreasonable since as an RN I usually do both visits. Shouldnt an RN...

  19. May be a dumb question but curious!!

    americanTrain replied to incredibleme's topic in Wound, Ostomy, Continence

    Measure the entire area. Since stg 1 is nonblanchable redness, stg 2 is an open area. Measure wound using the clock method; measure the redness surrounding, because this could open up even further...

  20. Friedreich's Ataxia

    americanTrain posted a topic in Hospice, Palliative

    Does anyone else have a pt with Friedreich's Ataxia? This is fairly new to me in hospice, and I'm dealing with possible issues pain. It's very hard to read this one as pt is nonverbal even though I...

  21. Dx Non healing wound

    americanTrain posted a topic in Wound, Ostomy, Continence

    I have a patient with a diagnosed non healing wound to the sacrum. Complications include Diabetes, Bilat BKA, Colostomy, Urostomy, Spinal Stenosis, non compliance with diet, obesity. Stage 4, no...

  22. how to deal with the funky smell?

    americanTrain replied to orangepink's topic in Wound, Ostomy, Continence

    Spearment or peppermint oils on the sheets if patient at home, not so sure that would go over well at a

  23. Pressure Ulcer?

    americanTrain replied to limey's topic in Wound, Ostomy, Continence

    Any fluid filled blister while intact is usually already considered a stage 2 ,( some might say unstageable, but our protocol is stage 2, unless there is eschar involved). The blister now open, stage...

  24. Call schedule

    americanTrain posted a topic in LTC: Directors, Assistant

    I'm interested in how other LTCF's handle their on call rotations and who participates. As DON, do you ever take on call for a week in the rotation with other staff for call offs and make calls to...

  25. ADON misleading title? Rant from DON

    americanTrain posted a topic in LTC: Directors, Assistant

    Iam currently the DON at a facilty with census of 62, I have only been there a little over 2 months. Never having been a DON before. We have a Tx nurse, PCC who does careplans, and a ADON. I was...