americanTrain

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 qualify for the MSU program have to be willing to do t...

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 and teaching. The core of these programs is indivi...

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, lol

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

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 off. Now I work 8 miles from home. If the commute i...

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 and teaching. The core of these programs is indivi...

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. I have seen this in our place too.

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

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 discharge. We are getting admissions from hospitals wh...

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 erythma, tenderness and warmth, whether there is dr...

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 mistakes. I figured it was a reimbursment issue, muc...

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

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 experience before taking the course and test. I start...

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. But I always write down on my cheat sheet the lengt...

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 everything done just in one day without going into o...

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 all treatments on a daily basis,including at least 1...

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

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 only have to visit pt once every 2 weeks. We only ha...

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 since the tissue is already damaged. Describe your w...

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 use Painad scale. At different times of the day, cry...

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 tunneling, slough present one week, but gone the next. ...

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

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 2 depending on depth, which is prob what you now h...

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 find employees to work that needed shift?

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 recently told that I could not delegate duties because ...