AlixCoastRN

After 6 years working LTC, I am leaving it next month to go to workas a staff nurse on med/surg at and 80 bed hospital. I was the manager for the skilled unit, and the hospital did not think the transition back to acute care would be difficult. I will have about 3 to 6 weeks orientation depending on my needs. As an aside, my base pay will be about 7 bucks more per hour. I am excited about the return to acute care...

I am considering doing the opposite - getting out of long term care. Between corporate interference, new regs (still haven't seen anything on co. policy for the new incontinence regs), new forms, more paperwork, less time with residents I am no a very happy camper! The medicare gurus at corporate have even changed some of my MDS dates in the name of more reimbursement! geesh!. So I have applied for an ICU preceptorship at a nearby hospital - should hear soon. Bur not to discourage you - I would go back to charge nursing if I could...

I care plan psychotropics, antidepressants, pain meds, coumadin (and the like) and use a temp care plan for antibiotics. This isn't one care plan for each - I usually put the pain in with the ADL, psycho and antidepressants in with mood/behavior - like that. So for this has passed state inspection for me.

We have a res right now with MRSA in his blood and sputum. Last sputum culture a week ago was positive for 2 colonies. He is in a private room - resp precautions. We will be doing another sputum next week to see if he is still colonizing or not. And as a foot note: he has his own teeth! :chuckle Also when he goes out of the room for therapy or whatever, he wears a mask.

We dont' have computerized charting, lab results by computer or bladder scanners - we are starting to replace our crank beds with electric at the rate of 2 per month. (that alone will take about 2.5 years!) We do have automated lifts, using a wound vac regularly, wanderguards. I guess we are somewhere in the middle! Oh - we are more upscale with 3 fax machines in the building

Thanks Talino - sounds like a fair system to me - better than the flat rate Oregon pays - altho it means more assessments. Oh well, can't have everything.

I've never heard of TILEs before either - except those you put on the floor or play scrabble with :chuckle As a Resident Care Manager with over 5 years experience, I input and schedule the MDS, write the care plan, ensure the care is delivered according to the care plan and physicians orders, do nutrition at risk weekly meeting, monthly psychotropic meetings, staff meetings, Medicare meeting (2 of them a week!), care conferences: my compensation is about $25.50 per hour but I am salaried and usually put in about 50 hours a week. I also play charge nurse, pass meds if needed, do treatments as needed, and counsel staff for their wrongdoings...sigh...No wonder I'm so tired!

Well, its over. The complaints were unsubstantiated. I am worn out.

Congrats - its a lot of work but fun and worth it in the long run. I believe the nursing schools in oregon require a CNA license before being admitted to the program. Becoming a CNA will really open your eyes to what being a nurse entails, since you would work with and be supervised by nurses. I have a BA in an unrelated field - and an associates of applied science (AAS) in nursing - RN.

2 compalint surveyers for the state walked in this morning during stand up. Of course we dont' know what the complaint is about. I have been thru surveys with both of the folks, so at least that is a known. Anyway, the bummer of the whole thing is that the DNS and admin are at a corporate meeting and apparently not coming right back. It would be nice to have the support instead of it on me, but may be they think I can handle it without them? Who knows? Hopefully I won't stick my foot in my mouth! Wish us luck!

I'm and ADN nurse who graduated from the University of Alaska in Anchorage. They also have a BSN program. There are 4 hospitals in Anchorage and surrounding areas: Elmendorf Air Force Base has a hospital - Air Force nurses I believe. Alaska Native Medical Center - managed by the Indian Health Service - serves the native population. Providence Hospital (check their web site for jobs) and Alaska Regional Hospital (they also have a web site - do a google search) I worked at Alaska Regional for about 15 years - the last 4 or so as a nurse. Great place to work.

We haven't even heard a peep out of our company regarding the new guidelines - hence, no policy and procedure from the corporate weenies on implementation! I found all the info - thanks to my fellow posters here - (thanks guys) and gave them to our DNS and she forwarded them to the corporate weenies - still no action and we are in our survey window. I think i will go play in traffic!!

I also work in oregon - as an RCM. Staffing ratios for res to cnas are: Days - 10 to 1, Eves - 15 to 1, Nights - 25to 1. These ratios are outlined in the Oregon Administrative Rules. As far as nurses go, I dont believe that there are any set rules - just that an RN has to be in the building 8 hrs a day between 700 and 2300 seven days a week. This is also in the administrative rules. Good luck with survey!

I have no problem with sending someone to the ER without the MD order - I will attempt to call the MD as a courtesy to let him or her know what has been going on. If there is any question at all, no matter the code status, I will ask the resident ( if cognitively aware enough and able to make that decision) if they want to go to the ER or not. I will also call the family, no matter what time it is. I think its ridiculous to 'ask' a doc for an order to send someone out to the ER if, as a nurse, it is medically necessary and/or the res wants to go.

We have about 47 residents right now - staffing is one RN (charge nurse) and 3 CNAs. We have 3 halls unevenly distributed with residents.