DaisyDoodle

I've been asked to come up with 15 nursing department safety goals for the upcoming year. Any ideas for other D.O.N's and nurses on how to improve the safety at the home?

Our funding is multiple. People pay privately to live in the independent living and assisted living. In the nursing home we have people who pay privately, our Medicare people are there for short term rehab and qualify for Medicare benefits which pay 100% for the first 20 days then 80% for the next 80 days then it is exhausted. These people are responsible to pay for the 20% difference. Some have private insurance that covers this difference and other don't. If they don't they pay privately for the 20%. Then the person pays 100% privately if they wish to stay after the 100 days. Average cost per month is $7,000 U.S. dollars. We also have a few beds that are public aid which is paid for 100% by the state. These residents have to had exhausted all their money, assets, etc. and can only have $1,000. We do philanthropy, a lot of fund raising for donations that comes from private people, local businesses, etc.

It sounds like where we eventually want to be. We are regulated by state and federal agencies. The age in place concept is something that has been done in our country I would say over the last 10 years and still has not been perfected because of the regulations. We are getting better at assessing people to see if they are able to stay in their current environment or move them to a different environment with a higher skill level. For example, in the community that I work at we have independent living cottages where people live on the campus independently but have everything taken care of such as painting and lawn work, etc. Then we have assisted living where the residents need little things done such as medication reminders, laundry, help with ADL;s. There is no real clear tool until recently that our facility could use to move the people that cognitively were no longer able to stay at the assisted living. We would get resident with multiple falls that would be transferred to us with a fracture and then have to stay with us. I always questioned, why are we waiting for the fracture? There has to be a tool. Now, we use a whats called Lifesteps and it is recognized in our line of business. It tests different areas such as cognition, balance, etc. I wish we could have a true age in place where the resident could actually stay in their own place till they expired but we don't. We have facilities that usually have 3 levels of care like mine, independent, assisted, then skilled and we move people along. As you can imagine, no one wants to wind up at the skilled... because that means it's the last stop.

I'm from the U.S. and I work in a nursing home. I am wondering how different we are from what you have. We call it Elder Care. There is a big push now in the United States to make the image of nursing homes seem more like a home and not an institution. I was wondering if you have heard of the Eden Alternative.... it is bringing the outdoors in to the facility. Bringing life in to the facility. For example, we can bring out pets into the facility. I bring my dog to work everyday. This is just very basic. If you have some time, I would really like to have some discussion about how nursing, especially geriatric nursing works in your country. Do you have LPN's? Licensed practical nurses or only RN's. We have both. The LPN's have less school and are limited by the duties that they can perform. The biggest difference is that they are not able to document that they "assess" it is only the nurse that can do assessments. Well, if you have time, I'd like to chat and share exchange information about our countries.

Hi! I had a similar experience. I really wanted to work at the local nursing home after graduation and everyone told me noooooo. So, I went to work at a hospital that was over an hour away from my house. It was a teaching hospital and I was there for 3 years. After that I moved on to home health and did that for 3 years and then applied at the local nursing home which also has a rehab center. I'm soooooo happy where I'm at right now. I don't think though that I would have the understanding that I do with assessment skills, etc. if I did not have the hospital experience first. I'm the Director of Nursing now and so I'm responsible for hiring and training of the nurses. I do notice a difference between the nurses that come from hospitals and those that come from other nursing homes. This is just a very broad and general observation though and I'm not saying it applies to all but the nurses that have the hospital or acute care experience seem to manage the patient load and emergencies differently from the others. They work more independent and have a self confidence about them. Just one person's suggestion, get into a teaching hospital with a good reputation for at least a year... you may find you love it! If not, then go and try your hand a geriatrics. There is so much out there!:)Good Luck!

Hi Becky. I would really like to email and share information. I was really excited when I received your e-mail. However, I'm technically challenged :typingand did not know how to reply to your message as it was a private message and I did not see a spot where I could reply to a thread. I went into your private profile and did not see any contact information. Which reminded me that I need to go in and put in my profile. I hope you get this message... let me know. In the meantime, I'm going to go in and try to do my profile.:typing

Hi! I'm a MSN nursing student in the United States looking to share information with an international student! I liked your thread and wanted to learn some more. I was wondering if we could chat on line and exchange information regarding nursing, nursing school and issues and how they compare and differ between our countries. Let me know....I look forward to corresponding with you.