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diane227 LPN, RN

Management, Emergency, Psych, Med Surg
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diane227 has 32 years experience as a LPN, RN and specializes in Management, Emergency, Psych, Med Surg.

RN for 32 years. Graduated from Texas Woman's University in 1978. Have worked in all areas of nursing, emergency nursing being most of my experience. Have worked at all levels of management for most of my career.

diane227's Latest Activity

  1. diane227


    If you have a lot of surveyors in your facility, some are probably in training.
  2. diane227


    CMS and the QIS process sets forth very structured numbers for review. Residents are pulled at random into the sample based on the MDS data and other things depending on our observations of the facility. It always disturbs me that surveyors are rude. I, fortunately, do not work with a team like that. We make a strict commitment to be nice and courteous to everyone. Because, like it or not, we are all here to make life the best that it can be for the residents who live in the facilities. There are a number of excellent systems out there and in every facility I have been in I learn excellent ways of doing things. It is a shame that the facilities don't talk to each other more and discuss what works and what doesn't. When I go into a facility I make the assumption that the facility is in compliance unless I see otherwise. And yes we do follow staff around because we are observing direct care given to the residents. Observation is the most important part of what we do. For the most part I have seen committed, friendly people who like helping the residents they care for. Most people do not come to work with the idea that they are going to do a bad job. When you have a negative experience with a surveyor, please call their field manager to discuss your concerns. These matters need to be brought to their attention. And remember, if you don't know the answer to a question it is ok to say that. It is not a test and you can't know everything. But you should be able to know where to find the information. And PLEASE use your care plan. Your care plans should be up to date, working documents that are used by all team members. This is not just needless paper work. The best facilities use their care plans, share the plan with all staff members and update them any time a change occurs. They are up to date and should be structured in a way that if you had a nurse who walked in off the street, he or she would be able to look at that care plan and know exactly what needs to be done for that resident. If you have a question, ask the surveyor. Most will be glad to explain the QIS process. You can also find out a lot of information on the CMS web site. We are not out to get you. We just want to make sure that residents are getting good, safe care. Remember, they live there, and those of us who come in, staff included, are visitors to their home. When you remember that this is their home, it has an effect on how you approach your daily work. Good luck to all of you in your next survey. Take a deep breath, answer questions the best that you can and ask questions if you need help.
  3. diane227

    Transplant error, nurse and doctor disciplined.

    Perhaps my expectations are too high but it seems like common sense to check all your lab results before doing any type of transplant, along with the donor history. Same goes for surgery. How the hell do you operate on the wrong body part?
  4. diane227

    Help! New grad nervous about LTC state inspection!

    I am a surveyor. The advice that I can give you is be honest in your answers and if you don't know, it is OK to say so. My role is not to pick on the staff and when you are asked a question it is not because you did anything wrong. Data gathering in the form of resident/ family interviews, staff interviews and record review are all part of the process. In addition, each facility does things differently and documents their data in a different way. We have to learn how you do it at your facility. You will not know all the rules and regulations and you are not supposed to. If you are observed on med pass, slow down and take your time. It is hard to do a med pass with someone watching you. Calm, composed. But know your medications so that you will know the correct way to deliver each medication.
  5. diane227

    Tracheostomy Suctioning Sterile?

    You should use sterile technique. It is the best practice. You don't want to introduce bacteria into the trachea and thus the lungs. Who ever thinks this is a non-sterile procedure is mistaken.
  6. It is going to depend greatly on what your conviction was for. I urge you to have legal representation and try to find an attorney who is a nurse or who has had legal dealings with the board previously. You need an attorney who understands the board rules for your state.
  7. diane227

    I am wating to go into lpn class with a felony

    Moving to another state will not help you because your background check will still show up. It also depends greatly on what your convictions were for. If you have convictions that have to do with domestic violence, child abuse, sexual assault or misconduct, assault, theft and certain other crimes, hospitals and nursing homes will not hire you. Because you would be in a position to care for a population that is considered vulnerable and the laws are very strict on this standard. What ever you do, DO NOT LIE on any job application or application for nursing school. Be honest and up front.
  8. diane227


    First of all, do not lie on your job applications. Be up front about the conviction. Was it a felony conviction? If it is off your record, why do you think you were not hired because of it? Battery is an offense that can keep you from getting a job where you care for patients because patients are considered a vulnerable population.
  9. First of all you have to know exactly what is going to be on your record and if it will be considered a felony or not. If it is not a felony (and usually it will not be with first offense if no one is harmed) then I personally would not disclose this to ANYONE at the school unless you have a mandatory alcohol course that you have to take that will interfere with your class time. Second of all, you need to speak with your attorney to see how this is viewed on your criminal record for the future. In some states, a DUI conviction stays on your record forever, even if the judge allowed you to plea to a lesser offense like reckless driving. In my state, Washington, there are two processes. The state process for your drivers license and the court process. Even in court if they plea you down to a lesser charge, the state has you down as having had a DUI. This has happened to a friend of mine. She cannot even visit in Canada now due to this conviction, which was not at a felony level.
  10. diane227


    First of all, it depends on the time frame of when you got the felony conviction and what is was for. There are certain felony convictions that will absolutely prevent you from getting any job in health care and those have to do with any history of client abuse, sexual assault and any crime against a person under your care. If you have a history of homicide, sexual crimes against a child etc, you won't get a job. It is IMPERATIVE that you be totally honest on your employment application about your felony. Give the dates and information about the conviction, and what it was for. For example, I had a nurse have a felony DUI 15 years before he applied for a job with me. And I was going to hire him. But he lied on his employment application and you can't do that. If he had been truthful I would have hired him in a minute. It was 15 years ago with absolutely no criminal history after that date. I had no reason not to hire him until he lied on his application.
  11. diane227

    "Graduating & Not Ready"

    I had a few classmates like that. Some were really book smart but could not do anything at the bedside. Some were just stupid. But they were weeded out on their board exams. One guy in my class got the lowest recorded score on a nursing exam in the State of Texas at that time (33 years ago). He was never able to pass the board exam. It is probably too late to do much about this. If the instructors have not caught these issues by now, they probably won't in 14 days... but I would tell them anyway. It is a matter of patient safety.
  12. diane227

    reporting abuse

    And speak to the patient again and ask if she would mind if you have the social worker come and speak with her. Social services often have resources for victims of abuse that we as nurses may not know about. In the future, try to take a bit more time to get a little more specific information about the situation so that you will be better informed when you make your call. And be sure to document all your actions in the chart and inform your charge nurse/ manager in case follow up is needed when you are off shift. It is never too late to go back and speak with her about the matter.
  13. diane227

    RN Orientation Length

    It totally depends on the area, your experience level and the requirements for that facility. I just started working for the state last November as a nursing home complaint investigator/ surveyor and my orientation period will be one year. And they no not expect me to really know my job until about two years. I have been a nurse for 33 years. It is a totally different line of work. So it is very variable.
  14. diane227

    Need advice

    If you don't like people, you won't like home health because you WILL be dealing with people. Social workers, case workers, doctors, family members. It can be intense. You might think about trying a job like being a nurse in a short stay area where you only have your patients for a short period of time. But I URGE you to work on your interpersonal skills... really. It will help you in the long run. My husband is also not a person who enjoys working with management so he works nights. He works in a 30 bed neuro ICU in a very huge county hospital but he still has to communicate with other departments, family members and lots of physicians. It is the nature of being a nurse. You gotta learn how to do it.
  15. diane227

    What's your nursing kryptonite?

    Spit does it for me... mouth care. I just hate it when people spit into a cup or into an emesis basin. I can take vomit, GI bleeds, gun shot wounds, open fractures, poop, people vomiting into my shoe (or into the handbag of the social worker), pus, maggots, etc but spit... Just hate it. One thing that kind of grossed me out once was placing a foley into a lady and getting nothing but pus back.
  16. diane227

    Think back to nursing school...

    I must have missed something in nursing school back in the dark ages because nursing school was just not that hard for me and I am not super smart when it comes to "book learning". I am a hands on learner. I rarely picked up a textbook and never read any required articles (I find I do much more of this now than I ever did in school). We did not have the internet or an Ipod and we had to actually go to the library to look stuff up. What a pain that was. Boards were two days long divided into sections. But I passed on the first pass and that was it. 33 years later, still at it.

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