beatrice1

Congratulations and good luck with your first Job! Honestly it is just as easy to make mistakes with computerized system, no matter what remember what you learned “5 checks” ?

Hmm, I guess I did assume that. Curious now to know if it is or not

How is this order set up in the Emar . If patient is on parameters, then entering the B/P in should alert you to any PRN orders. Maybe going forward this could be an opportunity to make orders more clear to avoid errors or near misses. You are probably not the only one that has missed this

Anyone have any advice on finding the appropriate Wound certification course. It is very confusing given the different organizations, certifications, prices and requirements... I am a RN with an Associates, I work in a LTC/SNF facility. Our 1 and only Wound care Certified Nurse left the facility and I was asked if I would like to work with the Wound MD who comes to our facility (Vohra wound MD) I took the Vohra wound certification course but it was very basic and not accredited. I would like more education if I am going to be working as "the wound Nurse" in my facility Although certification is not required in my facility, I would like to advance my knowledge base to go the job more effectively. I want to be Wound care certified. Any suggestions? I know I am limited due to not having a BSN Any advice will be helpful Thanks, Bea [email protected]

I work in a skilled nursing facility. I have been a nurse for 8 years and work on the skilled rehab floor. I have been working with the Vohra wound MD in our facility as his assistant. I took the wound certification course offered by Vohra wound care, however this is a very basic course and not accredited. Although it helped me get a better understanding of wound care, I feel like it wasn't enough to entitle me as the "wound nurse" in our facility. I think this may be a specialty I would like to explore but want to be more educated and don't know Where to start. What is the right path for me. I have a Associates Degree. So I know that limits me to some of the courses. Any suggestions as to where to start to see if this field is for me? Thanks , Bea

Occasionally in Long term care you have the family who Keeps their loved one on Full Code, even after patient is nearing their "End of life" Sometimes Patient has chronic illness or no quality of life but family members think they need to "do everything for their parent" My question (although may seem like a dumb question) If Patient passes away, and they are not found (say in the middle of the night) right away, they are Obviously deceased. Are you suppose to do CPR no matter what/when you find them? Is there ever a time you dont do CPR? What is the Ethical/responsible/ proceedural thing to do? Bea

Just wanted to hear other peoples opinions/thoughts or experience with online degrees. I am a RN with a Associates Degree and want to continue my education and get my bachelors degree. I am working full time 3-11. I am torn between returning to my state college or do online classes, as some of my co-workers are going this route. Are on line degrees accepted (respected) my most employers now? Do you feel you are getting a good nursing education this way? Is there anything I should look out for? Just any advice that will help me with this decision. Thanks for any input Bea

"My problem with your request is that you are looking for a chemical restraint. Think long and hard before doing that - or at east, don't post about it on a message board" @SuesquatchRN In My original post, I asked about Sleep Aids because the woman was already put on one at this point and I was questioning WHY Trazodone was used. I was questioning OUR MD's choice and wanted to know what other's peoples experience/opinion on this medication was. I am a fairly new nurse and still learning. I have only been in this facility and often ask how other facility deal with situations. I am NOT for sleep aids for the elderly, without trying all other interventions. Which is why I also asked "What are other sucessfull interventions you have used." I went into LTC because I don't think there are enough good Nurses that care about the elderly and thier care. But I LOVE it, and am proud to be a part of what ever time they have left and I believe they deserve the best of care til the very end. If anyone else has any advice that would help, I appreciate it. Bea

Thanks for the answers so far, I am surprised to learn that Trazodone is used more than I thought. The issue isn't just the wandering, in fact I don't mind the fact that she is up and walkig around, cause he is safe and not a fall risk, However, she gets awfully loud at this time (11pm-12am) she is wandering in and out of rooms waking sleeping residents up lookin for Mario, and she is upset that she cannot find him. I want to find a way to redirect and put her at ease.

Could you all give me some examples of Sleep aids you use at your facility to help your resident's rest/sleep when all other interventions do not work. ex. We have a Portuguese speaking dementia resident who sundowns and starts to wander in out of other residents rooms "looking for her husband" when there is no Portuguese speaking CNA on, she is very difficult to redirect. We have tried many non-pharmacologic interventions that are not working. she wanders around sometimes till 12am-1am, waking up the other residents and getting them upset. The House MD at our place seems to have a liken to Trazodone. This is what he ordered for her. (which isn't working) Isn't Trazodone an antidepressant? maybe drowsiness a side effect but not what it should be used for. I would love some input from experienced Nurses who work with Dementia patients. What are some successful interventions you have used. And Is there a safe sleeping aid for elderly as a last resort? Thank you, Bea

@JBMommy I loved your post! You stated exactly how I also feel. I too started as a new Grad in LTC. Although I always loved working with the eldely I felt as though I should be working in the hospital for "more experience, learn more skills...ect) However, I have learned so much this past year working in LTC. We are not just a "Nursing Home" We are admitting more and more skilled residents, rehabs patients from hosp, younger elderly rehab patients,ect. I have learned that LTC is more challenging and you really have to know your stuff. The Doctor may be a phone call a way, but I am the one doing the assessment and what I find and report to him is what he bases his orders on. I also had to learn to know what to suggest to him exactly what I wanted from him, so you have to know your stuff. I love getting to know "my residents" and thier families and making there day a better one. I believe these people derserve the best care and deserve a caring Nurse watching over them. There really is alot of opportunity in LTC, especially if you want to make a difference. Thanks for the positive post Bea

@JeanMarie Thank you for sharing your personal experience with your Dad. It was very insightful and also reminded me how to consider the change in routine/place can make them appear to be disoriented or disoriented more than usual, and more conversation may be needed.

How do you all check orientation in the elderly in LTC. Most of them are oriented to self, but what is the best way to check time and place. Do we really expect them to know the date, even the month when every day to them is the same routine. and how about place? Do you know where you are? What are the questions you ask? Bea

I am a new nurse working in LTC. I carry alot of resource books books with me to work... Lab tests, drug book, nursing proceedures...ect. Can someone tell me a great Nursing resource book that includes everything so I don't have to carry so many books. or another words.... What is the one Book or Nursing resource that you cannot do without??? Or Nursing App? My facility is not computerized yet so I don't have that resourse at hand But I do have a smart phone, so any app recommendation will be appreciatedT Thanks, Bea

This is my first job as a charge Nurse in a LTC facility. I float between two different units and work with with alot of differnct CNA's. I would like to give them all a little something as a holiday gift. Can you all give me some ideas as to what you give your girls for holiday gifts to say thank you for all you do? I probably have a bout 10 different girls to buy for. Thanks for any ideas Bea