notanumber

notanumber

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All Content by notanumber

  1. Palliative Standing Orders

    notanumber replied to notanumber's topic in Hospice, Palliative

    No, we care for residents through to the end of life. Hospice is generally for patients coming from the community or acute care who are already at end of life and need short stay skilled nursing care...

  2. Wound care certification necessary?

    notanumber replied to Bostonnurse06's topic in Geriatric, LTC

    We don't have wound docs here. 95% of wound care is a result of nursing collaboration to create a treatment plan and schedule of reassessment along with involving other disciplines as necessary...

  3. Giving med outside scheduled time.

    notanumber posted a topic in Long Term Acute Care

    I know, it happens a lot in LTC, but . . . Resident has short acting opioid scheduled five times a day, including one at 2400. Resident frequently over sedated at this time d/t multiple sedating meds...

  4. Giving med outside scheduled time.

    notanumber replied to notanumber's topic in Long Term Acute Care

    You're right, I posted in the wrong

  5. Foley in patient with undiagnosed urinary crystals

    notanumber replied to notanumber's topic in Patient Safety Issues

    First I'd ever seen it too; pain only during removal. Fortunately we've dodged the foley for now, not sure how long that will last though. I'll ask for a urology consult but doubt it will be seriously...

  6. End of shift narc count

    notanumber replied to NurseQT's topic in Geriatric, LTC

    Our facility permits the count to be done by one nurse and one aide (as long as at least one nurse is

  7. Too much Morphine-scopolamine+stesolide

    notanumber replied to KarinBe's topic in Geriatric, LTC

    Hi Karin, I see Kussmaul's breathing frequently in the actively dying. Yes, it is most associated with DKA, but the metabolic changes occurring during organ failure (active dying) can cause it as...

  8. Giving med outside scheduled time.

    notanumber replied to notanumber's topic in Long Term Acute Care

    I took care of it, I just wanted to know if anyone would have "just given it" at 0300 like the baffled day nurse who I handed off to

  9. Giving med outside scheduled time.

    notanumber replied to notanumber's topic in Long Term Acute Care

    That's one thing I suggested to the MRP in the fax I sent, but unless pain is really uncontrolled I wasn't going to phone the on-call in the middle of the night for an

  10. Getting a puppy and working 12 hour shifts?

    notanumber replied to Hwills94's topic in General Nursing

    First thing, you need to take time off to get puppy settled in. A month is ideal. This will allow you to get potty training and basic OB/manners a good foundation. You need to establish a routine and...

  11. Smoking on the property - supervisory question

    notanumber posted a topic in General Nursing

    Hey guys, thought I'd get some advice on this. I discovered one of my care aides had been smoking on a patio that is adjacent to his floor (not ground floor). He is aware that smoking is only allowed...

  12. Palliative Standing Orders

    notanumber replied to notanumber's topic in Hospice, Palliative

    Good questions! We have oxygen as a standing order for 99% of our residents (2-4L via NP or mask), so it is available if needed without adding to the palliative orders as a reminder. I thought about...

  13. Urine Strips

    notanumber replied to punkdmm's topic in LTC: Directors, Assistant

    We have urine strips but are considering phasing them out. Too many false positives. Latest seminar with a pharmacist on bacteriuria determined that they are useful for ruling *out* UTIs, but not in...

  14. Don't wake the Dr, Or maybe I should?

    notanumber replied to Beautiful_Soul's topic in Geriatric, LTC

    I'm an LPN and night charge nurse as well (1900-0700). Essentially, if there is a significant change in a resident's condition that I cannot fix through set protocols (e.g. initiating palliative...

  15. Mini-Vent: Incompetent Supervisor

    notanumber replied to notanumber's topic in General Nursing

    I'm in ****. I emailed the managers asking if a report had been filed yet, stated I was concerned, stated that was my duty to file one. Got an email back saying it was none of my business and that I...

  16. Mini-Vent: Incompetent Supervisor

    notanumber posted a topic in General Nursing

    As an LPN in extended care, I am responsible for 25-45 residents and 4-6 HCAs including most meds (the policy here has HCAs giving some regularly scheduled ones . . . I know . . .), assessing,...

  17. Mini-Vent: Incompetent Supervisor

    notanumber replied to notanumber's topic in General Nursing

    I document the heck out of everything when I can. I am seriously considering filing a complaint with her licensing body for previously mentioned Very Bad Med Order Error. I wasn't the one who...

  18. Tough shift. First death.

    notanumber posted a topic in General Nursing

    Thought I'd share my emotional rollercoaster of a shift. Yesterday evening (I work 1500-2300 at an extended care facility) I went in to give a res. her 1700 meds and found that she was deceased. I was...

  19. When to get pregnant?

    notanumber replied to WorkofHeart8's topic in General Nursing

    Interesting topic...my hubby and I are both LPNs looking to finish our BSN. I'm going first so he can work full time while I do school and work part time. We are figuring on both of us getting degrees...

  20. Tough shift. First death.

    notanumber replied to notanumber's topic in General Nursing

    Thanks for your replies. Very

  21. Tough shift. First death.

    notanumber replied to notanumber's topic in General Nursing

    Yeah, my husband is a nurse as well so he's good to talk to (sometimes...), and I debriefed the night nurse (we work together every shift) and we had a good discussion. The on-call RN was very...