KATTB_RN

AMEN SISTER!!!!!! I have worked in LTC for 17 years, started as CNA, LPN, MDS/Careplan Coordinator, and now DON. I have worked in some terrible places, and I have worked in some wonderful places. I think the same goes for all different areas of nursing. I love LTC, and will agree with you on this one.

I would definately just put the classification of the med-not the specific name. And as far as other nurses transcribing orders and tx's on careplans-where I work at the MDS/Careplan Coordinator is the only person that does anything to the careplan. It works out well that way. But I have worked in facilities where the nurses that get the orders are responsible for transcribing them on the careplan, and it worked fine to.

A careplan should be like a book of the resident. It should reflect all the care that that resident should recieve, plus there certain preferences that they request. You should be able to pick up a residents careplan and know exactly how to take care of that resident.=)

I am now a DON at a facility, but before that I was MDS/Careplan Coordinator for 4 years. I think that as the MDS nurse it is important to attend all the meetings as where pts are concerned-especially if you also do the careplans. We have daily stand up meeting where all dept heads attend, weekly skin and wt meetings, monthly QA meetings, and weekly medicare meetings.

You need to have weekly medicare meetings to make sure that every one is all on the same page with skilled days-like how many they have left, how many they have used, discharge planning, how therapy is working with them, like if they are improving or at a standstill, and also the ARD's. These meetings are usually pretty short and sweet-just makes sure that everyones information is the same.

I am a DON at a facility that has 46 residents. Prior to being DON, I was the MDS/Careplan Coordinator. I will tell you that any full assessment that you do-which is your admissions, annuals, and significant changes-take quiet a while to get done. Especially admissions-because alot of the times you spend a great deal of time just trying to gather all of the information and such because they are new to your facility. You also have to formulate the careplan, and if it is done correctly that takes a great deal of time. On other MDS's such as your routine quarterlys and skilled assessments, it doesn't take as long and you only have to update the careplan-not completly formulate another one. I don't have an ADON at all, and it is extremely overwhelming to me at times-so I do feel your pain. But honestly, I don't feel that the MDS Coordinator has alot of extra time to do alot more if she is doing what she is supposed to be doing. Hope this helps!

You need to check your states regulations and it should tell you in the regulations manual about the DON and the amt of hours that they can work as charge. I know the state where I live it is like two shifts a week. But if a shift has to be covered and there is noone else to do it, guess who does it? DON is the last resort-but it does happen. Also-as far as helping the CNA's with things-I think that is great for the DON to help-I do all the time-and I enjoy it. Especially when they are short handed. It lets your employees know that you care. But be careful-you don't want to not do your job just because you cant say no-I have learned that the hard way=)