DPRN

I create a two page monthly newsletter for my staff. Through out the month, I email myself tidbits of information that I need to tell my staff. These tidbits usually fill the newsletter. I also provide education on new meds, new diagnosis, new processes, etc. Each staff member receives the newsletter in their mailbox so that I know they received it. I also have used the newsletter as proof of them being told since they often might say, "I didn't know that."

My nurse aides are complaining about the actions of a nurse aide peer. Does anyone have any recommendations on how to address these statements if nothing is witnessed by management. For example, one nurse aide is stating that the peer gets angry at a resident that has dementia and addresses our residents angrily. Nobody will write the accusations down in writing. All of the comments are verbal statements. If none of this witnessed, how should I address the problem without it looking like hear-say? By the way, the staff are in a union and will pull their union into any disciplines.

Interesting article! I work in a PA personal care home which is part of a nursing facility. The entire facility has an emergency preparedness handbook accessible to all staff. Without looking at it, the topics include staff contact information, disaster preparation, food storage/preparation, water storage, fire drill info, and weather warnings/watch information. Our book gets used by all staff through out the year to answer questions that arise. My personal care home regulations require some of the emergency preparedness issues be intact.

I work in a Personal Care Home in PA. DPW (Department of Public Welfare) is our regulating body. Meds are all observed when given to be sure that the meds are actually taken. Observation would prevent a medication error of someone taking someone else's meds at the dining room table. The only meds not observed are the self administered meds. The MAR is to be signed after the meds are administered. If meds are left, they are not truly administered so how can the MAR be signed accurately?

I am the RN in charge of the Personal Care neighborhoods at work in PA. I manage the care of 50 residents with the assistance of LPNs, Med Techs, and nurse aides. I am on call most of the time, but do not receive too many calls. I have taught my staff how to manage most situations and am willing to teach them whatever they want to learn. Personal Care is heavily regulated and I incorporate the regulations into daily practice. I really enjoy my work.

My staff use a "brain" to get through their shift as well. We have all residents listed on an 8 1/2 x 11" paper in alphabetical order because our med cart is also in alphabetical order. Beside each name is a column listing their med times (which can be highlighted or crossed out if needed) and a blank column for notes. Some of my staff color code their cheat sheet by med pass (for example yellow is the AM med pass, orange is the noon, etc.). Each staff member writes notes as they desire to get through their shift. Good luck to you.

We encourage bedspreads and fleece blankets in my ltc facility. Both can be individualized to make the resident's room more "homey" and individualized.

I am at odds about staffing in our building. If a nurse aide is needed in unit A, should the nurse aide be pulled from unit B or should unit A have their staff work overtime? My staff on unit B is tired of being pulled to unit A because of a hole in unit A's schedule. I feel that unit B is the float pool for unit A. Usually the replacement to unit B is an RN. Why can't the RN who wants to work, work as a nurse aide instead of creating havoc on the other units? As long as the RN is paid RN wages, does it matter how they function?

My med techs (nurses aides with medication admininstration training) pass medications including narcotics. The narcotics are kept double locked in the med cart and each narcotic is signed out at time of use. Narcotic count is done with shift changes.

Our facility made dining scarves from this website: http://www.diningwithfriends.info/docs/DiningScarfPattenDirections.pdf We lengthened the scarf pattern so the lap is covered when sitting. My assisted living residents enjoy them and use them daily.

My LTC housekeepers are the best!! They will ambulate with residents and answer call lights in a pinch if needed.

We list all routine labs on a word document. First column is resident name. Second column is the lab orders. Third column is what month the lab is due. Our Dr is lenient on the actual date of the lab. Most routine labs just need done within that month. No specific date is needed. Upon admission or at the beginning of a new year, all routine labs are transferred to our labwork calendar. Routine labs are written in a color (pink this year) on a lab day in that particular month. When lab reports arrive, each ordered lab for that particular day gets a checkmark beside it to signify that the lab was done with a report received. This works well for the 50 residents that I am in charge of their care.

The Dr rounds on Mondays and his CRNP rounds on Wednesdays and Fridays. Usually all concerns are held until they arrive. For an emergency, we call the office or his cell if after hours. Our Dr is very kind when being called at home. For those of you that text the Dr, do you have a facility cell phone or do you each use your own cell phones? Just wondering.

As a DON of an assisted living unit, I have created stickers (address label stickers about 1x2") with the following info on the stickers: ____MAR, ____PO book (physician order book), ___Nurses Note, ____Shift report, ___fax pharmacy etc. Whoever receives a verbal or written order attaches a sticker to the bottom of the order page and must initial the line before each item as the new order is transcribed on to each form. These stickers are easy to create and update with info as needed. Hope this idea will help you as much as it has helped my staff. It has helped me to track which nurse is transcribing orders incorrectly since I can tell by intials which nurse did the transcription. Good luck!

PammyRN, CEN- the cheat sheet is simple to create. I have columns on the form. The first column has med times for each resident (8-12-8 for example), the second column has resident name and room number, and the third column is comments. These three columns take the left half of the 8 1/2 x 11 paper. The right half of the page is a repeat because I track a total of 50 residents. I do not have this form here at home. The master is on my work computer. Post again if my description does not make sense to you and I will email you a copy when I return to work on Monday. Good luck to you!