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long term care, school nursing

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  1. DPRN

    Narcotic Counts

    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.
  2. In PA, the names have been used simutaneously up until the new regs. Assisted living seems to have more strict regulations such as square footage in resident rooms. I believe that assisted living level of care will be between a personal care level of care and a nursing home/intermediate/skilled level of care. I will remain working in personal care (rather than changing the name to assisted living) because we can not remodel our rooms to be the proper square footage. Hope that this helps!
  3. DPRN

    Clothing protection ideas

    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.
  4. DPRN

    Does anyone enjoy nursing?

    Yes, I do enjoy my job taking care of my 47 personal care residents! We laugh together at least daily. Good luck to you!!
  5. DPRN

    Housekeeping wish list

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

    Lab Tracking Logs

    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.
  7. DPRN

    LTC Nurses How do you get a hold of your Doc?

    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.
  8. DPRN

    Physician Orders: How to stay organized?

    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!
  9. DPRN

    New to assisted living

    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!
  10. DPRN

    Core schedules...what's your opinion

    I create schedules for my staff for a four week period. Full time and part time staff all have a basic rotation that they can predict their schedule for the next year if they so choose. Schedule requests for vacation days are due by the end of the second week of the current schedule. The new four week schedule is posted by the end of week three of the current schedule. I am creating an eight week schedule right now so my staff will be able to make their holiday plans. By the end of this week, a schedule will be posted to run until January 1 so holiday plans can be made.
  11. DPRN


    Thanks! It is nice to hear that once and a while.
  12. DPRN

    How do you balance your med pass?

    To assist my nurses in being in time compliance, we adjusted some of the med times. Some morning meds are scheduled for 8am and others are for 9am for those residents that are not up early. It works on most days.
  13. DPRN

    What kind of degree do most DON have?

    At my facility, the DON's have BSN degrees. The administrator has an MSN.
  14. Kellyma- Regarding the A&D ointment: on one hand, I would permit families to bring in the ointment for the resident to use since it has no medication in it. But on the other hand, in assisted living, the residents should be able to move and care for themselves quite a bit so you should not have rashes you know where. Just my 2 cents worth. And catheters are permitted in AL if the resident cares for it independently or with some guidance. I have a resident that is about 90% independent with a suprapubic catheter. Home health care visits monthly to change the catheter. My staff assists with education, hygiene, and reminding to empty the bag. Hope this helps.
  15. DPRN

    Alzheimer's unit at assisted living facility

    The nursing assistants that work in the Dementia Unit really enjoy it. The dementia unit only has 14 beds in it. Their normal routine is to assist the residents with showers and dressing/ undressing depending on the time of day, serve meals, provide activities, and accompany on outings. This unit is staffed by 2 nursing assistants during the days and afternoons and 1 nursing assistant at night. We have a laundry/housekeeper that works in this unit 4-5 days per week. The food is brought to the unit and served from a steam table. Sample plates are created of each meal offering (ex: hot dogs and fixings or hamburger and fixings) and then each resident is able to look at each plate and choose which they want to eat. Our secured dementia unit has an enclosed courtyard so the residents and staff spend a lot of time out there. Our residents are treated as if this is their home so if they want to eat outside then they do! We tend to spoil our residents where I am the Director of Nursing. Good luck to you.