debRN0417

debRN0417 has 31 years experience and specializes in LTC, ER, ICU, Psych, Med-surg...etc....

debRN0417's Latest Activity

1. 

   State reportable incident..but who is "state?"

   debRN0417 replied to Marshall1's topic in LTC Directors

   Office of the Attorney General, or Department of Social Services- Adult Protective Services, or the Office of the Inspector General. Ususally ALF are "surveyed" by the Department of Social Services.
2. 

   Multidose Packaging

   debRN0417 replied to Megan-Cho's topic in Geriatric

   I have seen it packaged separately for each resident, but also I have seen nurses administer meds directly from a large "house stock" bottle (dated when opened). Meds like Tylenol, Calcium, multi vitamins, ect....
3. 

   Assited Living: The new skilled care

   debRN0417 replied to NJayne17's topic in Geriatric

   Absolutely correct. ALF's are not inspected by the "state" however they answer to DSS (Department of Social Services). Now I know a great bunch of social workers, one which is very special to me, HOWEVER- none of the social workers I know can inspect a bedsore, watch for proper technique on incontinence care or wound care...not sayn they can't- just that they are not trained to do that and according to regulations, only a nurse can look at "private areas". Where I come from, the ALF's are private pay and because their rates are cheaper than LTC, thats where people go. Most advertise that they have "Special dementia care" which is lovely, but when the person becomes total care, then who provides that? I have seen nghtmares come from ALF in terms of residents who were really more care than they could handle and developed horrid bedsores, weight loss, and so forth. I am not saying all ALF's are like that...but some are.
4. 

   question about narcotic dispensing

   debRN0417 replied to kappykatlpn's topic in Geriatric

   According to my state pharmacy regulations: 18VAC110-20-520. Drugs in long-term care facilities. Prescription drugs, as defined in the Drug Control Act, shall not be floor stocked by a long-term care facility, except those in the stat drug box or emergency drug box or as provided for in 18VAC110-20-560 within this chapter. d. Long term care facilities shall destroy discontinued or unused drugs or return them to the pharmacy within 30 days of the date the drug was discontinued. Please check the specific regulations in your state and your facility policy and procedure.
5. 

   Is it illegal to initial when.....

   debRN0417 replied to onthemark's topic in Geriatric

   The problem is- if the treatment is not done or there is a reaction, or something happens- whose initials are on the TAR? Yours. Who is responsible? You. The CNA's need to sign their own sheets- CNA treatments should not be on the nurse's TAR unless the CNA is able to access the TAR and sign the treatments they do themselves.
6. 

   Resident Care Coordinator

   debRN0417 replied to Nurse Amy Jolie's topic in Geriatric

   The facility should have some standard documents they use.
7. 

   Considering LTC in the future

   debRN0417 replied to iwillact's topic in LTC Directors

   I agree with CCM. The position of DON is NOT a position that is easy. You must have a good solid knowledge of the workings of LTC. Starting as a staff nurse or supervisor is the best way. Not only will you learn the workings, but you will be more respected by your staff because "you were once one of them" and will have an understanding of what the "real" world is like on the floor. I'm not saying that you don't know some of this already since you have had past experience, but being in a position of supervisor or charge certainly opens the door to more of the reality of administration. It will help you determine if it is really something that you want to do.
8. 

   New grad RN needs advice on resigning

   debRN0417 replied to MidnightStars's topic in First Year

   I agree with the other posters-NEVER leave a job without another one lined up. Start your search. Then when you land another job you can say something like: "I appreciate having been given the opportunity to work at your facility, however I must resign my position as (whatever your job title is) effective (give 2 weeks notice)." You do not have to give a reason, but it is courtesy to do so. NEVER burn bridges. You may tell them that you have accepted a position which affords you the opportunity to grow in the nursing profession, or speciality area. You may cross paths again and you do not want to leave a bad taste in anyone's mouth because you my need to work for them, or their company again in the future.
9. 

   lets hear from Nurses who started with No nursing experience at all!

   debRN0417 replied to beatrice1's topic in Geriatric

   I went straight from high school into nursing school, then straight to the hospital on 11-7 as team leader/charge RN for pediatrics and med surg. I was as green as grass and as immature as could be. I learned hard and fast. My advice: Listen, write things down, look things up, ask questions, and always look for opportunities to learn.
10. 

    Resident Care Coordinator

    debRN0417 replied to Nurse Amy Jolie's topic in Geriatric

    Years ago when I was a Resident Care Coordinator, it was the same as being what is now most often referred to as a Unit Manager or Unit Coordinator- EXCEPT- I was responsible for staffing, Care plans (at that time there was no MDS- believe it or not), all admissions, assessments, and yes-oh-yes- filling in when they were short staffed on the unit. Lovely.....more time passing pills than Coordinating, and yes-oh-yes was required to do off shifts as needed...more lovely....
11. 

    And the survey says......

    debRN0417 replied to RottieGrlLPN's topic in Geriatric

    Oh my...I also still have nightmares about nursing suff- especially being in the ER and not being able to find things or crazy stuff like things stuck to the wall (BP and O2) and not being able to get them loose!
12. 

    Complaint Survey

    debRN0417 replied to txdon's topic in LTC Directors

    Miss Know-it-all-surveyor should have observed and resident and reviewed the plan of care and should know whether or not the resident can reposition themself or not....
13. 

    Funny things they say....

    debRN0417 replied to joanna73's topic in Geriatric

    Nurse! That man! That man over there! He...he...he told me he wanted to...well you know what! Me: No, what did he tell you? He told me he wanted to- oh! I just cant say it! Me: Please tell me what happened. Well I was sitting right here just minding my own business when he came up to me and told me that he wanted to...to...to...well he wanted to ... Me: What did he tell you he wanted to do? He said he wanted to (blank stare)...well sh** I forgot...but I think it was bad! I just love these folks!
14. 

    Skin Sweeps

    debRN0417 replied to txdon's topic in LTC Directors

    The Surveyors I know do not care who gives the bath just as long as it is done, or the reason is documented (refused).
15. 

    State~!

    debRN0417 replied to nghtfltguy's topic in LTC Directors

    It would be very unprofessional and unethical to offer a job on a survey. I have had staff inquire as to how to apply. I have given them the website. I would not solicit anyone while on site. I think people freak out on survey because they so want to do the right thing. It is so hard to have someone standing over you watching every move. When you watch someone, you can tell if they are consistently doing the right thing and not just what they think you want to see...I try to reassure them to just do what they do every day, and that it will be fine, and 99% of the time it is. One little mistake does not mean the end of the world, I mean if a mistake is made and the person says right then and there, "Oh I didn't mean to do that, or I should have done this first" I can live with that because I know they know the right thing to do and nerves just took over. I will often have them just tell me what they should have done, or give me a step by step, and take their time. I try to talk to them a little beforehand and at least try to make them feel a little more at ease. It is often helpful if the resident joins in the conversation because you sometimes never know what they're going to say and it usually really breaks alot of the tension. I also try to tell them beforehand that I want to watch something so they have time to review their policy, or smoke a cigarette, or take a valium (hehe).... so they have time to mentally prepare...it is hard to be watched. We all know that it is very intimidating no matter who is watching.
16. 

    Has Mr Peabody been here with his Way Back Machine?

    debRN0417 replied to CapeCodMermaid's topic in LTC Directors

    Haha! I pasted a picture of Olive Oyle on my badge and took one of those lable maker things and put the name on it too! Got away with it for 2 weeks before my supervisor told me that some patient wanted to speak to nurse "Olive". The staff should be able to wear whatever they want to (scrubs) unless the corporation is willing to buy the scrubs for them. That was what happened to us once. We the entire hospital staff in a meeting) all told them we would be happy to wear whatever "they" provided. I told them I had a closet full of colors and on the salary they were paying me, I could not afford to go out and purchase all new scrubs at that time, but if they wanted to buy me 6 sets, then I could probably live with that. We also told them that they needed to provide us a uniform allowance at least twice a year in order to replace the scrubs that were worn out because there are times when they become worn, soiled and unwearable...they decided not to go through with it.