debRN0417

debRN0417

LTC, ER, ICU, Psych, Med-surg...etc...

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All Content by debRN0417

  1. facility acquired pressure ulcers

    debRN0417 replied to CNL2B's topic in LTC: Directors, Assistant

    Why not ask the State Agency to do an investigation? I mean, many complaints are called in regarding care issues. If you call and give them specifics, like you have done here, there would be...

  2. Tidbits, facts, save-your-butts...for new nurses in LTC

    debRN0417 replied to CharleeJo.RN's topic in Geriatric, LTC

    Wash your hands...document medications as they are given and vital signs as they are done so you don't forget and there are holes and messes in documentation, don't be afraid to say "I don't know, but...

  3. What did you say?!?!

    debRN0417 replied to CapeCodMermaid's topic in LTC: Directors, Assistant

    I got my nose pierced at 45....thinking about a belly ring this summer and still want a tattoo- I always wanted the Rolling Stones Tongue. When I am in the Nursing Home they will say "Wow! That Old...

  4. 2010 survey focus

    debRN0417 replied to ktwlpn's topic in Geriatric, LTC

    I don't know what other states do, but we do not have a particular focus at any time. The survey just is what it is. I mean they don't tell us to focus on one thing or another we just go in and do...

  5. facility acquired pressure ulcers

    debRN0417 replied to CNL2B's topic in LTC: Directors, Assistant

    The first question is were they avoidable? What is the patients condition? What are her labs. She now needs LTC and did not before, this is a clear indication that her condition has deteriorated....

  6. Glucometer / Infection Control

    debRN0417 replied to ktwlpn's topic in Geriatric, LTC

    If the glucometer is terminally cleaned at the end of each shift and then wiped down between residents- what is the problem? I am a surveyor- I don't understand...I watch this all the time. Am I...

  7. Pharmacy is now doing our MARS...

    debRN0417 replied to Finallydidit's topic in Geriatric, LTC

    So when did the Nursing facilities start working for the pharmacies- I mean who is the one being paid for the service? Looks to me like the one getting paid should be the one doing what the customer...

  8. Can you really change a bad LTC?

    debRN0417 replied to lisa41rn's topic in LTC: Directors, Assistant

    One of my friends once said that the "fish starts stinking at the head"- meaning that if the top of the chain is crappy then the crappyness flows down. That is not to say that everyone is crappy...

  9. 8 or 12 hour shifts for nursing staff?

    debRN0417 replied to Bubbles82's topic in LTC: Directors, Assistant

    I have worked 12 hour shifts and worked 3 days (36 hours) and then had off four. I could choose to pick up an extra 4 hours to have 40- but mostly ended up doing an extra shift for 8 or 12 hours...

  10. Dirty little secrets to managing LTC

    debRN0417 replied to Kashia's topic in Geriatric, LTC

    I agree. Why are we so consumed with the time? Yeah the regulations talk about time, but if you do not give a colace within an hour of when it is ordered (before or after) is someone going to die?...

  11. Independent LOA

    debRN0417 replied to CapeCodMermaid's topic in Geriatric, LTC

    I echo the statement- "If they can go running all over town without help, then why are they in a nursing facility?" I mean, I am all for independence and getting out and having outings, but that...

  12. LTC interview and background check

    debRN0417 replied to Marshall1's topic in LTC: Directors, Assistant

    It could be anywhere from 1 week to 30 days. Hopefully one week, but I have had them take

  13. New Grad: Where to start a career with geriatric patients

    debRN0417 replied to rchembunny's topic in Geriatric, LTC

    I think that every nurse should have at least one year of hospital experience before going into long term care- that is just my opinion. There are many, many nurses who go into LTC as soon as they...

  14. INFECTION CONTROL: New Bed Pan Washing Regulations

    debRN0417 replied to kwvath's topic in LTC: Directors, Assistant

    CMS is not going to tell you HOW to do it, they are just going to tell you you HAVE to do it....it is easier that way- it's like a

  15. blood sugar checks and insulin

    debRN0417 replied to makes needs known's topic in Geriatric, LTC

    I used to go get all my blood sugars first, then give the insulins. I do my own blood sugars. I am liable for the amount of insulin I

  16. Infection control

    debRN0417 replied to noc4senuf's topic in LTC: Directors, Assistant

    How about ADL care that is done with gloves on and never changed until it is all

  17. LTC in Northern Virginia?

    debRN0417 replied to Nurse!Nurse!Hello?'s topic in Geriatric, LTC

    I am from Virginia. There are numerous LTC in the Northern Virginia area that I am certain are in the market for nurses. There are facilities in Arlington, Manassas, Alexandria, Warrenton,...

  18. State reportables

    debRN0417 replied to Nascar nurse's topic in LTC: Directors, Assistant

    According to the regulatory language a second degree burn could be harm for the resident. Fortunately the family did it and not the staff, but it could be harm none-the-less. This is something that...

  19. Blood pressures

    debRN0417 replied to Schmoo1022's topic in Geriatric, LTC

    When a resident is stable on blood pressure medications it is crazy to do them more than once a week...I would even talk to the doctor about bi-weekly or monthly. As has already been mentioned, if...

  20. Antipsychotics

    debRN0417 replied to CapeCodMermaid's topic in Geriatric, LTC

    If I am in a nursing home and am so agitated and confused that I am suffering, please, please, give me Seroquel and a touch of ativan or something so that I am comfortable...I am all about the...

  21. State surveyors here again...and being super picky...

    debRN0417 replied to IowaLPN's topic in Geriatric, LTC

    An Ice cooler in the hall is not unsanitary, unless it is used in an unsanitary manner and is not clean....here in Virginia, they use them all the time to pass ice. And the survey requirements are the...

  22. MDS 3.0

    debRN0417 replied to Strawberry63's topic in MDS Coordinator Information

    Yep the reg says accessible and accessible is as accessible in a computer as accessible in a

  23. Need Help

    debRN0417 replied to cleo777's topic in Geriatric, LTC

    There is no mandated staffing ratios according to CMS that I am aware of (in my area). There may be some states that have them, but as a general rule the facilities set their own staffing and it goes...

  24. Antipsychotics

    debRN0417 replied to CapeCodMermaid's topic in Geriatric, LTC

    We all know that antipsychotics are dangerous for the elderly, but most dementia behaviors respond to these medications. I guess it all comes down to getting a psych diagnosis for the use, do the...

  25. Falls interventions

    debRN0417 replied to CapeCodMermaid's topic in LTC: Directors, Assistant

    Sometimes you gotta do what you gotta do....I had a resident who I know fell about 40 times in a month- sometimes three or four times a day. Alarms- personal and sensor, anit-tippers, brakes on the...