debRN0417

I have seen LPN's who are Unit Managers and RN's working the floor as the "charge nurse". It sounds weird, but in that case the Unit Manager was "in charge of the unit duites" but the RN was "in charge of the unit"...clear as mud???? The RN preferre...

I agree with CCM- if the resident/patient is requesting medications before they're due, then the MD needs to know to reassess.

The area on aging in my "area" would have referred this to us and we would have investigated...I have never heard of them "citing" like that, but I guess its because its a different state??? We receive all kinds of F.Y.I's as we call them, from the ...

It is all how you say it. You have to be honest and thorough in your charting and not leave out pertinent details, however, how about "Resident found without O2- list sats- document starting the O2 and at what rate-document your full assessment of th...

love it!

Just be careful. Make sure you look at the labor laws, I mean if you are requiring someone to be on call and stay near the phone or being available, what are the laws concerning this where you work? They may have the right for some type of reimburs...

That's the problem with alarms of all types...too many alarms...not enough nurses. After a while you tune them out. It is frustrating.

Thank you CCM. I appreciate that. I just try to live in the real world....

If they are "physician ordered" suppliments they could come under scrutiny by the DHP regarding calories, additives--yada yada..but if they are something that you are doing for "snack" or "pleasure foods" then all you need to do is make sure that wha...

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.

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....

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 inspe...

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 em...

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 unle...

The facility should have some standard documents they use.

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...

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 re...

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, writ...

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)...

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!

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....

I hate double dipping....good luck!

Your medications need to match the order/MARs. If you have two different drug strengths it must be reflected on the MAR that you are giving two different strengths to total the ordered dose. You must have the medications kept separate from each oth...

CCM is right. In most LTC/SNF facilities, the medical director is the one who is called. He is responsible for the overall physician's services for the residents. It is ultimately his responsibility to make sure the docs are doing what they are su...

You will have a revisit at some point after the date you set as your AOC- allegation of compliance. The team will focus on the issues you were cited for but also can look at other areas as well. Pray that you do not get another complaint before you...