sandra p. R.N.
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In my experience, it's best to hire case managers or train all nurses to case manage. Some agencies, very few, use LPN's to do field nursing and all RN's are trained to manage their own cases, i.e. Oasis SOC, ROC, and DC Oasis as well as Recerts. However, for the top hat, Case Managers should be getting much more pay (equal to PT's).
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Sounds like you guys are talking about a pretty big operation. The smaller agencies are mostly owned by another decipline other than RN or MD and don't know the first thing about whether the DON is doing her job until the surveyers march in. They have unqualified QA and most of them are incapable of qualifying their operations to the surveyer. They just do as they are told in order to keep the money flowing. Most of these agencies are folding like napkins.
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What, exactly, don't you like about it? Is it the paperwork? Is it that the client's are overwhelming? Is it the feeling of wanting to be in the company of co-workers? Is it the driving? Let us know because you sound as though you want to avoid complaining to your employers, at this time. However, don't feel that you have to avoid asking for help from your employers when you are in need of it. That is what they are there for. Good Luck
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Your nurses assesment IS the multifactorial fall risk assessment! Fact #1. Meds that can cause light-headedness or other s/e's causing risk for falling #2. Confusion....Mental deficits... #3. Physical Therapy referral #4. Use of an assistive device #5. Joint pain, stiffnes
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The answer to that question M1910 is always "yes". My patients are always at risk for falls and have always been assessed for that.
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How long to stay can vary, depending on the POC which is suppoed to be individualized with agreed upon and obtainable goals. You would already know the goal(s) for the wound. 1. When the pt/cg is able to demonstrate wound care, correctly. 2. When pt/cg understands s/s of infection and to report to physician. 3. When pt/cg verbalizes and demonstrates infection control, proper diposal of hazardous waste material. 4. Also, when the wound bed is responding well to the wound care treatment that was ordered.........THEN........RUN FOR YOUR LIFE.......NO...LOL