nursecms

A few years ago, I worked in a rehab hospital. A few of my fellow co-workers would make notes at breakfast, lunch, and dinner, that said nothing more than, "call light in reach...eating meals EOB..etc.". They said that they didn't want to be blamed if "something went wrong". I'm indifferent. I think these generic comments are important, but not in multiple, small notes. I'd rather have one detailed note, unless there was a change in condition/behavior.

I've worked in a rehab unit in LTC for over 2 years. They do not like sending patients to the hospital because they do loose money, a lot. As you may know, it becomes very stressful for admissions when census is low. A year ago, a pt. was sent to the ER during the 3-11 shift, and they returned to the facility at 0130. I was asked if the pt really came back at that time, or "could they have come back at 2330". The reason being is, if their head is on the bed by midnight, the facility gets paid, and that expensive increases if they had therapies. If not, that entire day with rehab charges, goes unpaid. Sad and unethical. Remember, when in doubt, send out !! This is not only to CYB, but the well being of the patient/resident.

My suggestion would be to go and pay for your own drug test. It maybe too late for metabolites to show in a urine, so the best thing to do is pay for a hair follicle test which will show up to 3 months of drug usage. Have a written statement for the board of nursing when you are contacted, along with a copy of your negative test results. With this information, you can just be disciplined for inaccurate documentation. Just because there was missed documentation does not mean there was drug diversion. If there was no actual proof from your employer-appearing under the influence or any people staying they saw you place meds in your pocket, how can they get you? You need proof. Go get a hair test and stand your grounds of innocent!

nobody walks on water. doesn't matter how long you have been practicing :). i would suggest that after 6-8 hours into your shift, if you are working 12, to go through the physician order section in the chart and check to make sure that there aren't any new orders and the ones that were written have been processed and documented. do this again before you give report to the next nurse. i always flip through the mar and kardex to make sure the meds were given, signed and initialed.