TammyArkansas

There is hope. If it's like my facility, it may take 2 months or more to get some smart people in there. We FINALLY raised our hourly salary for LPNs to equal the surrounding communities' other nursing homes. The ad just ran. When they fill the 3 LPN bedside positions, then the ADON won't have to work graveyard shift anymore and she can do the ADON job. And the DON won't have to work call-in shifts and she can do her DON job. And the MDS nurse won't have to do treatments. But you know what it took for the "uppers" to realize what we (the "lowers") were saying is true? State Surveyors to come in 3 times within 2 months. FINALLY! So there is hope for you all out there.

You're right Nascar. Good thinking. For Alzheimer's and /or those on the locked Neg Behavior Unit, there should be ways to capture all the time it takes to re-direct, talk to, and calm them down, etc. I'm sure there are procedures in the works. Keep on chugging along. God Bless.

Yes, sadly to say, some administrators and DONs will keep, shall we say, "not the brightest" bedside nurses and CNAs because they fill the shift slot numbers. It would be great if the people with a conscience and caring hearts ran the individual nursing homes, were district mgrs, were corporate, etc. I agree it is very frustrating. Do your best until it pushes you to resignation, I suppose. God Bless.

i have been in contact with nursing home reform people all over this country and the general consensus is that until we get out from under the powerful lobby of the multi billion dollar a year healthcare industry and a new congress nothing is going to happen. there are propositions that do address these issues, but have not been acted upon in the last 6 years, due to this conserative administration. i have hope that with the new congress and the possiblility of a new liberal administration in 2008 , these issues will finally be brought in front of a voting body. thanks for the info, ingelein. good, re: hope with a new congress. i don't understand why the repub congress did not pass more legislation. those politicians are also sons and daughters of elderly people (who are the majority of nsg home/rehab residents), so they should realize the problems and should want to correct them or at least try. when it comes to money vs. the treatment of your loved ones, where's the difficult decision? it's beyond me.

Oh, exactly! I feel your pain. That's why I posted a thread about Legislation in LTC recently. (But no one responded). I am through complaining because the budget of the Nursing Home Owners/Administration is not conducive to bedside care that is needed. It's going to have to come down to LAWS and MORE of them. Yes I also already HATE it when state comes in. I'm the MDS Coordinator and I care what kind of work I produce. I do not stand around gossiping nor do I take smoke breaks. Actually never had taken an actual go outside and breathe break. However, I do eat my granola bar at my desk around 10-11 most days. Just today the interim administrator, who was brought in by Corporate since the NICE female adminis was let go because we got tagged by state on some things, said there is enough hours in the day to do everything she is telling us to do. BUT they only want us to work 7.5 hours/day. I'll tell you what my facility needs: Updated computer hardware that doesn't freeze, lockup, and lose precious, time consuming MDS data; the money to pay decent salaries to LPNs to fill the shifts so the other MDS Coordinator can actually help me instead of being pulled to the floor for numerous things, like: treatments, training a new nurse, working a called-in shift, etc. We also need not to be pulled away from our MDS/Careplan/Medicare duties to do: meal monitoring, inspection action rounds, compliance confirmations, etc. Oh my goodness....it goes on and on....doesn't it. Today in our Stand Up meeting, after the militant administrator told us there are enough hours in the day to do all she demands, I asked her what is my priority: MDS, careplans, or inspection rounds. She said the am rounds. I told her I fear later when we are asked why something is not done, I will be reprimanded. She did not accept that. Treats us like dogs, worse than dogs, so rude and condescending. She leaves no room for negotiation. UGH!

Set up a computer program where you don't have to duplicate pt names and unchanging info. Does your area keep a Kardex? In time, you will know what not to repeat because certain things "are understood" or "are a given". I did the same thing when I began 10 1/2 yrs ago. Are you young? Is your brain free from distractions at home? I hope you do well. Always remember that old saying: Some experienced nurses eat their young. Keep good intentions. Apologize when necessary. Promise to go find the answer. Don't be lazy. But do take your breaks. that's my humble opinion.

That is crazy - not a science.

I am wondering if any of you are actively involved in the legislative process to improve LTC? I researched just now on the net and saw two blurbs dated 1/24/07: 1) In England they are trying to mandate having an RN in the building 24 hrs/day. 2) In the US, Warren Stewart, AARP Virginia president, said reforms are needed in long-term care, because by 2020, more than 1.4 million Virginians will be 65 or older -- an increase of 77 percent from two years ago. One bill pushed by AARP would streamline services by designating the secretary of health and human resources to coordinate the work of agencies providing long-term-care services. Another bill would expand the definition of long-term care to include transportation, education and housing services. Assoc Press Two questions: 1) It seems like England has a better plan; which legislation do you think would help more - the US' or England's ? 2) Are there any other things that are going on to improve LTC in America? I think the basic needs are: 1) a cap on CEO's salaries which filter down to competitive salaries for bedside help from LPNs and CNAs. 2) Federal staffing minimums based on acuities. And those #s should be decided by LTC staff with more than 5 yrs experience. Please tell me your opinion. thanks.

For the masses, where can an Asmt Wheel be purchased? Does anybody have a website? I have looked but can't find. thx

So on ALF, the State regs don't apply re: there must not be more than _______ hours between meals?

Here's an example: last survey (early Jan x 5 days), State walked in at 1215 lunch time, HR/Personnel Mgr was the next in line as being the boss at the time, so when the Surveyors asked for someone to walk with them on each Hall, HR told me to. I said I do not know the residents enough to answer what needs they each have. They all looked at me weird. Later someone asked me, "you're the MDS nurse, why don't you know each resident?". I said, "yes, I enter the information into the MDS but I cannot possibly remember everything about each resident". We have 65. A CNA walked with them. The LPN/floor nurse was busy. It concerns me that other staff think I am not doing as well as I should be. I think they just don't understand the complexity and details of the MDS/res asmt process. I am just wondering if anybody else feels this way or gets treated like they should know and memorize every single detail about every resident? Am I too old to do this (40) re: not able to memorize it all? Do you young MDS people memorize it all? Thanks.

A question for the Federal Surveyor please: why do the State Surveyors expect the MDS Coordinator to have every answer to every resident's MDS memorized ? I do my best, but I still don't know everything they ask me at survey. thanks.

To RN4Life, That would be great. Thank you. To CapeCod, Sure but I don't want to get in any trouble for copying. Thanks, Tammy

I hope you can help me. I am trying to locate where I can purchase an MDS Wheel. I had one at my other job in 2005 but my new facility does not have any. I have searched via the internet and cannot locate one. Don't they still exist? It's kind of like a pregnancy wheel but with this, you put the arrow on Day 1 Admit and the asmt days and grace days are indicated so you don't have to count the days on a calendar. It prevents making an error on 30 day, 60 day, 90 day, last covered day, and OMRA asmts. My software program does not have a way for me to print of a PPS Tracking Schedule. I have been getting them from Therapy but I want to stop bothering them about it and do it on my own. Please help.

Wow, that sounds like it was difficult. I went to the salary.com, but they didn't have anything specifically for ADON nor MDS Coord. They only had DON. Other sites I visited said avgs of: Nsg Superv $52,700 or Nurse Mgr $60,300. I can't get a lock on each of these positions salaries. I guess I will wait until I submit my application to find out the answers. Thanks. If you are wondering why I want to go into this field, here's my story--maybe others can relate here. I have been a peds bedside nurse for 8 yrs. I am recognizing my symptoms of burn out. I would like something not at the bedside all the time, but something that lets me be with the patients, families, staff, mgmt, and at a desk. I do not know what the learning curve is for the MDS tools/Medicare and all that, but I am willing to learn. Any examples of your experiences are welcome. Thank you.