Papercutz

wow. how'd they figure out she was recording?

Hi all! I've been doing per diem in a nursing home, and I have a young patient constantly on a laptop. For some reason I think this patient might be recording me, no proof of that just a feeling. Is this legal? Has anyone come across this situation? Thanks in advance.

I understand what carwin says; but sounds like this is not a universal policy. I've been searcing the CDC website and others looking for this specifically and don't see it. Of course it talks about handwashing as a standard precaution, but nothing about turning the faucet on with a paper towel. If anyone has a reference i'd love to see it.

Can someone explain the rationale for using paper towels to turn on the faucet before washing? Is this every agency's policy?

Thank you. The supervisor is filling out the form and getting the answers from me. I don't have the form. I'll have to discuss with the office. TY

Greetings! I am a PT not long in homecare, still learning the ropes. My agency has no policy in place currently regarding PT only cases and the discharge oasis. RN does Soc. We had a patient who was PT only, the PT spoke to the supervisor in the office on the phone so the supervisor could answer the oasis. The supervisor fills out and signs the oasis but writes 'written with consultation from PT Smith'. Is this ok? What are your agency policies regarding PT only and oasis discharges?

Understood; wasn't really looking for med advice, just thoughts on bicitra; sorry if it was misleading. I'm just doing research about this medication and looking for input. Thanks for the info about the CT.

This thread popped up on my google search of 'bicitra and aspiration'. Unfortunately my mother just had a lumpectomy and was given the liquid bicitra prior to surgery by the anesthesiologist. Not being a nurse, I thought nothing of this (i mean, this was the anesthesiologist giving it!). Post op she developed hypoxia/hypotension and the anesthesiologist was saying 'she's got mild congestion, not sure why'. After a Chest CT/perfusion scan to r/o pulm embolism, a pulmonologist told my mother "you aspirated the medication you were given prior to surgery'. When we told the anesthesiologist what the pulmonologist said (imagine the catfight that caused), she said "no, there's no scientific evidence not to give the bicitrate. in fact, i'm glad i gave it because otherwise you would have aspirated pure acid into your lungs. you have a hiatal hernia which we didn't know about pre op which caused the aspiration. If we would have known about it, we would have intubated you instead of the iv sedation". Thoughts?

This is what I thought as well. But what if your patient is not a candidate for the TUG test? ie need assist to walk or are bed bound? The answer will always be technically "NO" but they are still at risk for falls. Our agency will document that and still do a PT referral, but answer "NO" because a multi factorial assessment was not done due to patient not qualifying for the test..

Just trying to get an idea of thoughts on this question about the multifactorial falls risk assessment. Seems to me that if a patient can't do a TUG test (bedbound, or needs physical assist to walk) that the answer to "have you done a multifactorial risk assessment?" is NO. Thoughts?

I'm new to homecare so I don't have much to compare to. That being said there are a lot of changes with regard to PTs answering drug regimen review questions. A big change for us is the timed up and go test (tug) to answer M1910.

thanks for the replies and the question. PT new to homecare here; a lot to learn!

I know how you feel....it's an awful gut wrenching thing, but sounds like you did everything correctly. I second guess myself a lot in certain situations...but you can only go forward and try to keep learning from every patient interaction or transfer. Yes, anything can go wrong during a transfer, and it's almost impossible to predict every type of scenario. I've been ambulating the most stable of patients (and I have to go on stairs with them as well!!), only one day to have their bp/bs drop suddenly or knee buckle down and bam we're almost both on the floor. My only advice is if i'm working with a new patient, regardless of what the care plan says, if the patient is large and I even suspect I might have a problem, I get another person. And believe me, i've gotten other people and there can STILL be a problem! Don't beat yourself up sounds like you did the right thing.

thank you very much for the info!!!

This happened quite a while ago, but I remember it was quite a difference, maybe 40mm/hg. That's my concern!

Hi all! Long time since i've been on here but glad to be back. I have a question for you about taking blood pressures. I was taught that the systolic reading is the first sound you hear after releasing the valve. However, when looking at the dial, sometimes you will see the needle bounce before any sound. I was taking a blood pressure on a patient and a PA was standing next to me and saw the first bounce and called that the systolic, even though I heard no sound (or for the several bounces after that first bounce), therefore my systolic was lower than what the PA interpreted the systolic as. Can you tell me who's right? And what do the first few bounces mean if there's no sound? How to interpret this...Thanks in advance :-)

I've always been searching for a comfortable pair of shoes since after a day of work my feet kill me. I found a pair of Spring Step nurses' shoes and LOVE THEM!! They come in black or white, have a zipper on the side. Unfortunately the first pair I got the sole wore out very quickly (I was wearing them also in the rain which I think also damaged them), brought them back to the store and got a new pair no charge. I'm on my third pair and still love them. I buy 2 pairs at a time. I got them in NYC for $50.00. Well worth it.

hey ruby keep your ex away from this pt lol!!:chuckle reading through this thread has been enlightening. personally i don't recall anything being taught about this in pt school, and i haven't read any policy against this at my facility (but i work in a nursing home so unless your name is annanicole smith i dont think many staff/patients are hooking up!!). however, i keep hearing about this hot grandson of one of my patients and i'm wondering if i liked him could we date? i remember a patient's son asking out our nurse practitioner and she kept saying no because it 'wasnt proper'.

I was so excited to see this as a topic! Speaking as a frustrated PT working in a 240 bed LTC facility, I can tell you from experience that not having formal nursing rehab aides leaves the staff CNAs to do all the floor ambulation (yeah ok); since they are already overworked, of course it never gets done. We have an accountability sheet that the CNA must initial daily the distance the pt walks. Its so easy and convenient to put down "R" for refused because they dont have the time or dont want to do it. The problem for us in rehab is that after we d/c the pt to the unit, and they aren't ambulated for months, I get a call from nursing saying (guess what)" the pt cant walk please re-evaluate." Of course the pt cant ambulate! They've been sitting on their butt for months! So the moral of the story is: the best solution to the problem (but not the most cost-effective) is to have a Nursing Rehab department with aides specifically designated to do all the floor ambulation.

I work in LTC and we use a small pulse ox to check sats on our sickest patients, and what i've been doing afterward is swabbing it down with an alcohol prep pad. is this sufficient? i dont know how else to clean this...any suggestions would be helpful.

hi, although i am not a nurse (im a PT) i am a graduate of both laguardia and hunter college. i have been through all the red tape of cuny and then some. it can be very very frustrating and annoying, but unfortunately this is the price you pay when trying to get into a public (and very cheap!) college. For people who have families and need to get out of school and work fast it's almost impossible because it does take a long time to get all the prereq's done, because so many classes are filled up quickly. the bottom line is plan on taking more than 2 years to get an associates and more than 4 for the bachelors. The up side is I got a great education; and i've heard Hunter nursing students also get a great education.

OMG YOU CANT BE SERIOUS!!

As a PT working in long term care, i'm excited to see a facility implementing a formal Restorative nursing program. PT is great, but it's up to the CNAs to carry out our recommendations otherwise the patients decline (inevitably if they aren't ambulated) and get bounced right back to PT because "the patient isnt able to walk anymore". We also recommend active,passive and active assistive range of motion to prevent contractures. The CNAs are so busy as are the Nurse supervisors, that often these recommendations do not get carried out. I have been pushing for a rehab nurse since i started but of course the problem comes down to money. So hooray for you (and your facility) for starting a program! If you have any specific questions about rehab feel free to contact me.

I also had my IUD inserted during my period and it was absolute hell. I was on my probationary period at work and i had to go in the next day i was in agony despite pain pills. When I tried to explain what the insertion felt like to my boyfriend I used the analogy of it feeling like being stabbed with a hot butter knife. sorry to be graphic. maybe it all has to do with the person inserting it...