coolbreese45

Do you have a 24 hour report? This way you know who you need to assess, other nurses need to continue to update the log with new orders, change of condition, MD calls, census, admissions, labs, falls, incidents, ect. Each unit should have a 24 hour report and the charge nurse will have one for the whole facillity. Each facility is different in who can D/C from report, but this will give you a guide on what you need to follow. Good luck.

I've filled in as a PRN nurse in an assisted living facility. Passed meds, txs, assessments, blood sugars, ect. One building had dementia pts, two buildings, with about 15 residents with medical concerns and the apartments about 20 residents. The apartments were suspose to hoiuse independent residents, however, there were the worse to take of. I had one lady with fluctatng BS's, would administer sliding scale insulin, then she would turn around and drink soda so she would not bottom out. She liked to order the nurse around. Her on-call endocrinologist was half-way across the state, I would have to call because she was high. She was playing me until she found out that she was charged for all the extra calls she made to me. (She would even call the cook to track me down). The night nurse explained to her that someone had to pay for all the extra time I spent with her, and that she should had called the MD herself. The calls from her stopped after that. No way would I ever take a job at an assisted living facility as they are not regulated by the state, the staff you depend on are not even trained as CNA"s, scary! One other incident that comes to mind, a brand new staff member, second day on the job went into a pt's room, who had dementia, and was a two person. I caught her trying to get him out of bed by herself, did not ask for assistance, and didn't know how to use a gait belt.

I live in a small town and know some of the nurses, however, if I don't know them, I usually do mention that I'm an RN. It usually comes up when I'm talking S/S's about one of my kids to the nurse or assistant and I find that my concerns are taken more seriously.

I've worked longterm care for years so all the above has happened. (No broken bones, sexual assult or serious injury thank god). A few years ago, we had a resident's husband harrass the staff and interfer with his wifes cares. One afternoon, as I was transfering his wife to the toilet on the rehab unit (she was a stand by assist), he started yelling at me to hold her. I tried to explain to him that she was fine but he kept yelling at me and told me he was going to report me. By then I had enough of his harrassment and told him I would report him first. I went to the administrator and complained that he was harrassing all the staff and it needed to stop. (We have our rights too) The administrator was going to call the state ombudsman, but sad to say, the resident past away.

As charge nurse, I was called down to assess a pt. who was diaphoretic. The LPN and I both knew she needed to be sent to the hospital, though her VS's, BS's were ok. She had a recent fall, x-rays were ok. We thought something was broken and she was bleeding internally. We rechecked her apical and radial pulse, came up with a 20pt defecit. The on-call agreed and the LPN called the rescue squad stat. (It's a 25 mile drive to the hospital) As the rescue squad was loading our pt. on the guerney and wondering why we called them stat, she started throwing up blood. We were glad we did a thorough assessment and convinced the MD.