agingnurse

Wow, I'm new to HH and I've been just like Spidey's Mom, I live animals and I've been very friendly wit clients pets unless told otherwise! You've all given me quite a lot to think about before my next visit, where they have approx 6-8 small dogs that yip and yap the whole time I'm there right at my feet and or hands since they get on everything. Yikes!!!

Omnicare in our state provides excellent service, except on rare occasions. Haven't noticed any cuts to their service. I'm so jealous of everyone talking about e-kits, we aren't allowed to have them!! It's been my mission lately to see we do get them, finally got a law passed allowing them, pharmacy board working out details now!! Can't wait!!!!

Dear MTESSMER, Craziness!!! I'm so sorry you are having to go through this insanity!! Will say a little prayer, hold your head up and don't let the bad guys get you down!!! Keep moving forward!

Dear LTCRN4LIFE, Thanks for the antidotes!! All ideas are helpful, after 35 years I think I e seen and heard it all, but people still amaze me!! Thanks for your contribution to LTC, good nurses in our field are so important!!

Please PM me if you have any questions I might be able to help with!! Good luck!!!

I've opened several new buildings in our state, as the DON and as the side by side corporate nurse overseeing and helping with it all!! You have described the norm, crazy as it is!!! On average it takes us 3-5 months to fill up! In that process you are in a constant state of change with constant new staff! Since your new no one and I mean no one knows how to do much, you're all learning as you go!! The systems you put in place have to keep being adjusted based on census and acuity. It's exhilarating, exhausting, overwhelming each and every time!! But the good part is, it's very very rewarding to see it all finally come together, see your nursing staff turn into loyal family and so much to be proud of!! So hang in there it does all work out if you have 2-3 months of 10-12 day to devote to it!!!!

I work PRN in home health, I also have a regular full time job. I'm sure t depends in the company and the managers. In my situation, they call me last minute, they sometimes schedule visits ahead of time, but I always feel free to say no. They are always very kind about it. And very appreciative of the extra help. From doing staffing for years as a DON I understand its frustrating when you have a PRN person who always says no. If you have a sort of set amount you want to do, I'd be honest up front so they understand. Hope that helps.

The main thing here is LTC facilities must follow their own states licensure regs about the disposal of dc'd meds. No choice, but to do as mandated unless your state gives you options. I've been in LTC 35 years and we have always flushed meds whole, not crushed. That doesn't make it good, just regulated.

Thanks for your responses. Our facility's have a Condition Alert page in the front of the charts where we put all the stickers, DNR, allergies, etc. however, we don't mark the pt door/ name plate etc. they never stayed up to date with pts moving in and out. As a nurse I'd never strictly go on a doors stickers. But, these surveyors are citing a problem with having to go find the chart. So I just wondered if there was any other good ideas out there. Two of our facility's use an emar which is perfect, the info is tied automatically to the DNR order and is handy everywhere.

Three LTC facilities in my state have received IJ deficiencies recently for not initiating CPR due to not having the correct designation on the chart. They also have cited not having a quick method for determining DNR's besides looking at the chart. I've always found list, stickers any where but on the front of the chart to not be accurate and therefore have stayed away from that. Now having to reconsider or at least look at our policy. Any ideas or good ways you have seen.