BHolliRNMS

I don't think you will be fined monetarily for late submissions. However, if it is a widespread ongoing problem, state surveyors can give you a tag on it during your survey. I would write the problem up and take it to QA committee with a plan of cor...

I think most boards of nursing will tell you that you can make a late entry on anything that you can factually remember without a doubt. I think anyone would have a difficult time convincing a bon they can remember a month ago. In MS the bon doesn'...

The DON clocking in and leaving is as illegal as any other employee. Federal regulations require nursing homes to have RN coverage at least 8 consecutive hours everyday. If the nursing home does not provide this coverage, they are not meeting federa...

Track location of the infections per your facility floor plan. Could there be a px with hydration and/or incontinence care in a particular area? Track UTIs with catheters...is there a px with catheter care? Track organisms....which are widespread?...

i work in a 120 bed ltc and we just dc'd our last restraint. It takes a lot of creativity to keep people safe. you have to learn what each individual likes. Ex...we have one lady who liked to read...she is very demented...but she will sit and "rea...

I think it is great that you recognized the acute change in your patient. Usually a cna is the first person to notice a change in a LTC resident. However, taking the time to go get a pulse oximeter machine and "assess" the patient yourself BEFORE s...

in order to be a "skilled" patient under Med A, the patient must need care that requires the skill of a licensed nurse or therapist daily. Daily wound care, IV therapy, observation and assessment of many diseases, etc. The key to getting paid is in...

after sixteen years, some days I still want to puke...

I work in a LTC in the rural south. We see rather unusual names, too. If the person is from smith county, you have to pronounce the ending of every name as "er." Clytie, Clemie, Bertie, Pecola, Pocohantas, Rosie, Cola, Mable, Tiny, EW, Cleotha, L...

My daughter was born on Christmas Day and on during the holiday season we all call her Merry Christina Angelica Noel.

Not ALL crash carts in long term care are a joke. As a nurse, I feel it is my responsibility to check the crash cart at the beginning of the shift to be sure O2 etc is on it. Let's face it. People come to LTC to stay til they die. The families say...

It sounds to me like it was already getting better under your leadership. I have been a don in two different facilities. The first year in each, I was at work more than I was at home. I have been at the place I am now for four years. It is a than...

I don't believe in unnecessary charting or duplicate charting. I do think sometimes forms help nurses to document important information in a quick way. Our company doesn't require monthly summaries for instance. We do acute charting, MDS charting a...

I agree, it is necessary. I just think I would appeal the G tag on an alert and oriented resident who fell. She has rights to refuse restraints and alarms can be restraining. I get tired of everyone saying you have to have a new intervention with ...

ask the lawyers.

we have a crash cart on each nursing wing. We only initiate CPR until the paramedics arrive and they take over. If you know CPR, you should be fine. Play out the scene in your mind a few times and prepare yourself. It will happen sooner or later....

on 11-7 we have 1 nurse to 60 residents. The 11-7 nurse is responsible for acute charting, supervision of cnas (3-4), PRN meds, emergencies, 6am FSBS, and 6am meds (mainly the tube feeders). I have worked it many times and it isn't bad.

what about behaviors related to pain? Are we treating behaviors related to dementia when residents are actually in pain?

Listen! Always listen! Practice common sense. Remember, just because you are the student, you are not always wrong. Ask questions. Have common sense. Be courteous. Listen. Don't think you know everything just because you have an A average. Do...

LPN #1 reported to RN Sup that tube fed insuling-dependant diabetic patient with nausea and high residuals. RN instructed her to turn the feeding off, assuming the LPN had enough sense to recheck the patient in 30 minutes. End of shift arrives, RN ...

A coworker of mine has an uncle in the VA hospital. The nurses had to restrain him last nite, because he wouldn't leave his O2 on and his sats were really low. He also kept trying to get up..can't remember he can't walk. When his daughter arrived...

Long nails also subject patients to skin tears and scratches when performing procedures. Outlawed where I work. Do what you please on your days off, but when you come to work, have clean short nails, minimum jewelry...oh, and lay off the brow rings...

You know the right thing to do. But, who wants to be labeled a tattletale the first two weeks out of school, right? However, you must address the issues that you are aware of. Can you speak to this nurse first? Tell her your concerns. Sounds lik...

Not uncommon in south ms.....more common in poor communities. Sad, I agree. Hope the babies don't have the same dad. Many moms under the age of 30 with 3 plus kids in this area. Seems like the more kids they have, the more money they collect and ...

call your don before your next shift and ask her if she has spoken to this cna and what you should do if she has another outburst. It can be seen as resident abuse if the residents are frightened by her tantrum. If the don has not addressed the sit...