RainRN1

Not all directors are the same. I wish I could just work that.

That's not appropriate and an med error needs to be completed along with md and family notification!!!!! Complete crap. I have worked in ltc/snf'S for 18 years you wear gloves and you administer the correct dose of medication. That is resident abuse especially if it was a psychotropic medication that's a chemical restraint at the very least. If she did that in front of u imagine what she does on her own. Please if you don't report her, stop her the next time you see it. Your just as guilty if you don't report. Sorry but it's nurses like her who make those facilities scary and we r definitely not all like that. Nurses are responsible for lives not machines no matter what field we r in.

It's killing me. I'm ready to quit nursing all together. I've been a nurse for 18 years I've never seen staffing this bad. I know one thing I'm done working all different shifts whether it's as a nurse or an aide. How do you put your foot down when it's our responsibility to ensure resident care? I want the residents cared for I'm at a loss

Not quite sure how. I feel I am responsible for the residents which means ensuring care. I know there is no way to do my job right and cover the floor. How can staff expect change and better work conditions when some of us are on the floor too much. Maybe your don is trying to improve things for ur staff which can't be done if on the floor. Idk

It's feels like it's the norm now. I'm a new DNS and it's difficult to get down what I need for my responsibilities when I have to cover floor even the worry everyday about schedule is enough to cause a nervous breakdown. I want to be an effective DNS but thinking it's going to be impossible. I'm going to continue to plug away we shall see

How often are you covering open shifts? Seems like it's common and if so how are you getting your job done?

I bought nclex 4000 when I was taking the nclex for the 2d time, and just kept answering questions it is what helped me the most. Its not so much the content its the way the questions are worded and this nclex 4000 mocks the nclex questions. I knew the information but the questions are tricky and that was before they changed it to "answer all that apply" questions, I had them but they were not the bulk yet.

I am in charge of in services, employee PPDS, I am in charge of one hall, in charge of restorative program. I have no time to sit and do much of any of these I listed due to constantly putting out fires. My DON is new to the facility also she started a couple of months before me and is not from this state so we compliment each other I feel. My background in MDS and care planning helps with the regulation part of it. Our administrator is an interim who is done with the whole living out of a hotel gig. It has been interesting to say the least :) We are a bit staff challenged so working a lot of floor hours on different shifts, definitely getting a workout. Oh yeah and state is due in any minute. I love it so far just do not want to burn out being there so much but so far so good love the people I work with. Thanks very much for your replies....

I have been in LTC since 1991 started out as an aide, LPN, and have been an RN since 2010. I have been head of MDS department since 1998. I recently took an ADON position, I absolutely love my new job and the people I work with right along with the ancillary departments. However I feel like I am not doing enough to help the DON. She says I am fine but after all of these years in LTC I can honestly say I have never felt so inadequate at my job. I did not get much training which is alright. Can someone give me some ideas of what you expect of your ADON ?? Mine says I am doing fine but I really want to do a good job for her, she is a great DON. Thank You

pepsi

I stage the way the RAI manual says to. I do not go by any other standard. I am also a RAC-CT have been doing MDS since 1998. If you go by too many things you will get confused.

I have been Head of MDS department for 13 years as an LPN for 12 of them, with the DON signing and another LPN working under me. I decided it was time to further my education for myself. These comments almost make me feel bad for becoming a RN ??? I agree that the signature is stupid but why bad mouth all RN's ? Just venting a little.

If this person is medicaid and you give the significant change assessment an ard a day apart from the pps then what you are doing is giving this person a rug score on the medicaid side. I think that is what your corporate is talking about. But you have to do it after you do the pps using a different ard. This helps with the CMI in the end.

There are only 2 assessments you cannot combine with another assessment and those are the entry and death in the facility I believe. There is a chart in the RAI manual that tells you which assessments can be combined and which ones can't so double check me. Raine

Move the quarterly ard to the 18th I can't imagine it will throw you out of compliance unless you are using the 92nd day already Raine

Thank You very much for yur reply's I have been trying to get ahold of clients the day before also but I am finding the office changes my schedule on a daily basis which for a new HH nurse is hard to keep up with. But it is getting somewhat better. I also work as assistant to one of the supervisor 20 hours a week in the office and that half day is a real challenge. Thanks again Raine:)

I have a question - Do you always call clients the day before you go to their house or the day of? I am having a really hard time getting my day scheduled due to clients in bed til late or I cant go unless an aide is there. I just need some suggestions. Thank You in advance.

I graduated last year from Excelsior, I am not sure what has changed, but the way I had to do it was the 20 minute checks were done within the first 20 minutes of entering the room. The rest of your assessments you do the way the critical elements tell you. You only have have a certain amount of time to get it all done, so do your assessments timely following your critical elements for each assessments. The study guide will tell you if the elements for assessment has to be done in a certain order or not. You do not have to leave the room until you are done unless you need to get something. As far as the careplans go you only have to have the first part of your problem statement done at the beginning, you have to have the r/t and AEB done during the evaluation phase along with your rationale. Hope this helps, if you need anything else let me know. And all of this is the way it was done when I did it in August of 09. Raine

I have not really gotten an orientation today was my third day and I was on my own, my boss was there but she had to work the floor to due to call ins which is seeming to be a pattern. I think it is more disorganized than what I am used to but I think that is due to staffing. At least in my old job they would orientate the nurses at least a good week before cutting them loose at all of course there is always nurses there for help. The most challenging thing I have right now is the lack of orientation. It is just wayyyyyy different. I do like the different skills I get to use though. Sorry so winded I am very frustrated.

Congrats I just did the same thing after 13 years the only thing I can tell ya after 2 days is it is different. Good Luck hope you like it I still havnt made up my mind yet :)

Thank You both for responding. was an LPN for 14 years and have been an RN almost a year but I have worked in LTC until I took this job in med-surg. I have done skilled visits for home health in the past though. I am really liking the hours they are offering vs the every weekend option I am getting now including every friday. I dont know all I can do is talk to them and see I guess I really appreciate your responses Thank you very much :)

I am starting a med surg job tomorrow it is night shift weekend option after orientation of course. I recieved a call today offering an ADON position in home health???? I have been and MDS coordinator for the last 12 years. I am not sure what to do. The home health position is closer to home and is m-f no holidays or weekends. But the experience?? I really am soo I dont know what to say. Any advice??? Thank You..

Look up AANAC they are a group for MDS coordinators and are very active they do the certifications the membership used to about 120 a year but they are a great resource. I have been an MDS coordinator for 12 years and I really liked them

I dont know what caused them but I will tell you that I had one of my kids at Shriners for a burn that was blistered and the doctor did say to leave it intact if at all possible, he just had us doing aquafor oint. to keep it moist. Hope everything works out for your uncle.

Yay, I got a phone call this morning and I start the day after my other job ends so 3 8 hrs then 2 12 hrs !!! Thats okay didnot want to be with no job. Kayern thank you so much for your support it really was appreciated :))