AltaEnfermera

Thanks for the advice :). I'm lobbying hard to move the filing out of my office at the moment...It's a matter of coming up with a plan to present as an alternative to the current arrangement. (I've noticed that complaining doesn't help nearly as much as coming up with a plan and presenting it as "Hey, do you think this would work?", lol). Census is currently 60, 3 of which are Med A. PPS does suck, but 3.0 is a cluster-youknowwhat of unbelievably EPIC proportions, lol....I won't climb onto that particular soapbox. I appreciate the suggestions. I'm going to try and unearth a copy of my job description, but I'm afraid I'm going to find that "...and other duties as necessary" caveat stuck in there to absolve administration of any wrong, lol. Guess I'll find out, yeah? :)

It's ok, I didn't have a clue when I started the job, lol. MDS stands for Minimum Data Set; it's essentially an overview of a resident's condition that we submit to CMS to calculate reimbursement rates. Also, it's what drives care plan creation based on the "total picture"....aka, if the CP doesn't match the MDS, I get a tag, lol.

As do I, it's becoming more and more evident!

*I initially posted this in the MDS sub-forum, but it's more of a generalized issue, so it's here as well :) * I'm basically at my wits end in my current position. I accepted the MDS coordinator position in September because I loved the facility and was dying to come back in any capacity I could. It was the only thing available, and my DON (who is lovely, btw) thought I could handle it... I suppose I have for the most part, but I'm hitting a wall at the moment. The person I replaced was evidently quite burnt out with the job, and had essentially done less than the bare minimum for her last few months (years?). Care plans were dismal, MDSs were behind, et al. I asked to be told EVERYTHING I was to be responsible for, because I knew that I needed to develop a semi-routine to ensure I managed my time effectively. I was told "Just worry about this (MDS/care plans) for now. Everything else can wait." Now I suddenly am being delegated more and more, and it's severely frustrating. I knew this would happen, which is why I'd asked to know ALL my responsibilities in advance. I'm in charge of coding/collecting info for the MDS, writing care plans, doing ALL the nursing assessments, writing/maintaining/evaluating restorative programs, Medicare certs/recerts, AND fixing missing documentation for 3rd quarter billing (for which I was not even here!) so we don't lose our rate. On top of this, I was told by my administrator this week that "(my) office is a mess, and the owner was not happy"... Yes, it is a mess, for several reasons: 1) In addition to my other duties, I'm apparently Medical Records, so every scrap of past documentation gets dumped into my office, 2) The roof leaks and water drips through the light fixture, so said paperwork is piled on top of cabinets to avoid getting soaked, and 3) I taped trash bags over my windows because they don't seal and the baseboard heater plus my space heater can't keep the temperature bearable d/t the draft otherwise (and maintenance can't/won't do anything about it.) This is essentially a rant, but I'd welcome any suggestion as to how I might better manage my time and/or be more assertive regarding my workload, etc from more experienced folk. Thanks (And PS. You guys rock... I've learned a ton from this forum already )

I'm basically at my wits end in my current position. I accepted the MDS coordinator position in September because I loved the facility and was dying to come back in any capacity I could. It was the only thing available, and my DON (who is lovely, btw) thought I could handle it... I suppose I have for the most part, but I'm hitting a wall at the moment. The person I replaced was evidently quite burnt out with the job, and had essentially done less than the bare minimum for her last few months (years?). Care plans were dismal, MDSs were behind, et al. I asked to be told EVERYTHING I was to be responsible for, because I knew that I needed to develop a semi-routine to ensure I managed my time effectively. I was told "Just worry about this (MDS/care plans) for now. Everything else can wait." Now I suddenly am being delegated more and more, and it's severely frustrating. I knew this would happen, which is why I'd asked to know ALL my responsibilities in advance. I'm in charge of coding/collecting info for the MDS, writing care plans, doing ALL the nursing assessments, writing/maintaining/evaluating restorative programs, Medicare certs/recerts, AND fixing missing documentation for 3rd quarter billing (for which I was not even here!) so we don't lose our rate. On top of this, I was told by my administrator this week that "(my) office is a mess, and the owner was not happy"... Yes, it is a mess, for several reasons: 1) In addition to my other duties, I'm apparently Medical Records, so every scrap of past documentation gets dumped into my office, 2) The roof leaks and water drips through the light fixture, so said paperwork is piled on top of cabinets to avoid getting soaked, and 3) I taped trash bags over my windows because they don't seal and the baseboard heater plus my space heater can't keep the temperature bearable d/t the draft otherwise (and maintenance can't/won't do anything about it.) This is essentially a rant, but I'd welcome any suggestion as to how I might better manage my time and/or be more assertive regarding my workload, etc from more experienced folk. Thanks :) (And PS. You guys rock... I've learned a ton from this forum already :) )

...when you get a call on your way into work saying "State just walked in!" (LTC/psych) Or, you walk through the front door and are immediately assailed by a flying laundry bin/angry family member/some unknown food item. (Also LTC/psych...sadly, it happens more often than I care to remember, lol.)

Oh, I wholeheartedly agree with you! God forbid someone actually does it and manages to pass the NCLEX....I sure wouldn't want them at my bedside if I were a patient.

The OB incident was while we were doing OB rotation, which was during his 3rd try at PN school....She alleged that he was hitting on her, but I don't know the exact details. What boggles my mind is that he even made it TO the clinical rotation, because he was caught writing answers on the desks in the classroom! No one wanted to sit near him because he looked at your test, and per policy of the program, if someone cheats OFF of you, you're considered guilty as well. Faaaa!

OMG! He sounds exactly like a guy I know ....He was in the nursing program for 3 years in succession, because he kept failing out. He eventually got expelled from school for 1). Getting an OB patient's home phone number from the chart and calling her at home "to check on her and the baby", and 2). Showing up at our instructor's house after he failed one of her G&D tests. I can't believe he sent pictures.....blech!

Slightly different situation, (I worked in a large private/BOP facility), but I used to argue about this issue too. Our inmates were not restricted in any way, diet wise. According to policy, diet was dependent on the individual i/m to make healthy choices; they could choose from mainline meal or "heart healthy", which just meant slightly less fat. Problem is, there really weren't any options for diabetics offered. The only i/ms who had access to fresh fruits/veggies on a regular basis were those on "common fare", i.e. religious diet restrictions. So, to answer your question, our inmates were expected to restrict themselves in a sense, because there were no policies in place to ensure that they did. Which I agree with because they're adults, but I do wish they had more options available to choose from :S

It sounds like we have the same hair, lol. I always referred to mine as "wavy-straight" until I realized that, like ky_grl82 said, it really wanted to be curly hair. I'm a bit of a hair product addict, so my hair has quite the med list (heh): Head & Shoulders Fresh Shampoo (to knock out some of the greasy-yuck feeling at the roots) Silk Elements Megasilk with Olive Oil Conditioner (Hands down, the best conditioner ever. It doesn't feel greasy and leaves my hair feeling/smelling amazing. Based on absolutely no scientific evidence except my opinion, it seems like hair that gets greasy is usually dry on the ends; the greasiness is the scalp trying to moisturize, but for whatever reason it doesn't make it to the ends of the hair. ) FX Special Effects Curls Up- After squeezing the water out of my hair, (don't brush! Use your fingers to remove tangles), I use a tiny drop of this and sort of "rake" it through the bottom 3/4. SAMI Big Curls Creme Another tiny drop of this through the ends. I try not to scrunch b/c that just causes frizz, but I will wiggle my fingers through my hair and sort of "lift" it. That's it. After it dries, it stays curly without fuzzing, and I can put it up without having the flyaway issues. Good luck! :) Hope this helps.

I swear by Cornhusker's Lotion. My father used it for years on his hands (he's a farmer, so you can imagine), and was always trying to persuade me to "stop buying all that frou-frou crap, and try it". It doesn't have a smell, and is kind clear and odd textured, so I resisted- until I found myself with the most gawdawful case of chapped hands ever. The stuff is amazing...not greasy, no real smell, and feels amazing when you put it on. Good luck! :)

This is what we use to track what's drawn; it's a version of what we used when I did contract nursing at the Federal prison. I made a separate sheet to track standing lab orders, which is basically just a spreadsheet with the months at the top and each resident and their labs on the side; I check the month each is due, this way they can be combined as much as possible to avoid multiple sticks. Hope it helps :) LabRecord.doc

I love drug rep swag pens...dark ink, no skip-age, and they don't give me gnarly finger calluses (I apparently am an aggressive scribbler, lol); however, since the re-vamping of the laws, they're getting hard to come by. As an alternative, I like Zebra F-402s...they're metal, and thus heavy enough to feel substantial/dampen any "artisticness" that may happen when I'm writing in a hurry, 0.5mm ballpoint, and have a decently soft grip. I have a bit of a "pen thing", and they're my choice for charting b/c they seem to encourage me to write neatly. Also, the RSVP brand is decent, although they start getting skippy after a fairly short use. Good luck! :)

Here is the list I use....It's not super inclusive, but it covers most of the basic medical dx fairly well. :) icd9codes.doc