montecarlo64

montecarlo64 BSN

ED, Long-term care, MDS, doctor's office

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All Content by montecarlo64

  1. PPS tracking form

    montecarlo64 replied to miccay's topic in MDS Coordinator Information

    Thank you

  2. Skilled Therapy

    montecarlo64 replied to crazyforthis's topic in MDS Coordinator Information

    Skilled services are either skilled therapy services: PT, OT, or ST 5 days per week or a skilled nursing service such as IV therapy, injections, unstable medical condition, wound care, respiratory...

  3. locomotion

    montecarlo64 replied to kavdah's topic in MDS Coordinator Information

    I do not usually use limited for w/c locomotion. If someone pushes the wheelchair for the patient just 1 time during the shift, muscles are being used so it is extensive. I explain that to the...

  4. What kind of staffing do you have?

    montecarlo64 replied to TiredRN-momto4's topic in LTC: Directors, Assistant

    Sounds like it is way understaffed. 1 nurse to 20-30 is ok if all residents are stable with no complex stuff like traches, IVs, PICCs, frequent admits/discharges...4 CNAs to 65 is a little stretched,...

  5. MDS RN to resident ratio?

    montecarlo64 replied to crazyforthis's topic in MDS Coordinator Information

    I usually have between 15 to 25 PPS (had 28 at one time) and total census of between 65 to 70. When my PPS gets up to around 20, I struggle...They seem to be admitted and leave by the busload &...

  6. Medication Administration through a feeding tube

    montecarlo64 replied to lalexa15's topic in General Nursing

    The medications should technically be separated with at least 5mL of water between. The rationale is that if the medications are all mixed together and the tube becomes clogged during the...

  7. Wound Vac with suction device not on patient?

    montecarlo64 posted a topic in Wound, Ostomy, Continence

    Has anyone ever heard of a wound vac applied with the suction device being placed on foam which had been bridged to OUTSIDE of the patient's body (not attached to the patient's body). The wound was...

  8. Careplans and Quarterlies

    montecarlo64 replied to txdon's topic in MDS Coordinator Information

    Are you talking about quarterly MDS assessments or quarterly assessments such as bowel and bladder, braden, dehydration,

  9. lpn as ADON?

    montecarlo64 replied to nd deb's topic in LTC: Directors, Assistant

    Many years ago, when I was an LPN, I worked as an ADON; but, my title was "Director of Nursing Assistant" instead of "Assistant DON". The reason was that I could NOT step into the role of the DON, if...

  10. Morning PPD/Medicare meeting

    montecarlo64 replied to pixie120's topic in MDS Coordinator Information

    I agree to let the administrator know, too...They will not let anything affect the possibility of ending up with default

  11. Grace days (thru 10/31/-2011) 5 day, 14 day

    montecarlo64 replied to pixie120's topic in MDS Coordinator Information

    At my facility we will start the new schedule the last week of September..We have this week started setting our 14D on day 13 to get into the habit....So this is how we do it: 5D on day 8, 14 D on...

  12. MDS nurse needs a break

    montecarlo64 replied to montecarlo64's topic in MDS Coordinator Information

    Thanks for listening and for the replies!! No one knows except those of us who do this or have done this for a

  13. Choking Patient

    montecarlo64 replied to abbaking's topic in General Nursing

    I had a situation one time where a very large patient in a wheelchair needed the heimlick. I tried to get behind him, but couldn't get enough strength, so I had some one go get the sit to stand lift...

  14. Upcoming changes to 3.0

    montecarlo64 posted a topic in MDS Coordinator Information

    How does everyone think the changes regarding COT and assessment periods will effect our workload, reimbursement, scheduling, and therapy tracking? All opinions are

  15. Is it worth it taking out a loan for a CNA program certificate?

    montecarlo64 replied to mariposabella's topic in Patient Care Technician, Assistants

    Yes, Yes, Yes!! My daughter received a degree in business administration and racked up over $20,000 in student loan debt (state university & since I am a nurse, we made way too much money for...

  16. Upcoming changes to 3.0

    montecarlo64 replied to montecarlo64's topic in MDS Coordinator Information

    That's what I am thinking too! Good Luck to all of

  17. initial physician certifications for skilled residents

    montecarlo64 replied to crnacc's topic in Geriatric, LTC

    No. They just sign the day they are there. No back dating allowed. You may need to talk to the house physician to get him or her on board with a system to come in sooner, since this is new for your...

  18. initial physician certifications for skilled residents

    montecarlo64 replied to crnacc's topic in Geriatric, LTC

    I have them sign the initial certification and the "before the 14th day" re-certification when the physician makes the first visit, which is usually within the first week of the patient's

  19. New Grad in LTC - Feeling Overwhelmed (21 pts)

    montecarlo64 replied to simpreza2's topic in Geriatric, LTC

    I have had many years of LTC and, unfortunately, that is about the normal ratio. The residents used to be stable and easy to care for, but now they are younger, larger, and are afflicted with way more...

  20. career pathways out of MDS

    montecarlo64 replied to senseiRN's topic in MDS Coordinator Information

    MDS coordinator is it's own specialty..Takes many months to understand and years to be an expert...Even then, there is still always something new to learn..I suggest that you do not pursue this...

  21. Will the nursing shortage ever end?

    montecarlo64 replied to hopeless romantic's topic in General Nursing

    No demand for nurses for quite some time now! Last year I had a hospital interview: 108 applicants for 12 positions (4 full-time, 8

  22. Help! I can't decide where to work...

    montecarlo64 replied to Vblub01's topic in General Nursing

    I would take the job at the nicer facility & try to stay on as prn at your current

  23. Drug tests

    montecarlo64 replied to loveishope's topic in General Nursing

    I take an occasional antianxiety medication. When I went for the employment physical, I listed that medication as well as bringing in the medicine bottle...When I went to the lab, they did not want...

  24. Realist vs Optimist

    montecarlo64 replied to tokmom's topic in General Nursing

    Being a realist is a good quality! No need to sugar coat something or expect s**t to turn into roses!! It is what it is & I think that us realists do a good job of working with what we have to...

  25. Can't sleep anymore!

    montecarlo64 replied to DreamyEyes's topic in General Nursing

    I am also a chronic insomniac! No caffeine..I have a usual bedtime, but I still wake up after about 3 or 4 hours. I do take a sleep aide IF I have had less than 3 hours sleep AND I have at least 4...