txdon

txdon

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All Content by txdon

  1. Nursing Budget

    txdon posted a topic in LTC: Directors, Assistant

    I need help with my nursing budget. I need to make drastic reductions and would like some ideas on how to reduce spending costs on nursing

  2. Skin Sweeps

    txdon posted a topic in LTC: Directors, Assistant

    Just curious as to how other DON's conduct skin sweep. We currently have a "treatment" nurse who has no wound care experience and is making a lot of mistakes. He misses wounds, only does head to...

  3. Nurses as Case Managers Model

    txdon posted a topic in LTC: Directors, Assistant

    My facility is currently considering various nursing models. We have had unit managers in the past but as I have stated in previous post, that role has not been very effective. I was wondering if...

  4. Help

    txdon replied to CapeCodMermaid's topic in LTC: Directors, Assistant

    In my humble opinion I believe that nurses behave this way because they've been allowed to get away with it - holding staff accountable is vital. Unfortunately most DNS are "afraid" because they can't...

  5. Administrators

    txdon replied to c.oconnor's topic in LTC: Directors, Assistant

    Just you caring enough to ask this question says a lot! I agree with the prior two post, it is vital that the administrator allow the DNS to handle the clinicial issues. In my situation, I have a...

  6. Nurses as Case Managers Model

    txdon replied to txdon's topic in LTC: Directors, Assistant

    If the "primary" nurse is not on duty, the responsibility would fall on the nurse who is on duty. The "management" part would be that of the "primary" nurse. I am in desperate need trying to figure...

  7. Skin Sweeps

    txdon replied to txdon's topic in LTC: Directors, Assistant

    I know, I never heard of such a thing either. The explanation I received was that we have to show that we provided atleast the first two showers before additional outside services (such as hospice...

  8. Skin Sweeps

    txdon replied to txdon's topic in LTC: Directors, Assistant

    We use caretracker as well. The reason why we hired a treatment nurse was because our facility has had problems with treatments not getting done, particularly wound treatments. At my previous...

  9. Unit Manager/RN Supervisor Responsibilities

    txdon posted a topic in LTC: Directors, Assistant

    I am in the process of developing job responsibilities for the unit managers. Basically, the unit managers are acting as personal assistants to the floor nurses. The floor nurses love it because...

  10. State Tags

    txdon posted a topic in LTC: Directors, Assistant

    Just curious as to what facilities are getting tagged for this year. I heard that they are cracking down on glucometer

  11. Abuse Allegations

    txdon replied to txdon's topic in LTC: Directors, Assistant

    Our agency does have a compliance hotline. I will voice my concerns to them. I have never used the compliance hotline but the last person in management who did was terminated for "other" reasons. The...

  12. Abuse Allegations

    txdon replied to txdon's topic in LTC: Directors, Assistant

    We do have policies and procedures for reporting incidents. The problem is the DON is controlling the process. When an allegation of abuse is reported by a staff member, the incident is reported to...

  13. corporate nurse nightmare!

    txdon replied to americanTrain's topic in LTC: Directors, Assistant

    My recent experience was quite different. A team of two regional corporate nurses came to help fix our deficiencies. Our facility has lacked accountability and as a result the staff has been allowed...

  14. Unit Manager/RN Supervisor Responsibilities

    txdon replied to txdon's topic in LTC: Directors, Assistant

    In my state CMA's aren't allowed to pass meds in our facility. Does anyone have any other staffing suggestions or

  15. Unit Manager/RN Supervisor Responsibilities

    txdon replied to txdon's topic in LTC: Directors, Assistant

    My facility has 89 residents, 15-20 are skilled. Each nurse has a total of approx 22 residents. Most are LTC expect the 15-20 skilled residents. The unit managers are responsible for overseeing and...

  16. Abuse Allegations

    txdon replied to txdon's topic in LTC: Directors, Assistant

    Yes, all occurances are posted on the state's website. It describes whether or not the allegations were substantiated and what actions were taken if

  17. Abuse Allegations

    txdon replied to txdon's topic in LTC: Directors, Assistant

    I my State they publish all occurances on the state's website. Does numerous reporting result in a negative mark on the

  18. Abuse Allegations

    txdon replied to txdon's topic in LTC: Directors, Assistant

    Oh my. I thought that since the DON has taken on the responsibility to report all allegations of abuse then she was the one held accountable. Our state does have online reporting, but I have no idea...

  19. Abuse Allegations

    txdon replied to txdon's topic in LTC: Directors, Assistant

    I agree. The problem I'm facing is that I believe abuse is occurring and the DON unsubstantiates it. For instance, I had a resident report that a CNA pulled him out of bed while he was sleeping,...

  20. Samples of Kardex or other communication tool

    txdon replied to afteralltheseyears's topic in LTC: Directors, Assistant

    The lack of communication has been a huge issue at my facility as well. We considered putting a copy of the resident's kardex in the inside of their closet door, but it was considered a HIPPA...

  21. Proper Skin DX

    txdon replied to txdon's topic in Geriatric, LTC

    The wound nurse is not an Advanced Practice Nurse. Thanks for clarifying that. I plan on giving an inservice on this very

  22. Proper Skin DX

    txdon posted a topic in Geriatric, LTC

    Need clarification, is it okay to put on the treatment order dx: contact dermatitis? The nurse originally said it was a blister on the heel. Then we had a regional nurse evaluate and she said it was...

  23. Proper Skin DX

    txdon replied to txdon's topic in Geriatric, LTC

    She is wound certified (WOCN). Would that make a difference? I just wasn't sure because I have never seen a nurse write a nursing dx on an order, it's always a medical dx. Contact dermititis is...

  24. Pain Management

    txdon posted a topic in LTC: Directors, Assistant

    I am beside myself. I have multiple residents who c/o pain constantly. When asked what their pain level is, they reply 8-9. When I ask the nurse what is being done for their pain the reply is...

  25. Careplan Intervention Help

    txdon posted a topic in LTC: Directors, Assistant

    One of my weakness is in careplanning. Our facility has not been updating careplans correctly. Does anyone have suggestions on what type of interventions should be implemented on the careplans. For...