supervisorhatchet

Know what you know, and all the rest.....ask lots of questions. Use your peers to help you gain knowledge! There are never any dumb questions, and mistakes are just new opportunities to learn!

Don't worry too much. It is no different than any other nursing job....Your job is to follow the MDs order. No order no med, tx, etc. And in case of emergency....you are never alone! There is internet every where! You'll make it, and ace it to. ! :yelclap:

I worked at a place for over 2 years and never got a locker....When one did open up, it was on another unit, all the way on the other side of the building, on a lock down unit that I did not even have access to. >LOL<.. seriously i don need anything at work. bring my lunch enough for or figure if someone needs to steal food then they it more than do but really will share. carried property in left pockets and nursing stuff right . car keys cell phone bra. what ya a locker> something we did at another place what that the lockers were for daily issue only. if after shift change your lock was still on "your" locker, it became the locker with the lock cut off. this works nice if you share someone on another shift...people are crazy....specially bout things like lockers. I wouldn't worry about it. Get more pockets, carry less stuff.

this may seem silly, but how can I get into the ICU? I have been RN for 2& 1/2 years. I have worked med surg & long term care, and briefly in home health. They dont want new grads...so I am not a new grad anymore. But they still don't want me. What is it that they are looking for, or what can I do, to become what they are looking for. please HELP!

I just read a report from a recent survey, and one of the tags was that insulin was administered after the meal. Is this accurate? I thought that FSBS was checked before the meal...the insulin could come any time (W/IN 30 MINUTES) of the meal...before or after. please clarify....tell me which is right and what are surveyors expecting me to do? thanks

administrative, hourly paid RN if on call nurse can't get someone to come in, and the floor isn't covered, the nurse gets to work the floor:down::down:

no contract

It seems like every day I get a new job description. Can you do this. and oh today, I need you to do this. And focus on this today.. And today beat all. I was informed after being in my position for several weeks, that I will be having to take on call responsibility every 4th week I am really irritated. Part of the reason that I left my last job is because I really HATE being on call. And I am certain that I expressed this in my initial interview, and taking call was not part of the job description that I agreed to. I have a sleep disorder and I take medication. I take medication in order to SLEEP. I don't sleep without it. At all. NONE. ZERO. And I really can't be on call, if I am on sleep aids. Is there anything I can do about this? Do I have any rights as far as this is concerned? Other than the right to quit? And another thing, I am an hourly paid worker, and there is no "on call" pay. I know that the on call rate is only $2/hr or something like that...but don't they have to pay it? VERY FRUSTRATED!

without knowing what the nasal spray is...it is hard to say...However, there are different classes of inhaled medication... flonase is an anti inflammatory = reduces swelling then there are steroid sprays, antihistamine strays, and even sprays for thyroid troubles...so it really depends on the medication often a combination of meds gives the patient the best result

hi everyone...I am new to management, I need some resources for common meds that require lab follow up common dx that require lab follow up a system for chart audits and a system for compliance rounds

not sure about hospital procedures. in long term care, we do RCA for just about any negative outcome... such as pressure ulcers, falls, skin tears, etc it really isn't a big deal, it is a risk management strategy to find the cause...so that it can be prevented in the future this is esp true with facility related infections/conditions...such as catheter related UTIs, PUs...thing that medicare won't pay for if the facility did not do EVERYTHING to prevent them from happening.

thanks for the replies I have a lot of work to do. The administrator has sort of put me in charge of getting the MARS cleaned up. I found about 40 of this type of error on 1 med cart in 1 shift (I don't usually work the cart) thanks for the clarification...I guess the first thing I should do is sit down with my list and talk to pharmacy and find out what they can send...make sure all of the orders are right... URG!

just wondering... recently noticed several medications on the med cart not match what is on my eMAR... such as eMAR might say tylenol 650mg 1 tablet q6hrs...but what I have on hand is 325mg tablets & I must administer 2 tablets to get ordered 650mg dose. or it might say medication XYZ 10mg, and what the pharmacy sent is 1/2 tablets of 20mg tablets..still the right dose... I guess the question is...in preparing for survey, and as risk manager...does the eMAR have to match exactly to what I am passing or is it okay as long as the appropriate dose is being administered. If it needs to be changed, any suggestions avoid recurrence....and for wording on the order to stay in compliance. thanks in advance

I say the same thing..The bad ones weed themselves out, usually.

Just wondering if anyone can tell me what my legal/ethical/moral responsibility is when "RN supervisor" has been assigned to my name. and if I am going to be assigned RN supervisor, shouldn't I get a raise?

haven't had a chance to look at all the sites, but thanks so much. our safety commitee wanted to wait a couple of months, but admin said no...we are passed due and in our survey window... But as staff development coordinator, I felt the soon the better. It will give us a better assessment of our staff's deficits and real teaching needs... thanks again

I meant to say hot water heater for the kitchen. Which is gas powered...It is a good scenario, as our O2 is stored in the room next to the kitchen...it is ironic we planned this mock diaster for the upcoming week, and this weekend we actually has a gas leak...it was not a disaster..but a lot of protocol had to be put into play.

:DHey everyone. I am new to position of staff development and am responsible for filling in the gaps in education with my staff. This icon really shows how I feel ! next week we are having a disaster drill. Here is my problem, I am NEW to position and I don't think this facility has had an in service in 2 or 3 years. :down: (Seriously) So, I am prepared for it to go totally horrible. My question is what things do I need to assess for, as far as employee education needs. Here is our scenario. H20 tank in kitchen explodes. There will be injuries, deaths and evacuations. Oh this is a long term care nursing facility. And also, if anyone knows of any good resources for teaching please let me know. I am so new to position and have had no "staff development" myself. Any help would be greatly appreciated

:DHey everyone. I am new to position of staff development and am responsible for filling in the gaps in education with my staff. This icon really shows how I feel ! next week we are having a disaster drill. Here is my problem, I am NEW to position and I don't think this facility has had an in service in 2 or 3 years. :down: (Seriously) So, I am prepared for it to go totally horrible. My question is what things do I need to assess for, as far as employee education needs. Here is our scenario. H20 tank in kitchen explodes. There will be injuries, deaths and evacuations. Oh this is a long term care nursing facility. And also, if anyone knows of any good resources for teaching please let me know. I am so new to position and have had no "staff development" myself. Any help would be greatly appreciated.

Hey everyone. I am new to position of staff development and am responsible for filling in the gaps in education with my staff. next week we are having a disaster drill. Here is my problem, I am NEW to position and I don't think this facility has had an in service in 2 or 3 years. (Seriously) So, I am prepared for it to go totally horrible. My question is what things do I need to assess for, as far as employee education needs. Here is our scenario. H20 tank in kitchen explodes. There will be injuries, deaths and evacuations. Oh this is a long term care nursing facility. And also, if anyone knows of any good resources for teaching please let me know. I am so new to position and have had no "staff development" myself. Any help would be greatly appreciated.

LTC is hard work, if you are DOING your job it is HARD..from the CNAs, nurses, admin....It is hard. As a nurse, I don't ask my CNAs to do anything for me, because I know they have enough to do. If I see them sitting at the desk, I find them something else to do..Like trim all the toe nails on the hall, or clean wheel chairs... or something, even if it is MOP the floor, clean out the fridge. I am with you, I am sick of lazy. As charge nurse, I do try to end the laziness. And if I see the maintenance man, or housekeeper, administrator...walk by a call light....I make sure they know they DID.

Really thinking that would be great...We send so many out, just because we can't get the MD to return calls! Some nurses just do what ever they think doc will tell them to do...But I am not comfortable with that. I did not go to medical school .

Just practice.....When I was in school, we got a cath kit to play with. We took that kit home, and I found one of my daughter's dolls that had a hole big enough, and me and a partner quizzed each on other, watched each other until we were comfortable doing it. The more you do it, the easier it will be.

ok...having worked in ltc and having lots of peg and g tubes... wait...back up #1 rule !!!!!!!!!!!!!!!!!! always act in a way that you can defend in a court of law. if you can't defend your actions at the end of the day....then you can't defend your actions at the end of the day... i am an rn and i tell all nursing staff from care partners, techs, aides, lpns & rns...when in doubt do it by the book. if your actions come into question (in the real world nursing) it is you that has to answer for them. if nurse abc tells you to do it such&such a way, and that is the wrong way...nurse abc will not be the nurse in court...it will be you now that being said....in real life, on the floor, nursing.... gtube meds are supposed to be done exactly the way you tried to do it. if you are being observed, such as by state surveyor or horrible clinical instructors....do it the right way. and some things that you did not mention...always check for placement, each and every time you administer meds or flushes. flush with water first, each med, then water and water to follow. flushes and meds are to be administered by gravity (no "pushing"), it is just supposed to flow freely. bolus feeding are also by gravity and are not supposed to be watered down now in the real world with 35 -65 residents in a ltc or snf, 10-15 meds on each med pass, 3 or 4 tubes (if you're lucky)....i do mix the meds. and i have never seen or heard of a nurse that does not. i am careful not to mix potassium liquid with other meds because it does need to be administered slowly and the label specifically said do not mix. i do not mix promod liquid with any thing other than water because it tends to make things solidify (your liquid slurry turns to a brick). do not crush enteric coated or any long acting medications (er, ex, la, etc) in nursing practice i have done things that i never "practiced" in nursing school. but as a general rule, if i have no experience or no prior knowledge, i don't do it. and shame on your instructor!

Your (family member) comes on (day of the week), this is (day of the week). We have a room for you. It is number _____. Let me show you. We even have turn down service (pull the covers back). ______(family member), brought you _________(favorite item...food, article of clothing, etc) so that you would feel more comfortable. Yes, I will be here in the morning. (They don't know who you are, but you are a familiar face) take 2 minutes and sit down with him or her. That 2 minutes to have a drink of soda on the front porch (just like the old days), or providing an activity really DOES pay off. Make sure all of their needs are met. Safe. Fed. Clean & dry. remember that just because you saw them walk into the dining room doesnt mean that they ate, offer finger foods esp favorite foods a wet or soiled brief is enough to make anyone want to escape! I have seen a normally pleasantly confused resident become violent, exit seeking, very sad/emotional when constipated or with UTI (and unable to pee)....when assessing voids per CNA reports....ask how much! take a time out! sometimes you just have to.