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pnurse68

pnurse68

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pnurse68's Latest Activity

  1. Iluvmyjob, Thanks for the support! I am sorry you feel that way about your DON, but maybe she is supporting you in ways you are unaware of. No one at my facility other than my administrator has any idea that this has happened including the CNA assigned to the resident at the time of the event. I would not have discussed this openly had the allegation been against someone else, and I do not see the benefit to doing so in this case either. I go to bat for the nurses and the nurse aides routinely, without them ever realizing its happening, I consider that to be a big part of my job. Happy staff make happy residents. Please never refer to yourself as "one that dosen;t matter". Nurse aides are the backbone and the heart of every facility. Having started as a nurse aide, I still count those shifts as some of the most rewarding of my career. I have a CNA that works in my building who refers to his job not as assisting nurses (nursing assistant) but giving aide. I love that. What greater privilege than to give aide to those in need.
  2. Thought I would update for those of you kind enough to reply. My company's legal team has appealed this ruling and we are awaiting a hearing date.. It appears as if my name is now on some sort of watch list where it will sit for 3 years and then be removed. The watch list is not public, however this still is extremely concerning for me. I do intend to follow the appeal process to the very end. Hopefully we will be successful at the first level. The information we have been able to review so far seems to point to a less than accurate investigation ( politically correct verb choice ). Disturbing on many levels.
  3. pnurse68

    Most important things to know in LTC ????

    Hard to remember but we are often taking care of families psychsocial needs as much as residents! If you can empathize with the families and build strong relationships, your shift will run much smoother. Nurse with your heart as well as your head and know when to listen to both. Nurse's Aides and Unit Clerks are your best friends, cant live without them :)
  4. pnurse68

    New Nurse, when to send a patient out.

    Also might be helpful for you to request the diagnostic testing from the hospital that supports the admitting diagnosis. They sometimes add diagnosis that are questionable. Such as dehydration but the BUN/Creat dont support that dx, or impaction but never did a flat plate. Even when the diagnostic testing supports the diagnosis, reviewing those labs and comparing with her baseline and medical history is a great way to learn. I found it helpful when I could attach lab values and such to a face and a circumstance. So much different than memorizing book stuff.
  5. pnurse68

    hobbies to keep dementia pts happy?

    We have a small MIU and one of our most successful items are individualized memory books. Upon admission families are encouraged to help their loved one feel at home by bringing items for a memory book. The book is then put together scrap book style by a team of the caregivers the family and the resident who helps as much as they are able. Its a great way for the staff to get to know the resident, and for the family to get to know the staff. They generate happy memories from the start of the residents stay and begin to form those vital staff/family relationships. The memory books are then used, successfully in most cases, when residents are feeling down, or anxious, or agitated....... Even the most demented benifit from staff knowing as much about them in the "before world". Looks great on a care plan too!
  6. pnurse68

    Fraudulent charting?

    I am not so sure that such documentation would cover your butt. If I am a surveyor, I am asking the nurse who documented as above..."Unknown lenght of time? When was the last time YOU saw the resident?" Mattress malfunction same thing and no one cares who fixed it, just that it got fixed. Your mat. log will be your proof if you need it. As far as the BP meds, 13 hours between administrations would be visiable on the MAR and by drawing attention to it, you also open your self up to the question of "what did you do about it". RN Supervisor aware is not going to do it either. The next question would be "do you have a policy that states only the Supervisor can call the pharmacy". I understarnd your DON's concern. Ensuring the best care for the resident is paramount however, you do not know how long the o2 was off, could have been 2 minutes or 2 hours. You dont know how long the mattress was down, or that the ulcer was avoidable......... Caring for residents is a team effort and takes all nurses and aides involved. The cover my self thing usually dosnt work. At least in my experienc.
  7. ccm.....Thanks for the invite to PM...however I am still too new of a user to have that function enabled. Guess I will need to come up with more post topics:yeah:Spoke with legal today, a thankfully I work for a very supportive company that is willing to stand behind me. I have yet to speak to anyone who has seen this before. Kinda gives new meaning to the whole "your working under my license" line. Sometimes I wonder why anyof us give up the joys of floor nursing, heck even shift supervisor for this!
  8. That is the interesting part DOH did not tag anything. Just area agency on aging. I am filing appeal but have been denied access to the investigation despite the Right to Know Law. Will be talking to legal counsel today and will keep you all updated. Thanks for the support.
  9. pnurse68

    on call rotation

    I have doen call rotation a couple ways. Currently I rotate call with 2 Clinical Coordinators and if a need can not be met the person talking call covers it. I have also worked when all RN managers rotated call and our on call weekend we were required to come in for 4 hours each day. In return for that we took the following Friday off and had a nice little long weekend. I kinda liked that come to think of it
  10. pnurse68

    Bathing in LTC

    Our nurse aides are responsible for their showers. The showers are split between 2 shifts and the residents can choose their preferred time. The nurse aides must report to the nurse any deviation from the shower scedule such as refusal by the resident or held due to family outing ect. The nurse is responsible to confirm that information by visiting the resident and offering the shower again or scheduling an alternate time. That being said, it is also the residents right to refuse. Documetation and care planning are key.
  11. Hi, Looking for someone who has had a similar experience as my state's local aaa office nor the main office can help. I am the DON of a facility that reports absolutely everything that could even remotely be construed as abuse: the demented lady that state "the father of the would be child slipped in the the night with his friend and 12 men raped her", I mean EVERYTHING. My thought process is that I would rather report and withdraw than not report and get tagged. Recently while I was on vacation, a resident fell and sustained a hematoma. She is a long term resident with no fall history, no attempts at self transfer in the 9 months shes been with us, alert and oriented, transfers and ambulates with contact guard/supervison. Nurse aide assisted to bathroom and left her to do her thing. By history she has always used the call bell when she was done. This time she leaned over to adjust her O2 tubing and fell. Minor injury, hospital eval and back in 3 hours. I instructed the ADON via phone to report. DOH questioned if the the facility had followed the plan of care or was neglect suspected. I instructed the ADON to state plan of care was followed and no neglect or PB 22 needed. They accepted the report. ADON also reported to Area Agency on Aging. They investigated and wanted to substantiate abuse against the nurse aide for not staying in the bathroom with the resident. I stood behind the nurse aide stating, he would not have needed to stay in the bathroom with the resident as that is not her plan of care. She ended up not tagging the nurse aide. She substantiated neglect against ME as the DON, for not educating staff to stay with the resident. I am appealing and the road blocks are considerable, no one can even tell me who this is reported to, how it impacts my license nothing! Anyone have similar experience??????