Plagueis

For PRN orders, our consult pharmacist discourages orders without a specific time frame. If an order is BID PRN, it should be written every 12 hours, or for TID PRN, every 8 hours. This is to prevent confusion about exactly how much time should pass ...

I'm a newer LPN who was recently switched to the 11 to 7 shift. The last time I worked, a couple of the CNAs fell asleep around the nurses' station. They told me that they don't do it on purpose, but that it's hard to stay awake on a shift where th...

I have some questions about facilities requiring staff to stay after their shift is over because they cannot find people to work the next shift. This hasn't happened to me yet as a CNA (thank goodness), but I know of plenty of others who have told me...

The midnight shift is responsible for chart checks where I work, and that is a 24-hour check. In LTC, nurses often have 30 or more residents. When do they have the time to check 30+ medical charts for every single order before the med pass? Plus, I'v...

I've never heard of artwork being considered a state violation. Every LTC facility I've been in displays the resident's artwork. I would think there would be more serious things for state inspectors to worry about.

And I'm sure that at some facilities, the nurse who confronted the DON and wrote the complaint would be fired for insubordination, or for some other reason.

I was interested in the studies regarding taking a nap while at work that was previously posted, and how it can be beneficial. However, every place that I've worked (in LTC) at had rules that prohibited sleeping at work, even on breaks, and that slee...

I can also add the following assessment sheets that my old LTC used: Braden scale, pain, wander risk, and physical mobility. Also, we had to send the diet slip to the kitchen and weight the resident. Plus, sometimes there were consults for follow-up...

I work in LTC, and I've worked every shift. From a work standpoint, I would prefer to work the overnight shift over day shift anytime. I admit, I found it nearly impossible to sleep in the daytime, and noisy kids, neighbors, and insensitive phone cal...

In my experience, most issues with meds involve the pharmacy not sending refills in time, even if they are ordered. Just yesterday, for instance, two meds I pulled the refill label for last Thursday were still not in. (I was off the days in between....

Correct me if I'm wrong, but I'm assuming the Mucinex you're referring to are the granules, since the pills are extended-release. How well do the granules go through a peg tube?

I understand that resident's need a physician's order to apply ice, heat, or even for Vaseline, for instance. However, recently I've seen orders to D/C particular food items from a resident's diet. For example, one order was to D/C waffles with brea...

First, thanks to everyone who responded. And, no, our orders aren't computerized. Diet orders here, or so I thought, just list the kind of diet (ie. regular, puree) the resident is on. It just killed me when I saw the POS with these food preferences ...

Unfortunately, I know a few nurses who were written up for not giving a PRN pain med at the family's request, despite the fact that the nurses assessment didn't warrant a PRN. So some places may "punish" a nurse if they don't please the family. t

Hmm. I think I worked with the clone of that guy you mentioned. The nurse I know would finish his two meds passes in less than an hour. However, when anyone else (including me) worked that section, it would take almost 2 to 3 times as long to finish.

I've been hearing stories from my fellow nurses about not having enough equipment (or it goes missing) at work, so they end up buying their own, such as personal pulse oximeters or wrist blood pressure machines. I would then ask if they made managem...

I've had pharmacy reps follow me and my coworkers (not state surveyors), and there were a few things that they flagged that may not seem like biggies, but were important to them: Make sure all spoons on the cart have their handles up; don't use the g...

Yep. Same thing happens where I work. Some of my coworkers have been written up and suspended when they stood up for themselves, or tried to be firm with rude residents or visitors, because the resident complained to management.

The same thing happens in LTC, too, and it makes me very frustrated. I don't get it. When I've personally gone to a drug store with a script, and there is a question about what the physician ordered, the pharmacist herself calls the physician for cl...

I'm sorry that this happened to you. However, in my experience, this type of behavior is not limited to the younger generation. I've seen older people (50 and up) go crazy with the call bell, demand drinks and food for visitors, and expect personal m...

We must have the same pharmacy at my LTCF that you have. Moreover, the we-already-sent-it line often applies to other refills that we faxed days ago, but still haven't received, despite numerous phone calls to the pharmacy. We keep all of the receipt...

Two of my coworkers in LTC are in their 60s; one has decades of experience, while the other is a newer nurse who graduated from nursing school a couple of years ago. They both work the med cart (plus the desk, treatments, admissions, etc.), and are t...

I'm a LPN, and I'm conflicted about whether to leave the LTCF I work at, even though I'm still on "orientation." I loved working in LTC as a CNA, but ever since I've been on orientation as a LPN, I hate it! Although I'm still supposed to be on orien...

I'm a newer LPN with one year of experience in nursing homes, and I was wondering how the market was in the Dallas-Fort Worth area for experienced LVNs. (I'm currently in high-cost New Jersey.) I know that hospitals are out, and I'm used to LTC, so I...

Wow. 165 residents? Even 120 sounds like way too many to be responsible for, even on that particular shift. I had 60 when I worked the 11 to 7 shift, and I was busy the whole shift. One thing I'm curious about is how only around 10 of them have sch...