Medicarenurse1

Latest Activity

1. MDS - Where to Begin?

   Medicarenurse1 replied to janlem's topic in MDS

   Talk to your current MDS coordinator(s). There are big changes coming on October 1st, which may make some facilities not want to hire a new person until after the dust settles. Also check out: American Association of Nurse Assessment Coordinators....

2. Only Crusty Old Bats will remember..

   Medicarenurse1 replied to Pepper The Cat's topic in General Nursing

   Evening shift gave backrubs to all with one bottle of lotion, not a glove in sight. Taping hip to a full side rail, with buttocks exposed to the door so that the heat lamp could be on the sacral decub for twenty minutes and leave the door open so I d...

3. Ridiculous medical mistakes on TV

   Medicarenurse1 replied to adventure_rn's topic in Humor

   I liked House, where the doctors were always giving meds. Yeah, right.

4. Questions for an acute care nurse.

   Medicarenurse1 replied to dudette10's topic in Geriatric

   Hi, I'm an MDS coordinator, and as an acute care nurse, you would have no reason to know what that is, but my job is to provide clinical information to CMS for reimbursement. We have several levels of care in nursing facilities, and when a person co...

5. Restorative right or wrong??

   Medicarenurse1 replied to 120961mykel's topic in Geriatric

   In a perfect world, the floor CNAs would be able to do restorative programs, most especially ambulation, brace/prosthesis assist, feeding and actually all of them. The CAVEAT is the charting for both the CNAs and the nurses. The RN needs to over se...

6. section L and M question

   Medicarenurse1 replied to dianediane90's topic in MDS

   If the Braden is 18 or less, I proceed even if I don't think the person is really at risk, and I do that to cover my clinical decision. However, I care plan almost everybody except ambulatory psych residents if they are even rarely incontinent or ne...

7. No pain meds in ER??

   Medicarenurse1 replied to ShaneTeam's topic in Emergency

   Went to an ER six months ago with an acute kidney stone, 200 + miles from home, knowing it was probably a kidney stone. Drove to a hospital I was familiar with in the area (I travel the state as a reimbursement nurse for LTC.) Could barely walk whe...

8. Facility refuses to give raises

   Medicarenurse1 replied to baygrl11's topic in Geriatric

   One community where I worked, people in my position would step sideways every two years for this reason. I am an MDS coordinator, so when one facility lost an MDS person, we all moved over one facility. That kept us from getting into a pay rut. Ea...

9. Guilty and relieved at the same time

   Medicarenurse1 replied to mtjoanna's topic in Geriatric

   Well, I've been in LTC now for the last 16 years. What I have seen is that facilities ebb and flow in quality. I have worked at 5 Star facilities and 1 Star facilities, helped get a de-certified facility back certified, and lots of other in between...

10. Nursing Supervisor salary

    Medicarenurse1 replied to KBICU's topic in LTC Directors

    True with a caveat. It takes years to learn all 6000 laws regulating nursing homes in the United States, and missing some of them will lose you your license, just sayin....Remember 6000 LAWS governing, and you are responsible if your staff does not...

11. Social Media

    Medicarenurse1 replied to CapeCodMermaid's topic in LTC Directors

    I was visiting a facility where a new CNA came to the DON and resigned on her first day on the job. Someone had posted something mean about her on facebook after she got to work. The astounding thing was that three of the managers in stand-up handed...

12. HELP!! Care plans on MWD orders

    Medicarenurse1 replied to KathySandersSoffos's topic in LTC Directors

    The MAR and TAR having these things on them allows you to document that you did assess for behaviors, side effects and that you took preventive measures for risks. They may well be on a care plan, but no one will document that the way they do in the...

13. Preparing for state survey nightmare

    Medicarenurse1 replied to Khaos RN's topic in Geriatric

    Yes. As a Regional Consultant, I do "Mock" Surveys, pulling all the quality reports, creating a resident sample and remotely reviewing electronic charts before I go to the building. The med carts are so easy to keep clean and well stocked that it i...

14. New MDS changes

    Medicarenurse1 replied to g8torlpn69's topic in MDS

    Actually, rehab hospitals (like HealthSouth) have started having to do MDS like reports using the Functional Abilities and Goals. It means if we want to play with the big kids and get paid like the pros, we have to meet the same standards. The whol...

15. Humerus FX - Sig. Change

    Medicarenurse1 replied to Cecilianurse's topic in MDS

    One thing we tend to forget about sig change is: Is the condition likely to resolve? Now if it was a pathological fx, with underlying cancer or osteoporosis, I would probably see if it's time for hospice, and ask the team for their input. If it wa...