nikkibobicky

Hi, everyone. I left MDS a couple years ago to do floor nursing, and I just recently started back in MDS. One of the tasks I've been assigned is to shadow CNAs to observe their ADL care, and then match the care I've observed to how they're documenting the ADL care. I know ADL documentation is an issue in every building, probably everywhere in the country...but because this is part of the money making, this building is trying to ensure as much ADL accuracy as possible. My question is: Does anyone have any pointers or suggestions for training CNAs how to correctly document the care they're providing for residents? Occasional in-services definitely don't work, colorfully printed graphics explaining the difference between independent, supervision, limited assistance, extensive assistance, and total dependence don't seem to work. Other problems I've encountered is trying to explain the difference between walking and locomotion, charting before actually caring for the residents, when they should chart "activity did not occur." and generally being diligent about charting their ADL care for residents. Thanks for any tips and pointers!

About a month ago, I returned to working in a SNF after working in an acute hospital and an endoscopy center. I chose to return to the SNF setting mostly because you keep the same patients long enough that you can actually begin to see how you're helping them, and I think most of us went into healthcare in the first place because we wanted to help people. All that being said, the turnover and call-offs are EXTREMELY high in this place. I think one of the main reasons is the negativity among staff towards other shifts and even against specific staff. Like day shift saying the night shift staff doesn't do anything, the evening shift saying days didn't do this or that, and on and on to the point where the staff seem to belittle each other during shift change and then talk about other staff in a negative way during shifts. I personally think that if a good team is built, the residents overall receive better care because if someone misses something, the next person can come along and say "oh! this didn't get done, let me take care of that!" instead of "OMG day shift didn't do this AGAIN???" What are some recommendations I can bring to my management staff to help build a better team? P.S. Enforcement of the attendance policy is one thing I'm already going to bring to their attention.

Yeah, there aren't any actual calculations on the stat assessment- it's all theory. I made concept maps and focused only on the competencies. When I finished the test, I had no idea if I'd passed or not, but I did.

we're a mixed tele, med/surg, peds and sub-ICU critical access hospital. We get up to 8 each on nights, here. Sometimes with drips, blood transfusions, etc. We get most of the admissions on night shift, so even if we only have 3 or 4 patients at shift change, we may end up with 6 or 7. I feel like it's a lot, but I also am considered a "new grad" because my LPN experience didn't count as nursing experience when I got my RN and started looking for RN jobs..the other thing is that the particular county I work in is the poorest in the state, so I am underpaid not only by national average but also by state average....but....I am looking at it as a "learning experience" and am trying to remain grateful that I found a job in a hospital as a new grad RN since most of my graduating class (15) still haven't found RN jobs.

I finished the assessment class in about two weeks, and I'm scheduled to take my statistics assessment on Tuesday. I really enjoy my program mentor and I enjoy the way the classes are set up. My goal is to finish in 6 months, but, realistically, I'll definitely be done within 12 months at this rate.

I only went to CGCC for block 3 and block 4. I actually got into block 3 because of the lawsuit drama. Compared to the experience I had 6 years prior at Gateway in the LPN program, I think CGCC is a great program. The teachers actually work in the nursing field and one of them works to help develop NCLEX test questions. Yeah, it's difficult. I think it's very fair and, in fact, at the end of each block we were asked to meet with the director so we could give her our feed back about the instructors, the learning resources, and whatever other questions or concerns we have. CGCC has one of the highest NCLEX pass rates of any school in the state- including bachelors' programs. And let's be honest- nursing school sucks, it's stressful and consumes your life, no matter where you go.

I'm late to this conversation, but I just wanted to second the seniment that SNFs get a bad rap in the world and I think it sucks. I spent 6 years as an LPN working in various SNFs- first long term care, then sub-acute, then in administration- before I went back to school, got my RN, and now work in an acute hospital. After spending so much time in different kind of SNFs, it's hard for me to comprehend why they would be thought of as "old people warehouses," because more often than not, they're communities where the residents have extremely close relationships with other residents. Yes, the patient to nurse ratio is way higher than in an acute setting, but then again, you're most likely going to have the same patients day after day for months or years wheras in an acute setting, you may only have 6 or 8 patients but with admissions and discharges, it's not unreasonable to see 12 different patients in a shift. Personally, I think medicare.gov is a good judge of how a nursing home is run overall. But yeah, the biggest clue is if you walk in the door and it doesn't smell like it should.

I am!! I finished that EWB class in a night and a half and I'm pretty excited to start! I haven't gotten any mentor information yet, I'm assuming we don't get that 'till 3/1/13, but I can see both the classes I need to take and the stuff that transferred