Terse

A recent NPR segment highlights on-the-job injuries. Apparently we nursing staff (including Nursing Assistants) are injured on the job more often than police, firefighters and construction workers. Colleagues of mine have been injured on the job but not noticeably more than other professions in which friends and relatives work. 1.) Have we noticed relatively increased numbers of on-the-job injuries compared to other professions? 2.) What do WE as nursing staff (administrators, direct-care nurses and nursing assistants) recommend to protect ourselves from on-the-job injuries: lift teams, lift equipment, maximum work hours, employer health club contributions, in-services or anything else? What are our suggestions to keep ourselves healthy to better care for patients?

Sixtyseven: Possibly eight months ago one of our current RNACs proposed a "No Alarm" idea at a facility meeting. Our Director of Nursing expressed preliminary support for the idea. No policy has yet materialized. My experience has been similar to yours. During a standard night shift sensor alarms will ring and patients unsafe to self-transfer try to do so or have shifted precariously in bed. This is particularly true among patients within three days post-admission. We (Nursing Assistants and I) consistently arrive "just in time" to keep the patient from self-injury. Needless to say at first glance I feel the "No Alarm" policy warrants further consideration. The question is whether bed and chair alarms, possibly disruptive of sleep, peace of mind and patient dignity, perform a greater good by preventing falls, potential injury, and rehospitalization. I suspect that they do. We need evidence. Over the next month (February 2015) I'll keep secret tally of how many patients are saved from evident risk of injury through alarm responses by my Nursing Assistants or me. To be fair, I will also track ringing alarms unrelated to patient safety. Look for results in March.

Thanks.

...Or maybe I'm just making excuses.

Aside form my supervisor I was the only full-time MDS Coordinator in the office. Two others worked half-time each, making a third of sorts. All but one (who often asked me for advice) were very approachable and cooperative, answering questions I might have. Our Corporate RNAC was not directly accessible by me and was responsible for multiple (20?) facilities in three states. Training consisted in hour-long once-a-week teleconferences each of which covered two or three MDS sections line-by-line, not far removed from simply reading the manual. I did complete some self-directed MDS courses on the corporate Continuing Education website and these were helpful to reinforce some of the information. My duties also, of course, consisted in care planning, resident interviews and interdisciplinary meetings. I scheduled rarely. Perhaps worth mentioning is that our facility, still reeling from CMS reimbursement cuts, had just undergone a terrible Survey with 15 F-tags and correction plans followed by a management change. Perhaps Corporate's patience was already minimal.

You mention certification. According to the AANAC website, earning an RAC-CT will be $560.00--10 classes at $45 apiece not including the $110.00 AANAC membership. Is the program worth the cost? I calculate that it is but need to learn more to be certain. What do you think? And thanks.

Hello, colleagues. This is my first post to AllNurses and I have a question: I have worked at my facility as a CNA and a floor nurse and was just this past November (this being July) asked to work as an RNAC. We are a Pennsylvania SNF with 120 beds, approximately half of which are short-term rehab (average length of rehab stay about 8 to 10 days as a general estimate). Our reimbursement structure is roughly 45% Medicaid, 30% Medicare/Medicare Advantage and the remaining 25% private insurance. Needless to say, we're hopping. My supervisor, very knowledgeable and sincere, remarked to me as to how quickly I managed to learn the data-mining required for MDS completion. I also began feeling increasingly familiar with the MDS despite occasionally referring to the Manual for new situations. As time progressed, however, she began to comment that the MDSs needed to be completed more quickly than I had been finishing them. I was told to "do whatever it takes." As I focused on speed, accuracy suffered. The converse occurred when trying for accuracy. To curtail a long story, I was dismissed for insufficient or(/and) inaccurate work. I really like my colleagues and feel crushed at having let them down. I also LOVE sifting through the data to know what's up with the residents we're treating. Plus, despite the silent derision I received from the "real nurses" on the floor, I know we RNACS directly impact patient care as we help inform other disciplines and move the facility mission (no margin, no mission, as the phrase goes). It really is an important job. So if you were in my shoes, what would you do to win the job back? I know passing online training courses isn't enough--I must demonstrate competence. But how? Thanks.