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Any DNS job description includes: " any and all other responsibilities as directed by your Administrator", which leaves it open for ANY additional duties. We are at the mercy of Consultants who are only interested in Reports and how to cover themselves. However, when it all comes down to it,we as DNS's are responsible for all nursing related issues in our Building.Most work endless hours r/t ability to improve/implement nursing services & balance the paperwork required.We are also implementing "culture change" for our workforce,but until the culture changes at the corporate level, this will continue to be a problem for all of us.
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I presume you are computerized, which will make it easier to check for meds; start with unused prn's, if not used in 30 days, they should be dc'd. Check any neb tx that are continued after an acute episode has resolved ( pneumonia/URI), check Blood sugars for results, and if within range, decrease to BID, then QD ect..have you done reductions with psych and sleep meds? In my state we are required to reduce them quarterly and document behaviors, if none observed they can be slowly decreased over time. After that, you will have to work together with individual patients to see what is appropriate and discuss with MD. Over time, this can be done well with the cooperation of you MD and Pharmacy recommendations, it does take some time! Don't forget, per CMS guidelines, antidepressants/ anti-anxiety meds do not need to be reduced! Hope this helps!
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There is NO time in a patients stay where it is ok not to change him/her, or get him/her up if it helps with eating ect. Staying in bed and staying wet will cause decubiti in no time! This is NOT acceptable and you need to let your superiors know!
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Usually in these cases, nurse managers would perform a drug test on you before even letting you go home that day, then investigate the issue , and only if you are not cleared, report it to the nursing license board. ( this does depend on the State and the Hospitals rules). Check your handbook for rules concerning this!
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whatever you do, DO NOT talk negatively about your current job!!! No matter what you think about it! Speak about the future and what you aspirations are for it. Any time you speak about another work environment in a negative way, they may see it as a complaint , or a person not interested in fixing that problem. Trust me, I have heard it all in interviews and what makes me want to hire one nurse vs another..Good luck!
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Maybe some nurses have forgotten where they once were! All of us have to start somewhere. If we don't help each other, the job is even harder. I have been a nurse for many years and worked in all different settings, but have not forgotten what it was like to start out new!
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Depends where your area of practice will be. If you are going to work in a Hospital, you need to be an RN, most LPN's are being phased out. Even RN's need to have a BSN to work in most areas. If you are planning to work in a Long term care facility, you can get decent pay as an LPN.
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I dread the Holidays because of staffing issues....every Nurse and CNA would like to be off at the same time, but we need staff to attend to patients! Would love to be able to give all the day off, but that is just not possible! Tried different rotations ect,ect....have not found the perfect solution yet! But I am determined to find it for 2014 Holiday Staffing/Rn daily grind! :)
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The weekly meeting requires Long term care facilities to discuss Infection control, wounds, weights, falls, restraints, restorative ect. ( depending on state). I have all Care plan nurses attend, nurses in charge of individual departments, dietary, wound nurse, safety nurse, plus administrator, social services and charge nurses for each nurses station and discuss the residents that are in review for the MDS. This way we have everything covered with all involved disciplines and we all know what is going on with the residents. Hope that helps..can give more details if you need :0