I work in LTC so I have a lot of interactions with medics. I give them report, most times I'll stay through their initial assessment or collection of history so I can advocate for my patients, this isn't long at all. Then I'll ask "Is there anything else you need from me?" and go on my merry way.
Is the social worker newer at their job? Sometimes social workers don't really understand the nursing assessment and process. She also may have no understood that you handed over all care. Also the patient was discharged at 11am. He was no longer a patient of the facility, so you really weren't his nurse anymore.
casi replied to tnbutterfly - Mary's topic in Nurses
Much love and hugs to the Short Family and the AN staff. I am shocked and saddened by the news. I have been a member of AN for tooooo long and remember when it was small enough to see Brian take a more visible role with posting, such a nice guy.
I would find out from the nurses and the nurse managers what education they want and feel like they need. Some of my favorites are UTIs (not blaming every change or behavior on a UTI and getting away from constant UA/UCs), respiratory care (I can't tell you how often I find someone with a mask on at 2L), IVs, g/j-tubes, wound care, labs
I work in LTC/Post Acute and we are starting to see a lot of people recovering from influenza. We're also swabbing resident's like crazy. When I worked Friday the nurse managers were arguing over the few swabs we had in stock.
The post-acute patient's we are getting that are recovering from influenza are freaking sick. The local hospitals are d/cing some really sick people to make room for all of the new influenza cases.
I actually might suggest something like this. I may not say it so bluntly, but I'd point out that the use of MVI and other various vitamins frequently leads to GI upset and nausea. If they are worried about their loved ones intake or nutrition maybe they can bring in food from home or spend meal times with their loved ones.
What are you seeing that you consider deplorable? Maybe we can give you a better view of what is going on.
I've found that in most placed I've worked we've worked really hard to educate our families and resident's on EOL issues. For the most part most of the resident's I've worked with have had DNR/DNI orders and orders for no tube feeding and in some cases IVs. When you are at a LTC as a student ask about and look for patient POLSTs. Just because these people don't want CPR done, doesn't mean we don't treat them. Grandma can have a CVA or a MI and we are still going to send her to the hospital. Grandpa could come down with pneumonia and we are still going to give him antibiotics if his POLST states it's okay we maybe will have to do IM or IV antibiotics. If grandma or grandpa has something that it looks like they aren't going to recover from or will greatly impact their qaulity of life we'll be talking to the family about palliative and hospice care and changing orders to do not hospitalize.
casi replied to JustAdmitToObs's topic in Geriatric
This actually seems a little scary to me. I'm used to management leaving nurses to their own once they are "trained", but the lack of organization and the four days of training for a new nurse seem pretty scary.
I am so thankful that my current place of employment really pushes the idea of chronic urinary tract colonization and only treating symptomatic positive UA/UCs. Also not collecting UA/UCs just because Mrs. Jones fell, is more confused, or looked at a staff member funny. It's really a matter of educating staff and educating prescribers.
I also think that we are working with a population that believes there is/wants a pill or a cure for everything. I can't tell you how many patients I've had who demand cough syrup or Imodium after I explain that their cough or their small amount of diarrhea is beneficial in what their body is fighting off. I think that healthcare workers as a whole get sick of arguing are afraid of bad customer service surveys so they become complacent and give patients what they want.
AMDA: Publications - Caring for the Ages - October 2002