lewwilann

Not a debate, but I just have some questions. (I wish I could ask my dad...he was a steel worker) So....I have a friend that works in a place that has issued a strike notice. There are adds posted in the paper listing the jobs, the fact that a strike notice has been issued and that the positions are temp to permanant replacements. So...I'm not sure how this works? There is still time for meetings/ arbitration and I guess they can reach an agreement and a strike could be avoided. But if it doesn't then they strike. From the description of the help wanted add, "temp to permanant replacements" ,how can they replace these workers? What happens to thier positions?

In an emesis. Can you use a hemmacult test? This is LTC and that is all we have on hand, beside the obvious apperance of the emesis. Is it accurate for vomit?

So can a staff nurse report an aid to the BON? I had an aid come in say hi get her paycheck and a note left for her, I think punch in, chat for a few seconds with staff then just leave. That's it. Reportable or not?

So your raises are based on performace evals? Since we are a union facility, raises are in the contract. Just wondering what "good" are the evals? What are union facilities doing?

I've done them before for the CNAs and LPNs. Daytonine..your forms sound like what we did. Its been a while since we've done them and I want to get the higher ups to start doing them yearly. I think they do serve a great purpose. Everyone needs positive and negative critacism...it helps us grow and improve. It also lets the staff know that poor performance won't be tolerated and also should put a system into place to correct it and help the employees maintain or improve on their skills.

Do you do them? Who does them for who? How often? What do they normally include? What are the consequences of them? Are you union or not or does it matter? Just wondering. What everyone else is doing in LTC setting. Any input would really help.

one of my newer resident's daughters brought in a 10 page list of instructions on how to take care for dad. Most of them are basic nursing care...flush the g tube after feedings, don't mix meds with feeding, but she also wants a complete bed bath each day lasting 30-45 minutes, toes cleaned with toothets, wash and rinse twice, turn every 45 minutes to an hr...etc. Most of her and others issues deal with bad experiences. The man got a stage 3 decub at an other LTC. Yep we vent in the staff lounge, but most of the time they aren't wacko....just dealing, in a bad way, with the placement of a loved one. Try to meet their and the residents needs...finding our what the "problem" really is also helps. Now....I've dealt with my share of wackos, too.

First what I do is set up a plan. I work 3-11. come in get report. at 3:30, I start the blood sugars and will also give them the pills. Then I start on all the residents that are out of thier rooms and catch a few that go by my cart. Then I will start down the hall. If someone is isn bed and difficult to get positioned or awake, I will wait until the CNAs get them set up for dinner and just come in and give them thier meds then. Make sure your cart is fully loaded before starting.

It is a little more difficult to find or get a hold of some docs when you are a LTC facility. No interns, residents, attendings. Do they have a service to take calls? If this happens, I keep calling the service and letting them know how important this is. If no response, call the medical director for orders....

Michelle...I like your idea. Does anyone else work for this co? (Starts with an E)?? What are you doing? PM me if you have any idea?

Exactly! but this is a corporate form .....large nursing home chain. This is no misunderstanding...the directions on the form tell us to do it...Maybe someone else works for this company?? Nother question...so even if this is policy now...am I more liable?

My company now has a new form that we are to fill out for incidents. When we are done, we are to place it in the chart in the nurses notes sections. Then make a note...incident report filled out..date it and sign it. This report and notation would be our nurses note. since they will be out of order...that is why we will indicate that we did an incident report. Goes against everything I was taught...any one else doing this?