Nascar nurse ASN, RN

LTC, Hospice, Case Management

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Self Administration

Nascar nurse replied to Marija1's topic in General Nursing

Chances are someone in your facility has done an assessment on their ability to self administer their medications on some kind of standardized form. Once that has been accurately completed (an...
8 Dead at Florida Nursing Home without power after Hurricane Irma

Nascar nurse replied to Blackcat99's topic in Nursing News

I suspect there will be more to the story before it's over. I'd like to know if all those that died were in the same proximity, like was it actually a carbon monoxide problem rather than
I Have A Dream

Nascar nurse replied to crazynursesanemom's topic in LTC: Directors, Assistant

I attended a seminar recently and my take away message is "You have to plan to make time to plan". For years I've just let the job take me as it will...jumping from one fire to the next. I'm...
Excessive absenteeism

Nascar nurse replied to RRRNNN's topic in LTC: Directors, Assistant

Personally, I've got no time to play with a point system. Seems just to much work. 3 tardies = 1 absence, _X__ amt of absence = verbal, then __X_ amt = 1st written and so on until termination. I...
Showers in nursing home

Nascar nurse replied to Vonique's topic in Geriatric, LTC

Exactly as CCM said. Start with the DON and administrator of the nursing home. It is their job to handle such concerns & if he has been receiving "pretty good care all along" there is no reason...
Full Code patients in Long term care

Nascar nurse replied to beatrice1's topic in Geriatric, LTC

This is actually addressed in the new rules of participation as well. It essentially states that that you are to follow the resident/responsible party wishes if you have been unable to get a...
Full Code patients in Long term care

Nascar nurse replied to beatrice1's topic in Geriatric, LTC

Right out of the newest rules of participation - federal regulations =CPR will be started unless a valid DNR order is in place or obvious signs of irreversible death (e.g. rigor mortis, dependent...
Crushing Oral Medications...New Regulation

Nascar nurse replied to ltcnurse4u's topic in Geriatric, LTC

I just attended a seminar on the upcoming rules of participation and this was discussed there as well. 1. The rule is crazy and proof it's written by someone who has really never done a med pass....
Did I do something illegal?

Nascar nurse replied to NurseWC2's topic in Hospice, Palliative

Sounds to me as if you were just managing her symptoms to provide comfort. I've suctioned hospice patients and given
Your FAVORITE job

Nascar nurse replied to chacha82's topic in General Nursing

Hospice - hands down. Never felt like more of a "real" nurse...have never had more heartfelt appreciation and feedback....have never felt like I made more of a difference EVERY SINGLE DAY than that...
So long, farewell, adieu

Nascar nurse replied to CapeCodMermaid's topic in Geriatric, LTC

The best of luck to you! It's a sad world and we just keeping getting older and little closer to it
What happened to common sense?

Nascar nurse replied to CapeCodMermaid's topic in Geriatric, LTC

After over two months of trying to beat assessment skills and follow up documentation into my nursing staffs heads......Reviewing lab reports from previous day - already all scanned into computer...
Come On People, How Stupid Are You??

Nascar nurse replied to CapeCodMermaid's topic in Geriatric, LTC

I got nothing to add. I just came along to shake my
Management?

Nascar nurse replied to Shortone7's topic in Hospice, Palliative

Well, I was going to respond but Berryhappy did it for me! All I have to say it ditto to the above and
Falls!!!!Falls!!!!!Falls!!!!!!

Nascar nurse replied to texas tea's topic in Geriatric, LTC

Just a recent observation regarding falls in my own facility. I've been the DON of a small rural 42 bed facility for about 6 months now. When I started they had approx 15 personal alarms and...
Why is Neudexta not covered?

Nascar nurse replied to doggal's topic in Hospice, Palliative

My best guess is because it's not on any hospice's formulary. This is VERY expensive medication and it's really not a cost effective medication when other medications may provide a similar enough...
Using hospice protocol

Nascar nurse replied to sparkyswife's topic in Hospice, Palliative

The best advice I can give you is to get ahead of the "game" and stay on top of it. When admitting a patient, try to get physician to write for Morphine 120ml fill in 30ml increments, or Lorazepam...
Charting has to be done no matter what?

Nascar nurse replied to Blackcat99's topic in Geriatric, LTC

I wonder if you are misunderstanding your DON. Things such as medicare charting needs to be done daily but there is no requirement as to what shift it needs done on. Therefore if days doesn't get to...
Call 24/7/365, no back up - is this reasonable?

Nascar nurse replied to Lucky724's topic in Hospice, Palliative

Oh yea - this is basically what happened to me. And it was never good enough, never a thank you and IT WILL BE NEVER
Call 24/7/365, no back up - is this reasonable?

Nascar nurse replied to Lucky724's topic in Hospice, Palliative

I'll give you a comment. A couple years ago I helped open a local hospice company. I had been a friend of one of the owners (also an RN) for years. I was offered a great salary too due to knowing...
Hospice Compliance

Nascar nurse replied to ComplianceMgr17's topic in Hospice, Palliative

Actually, I'm surprised any pharmacy will even accept a verbal from a nurse on CII. None of ours around here would. Ultimately it would be the pharmacist/pharmacy that would be fined for this -...
Questions

Nascar nurse replied to The_thinker's topic in Hospice, Palliative

Yes, just like the above poster. We actually had a death once and no one was able to get to them. The local police were called who had access to 4x4 equipment and they went out - rest of death call...
Too much Morphine-scopolamine+stesolide

Nascar nurse replied to KarinBe's topic in Geriatric, LTC

I'm a Director of Nursing in a nursing home as well as a certified hospice nurse. Morphine is often used every hour at the end of life. I can only make an assumption that they got busy and forgot to...
Hospice EMR

Nascar nurse posted a topic in Hospice, Palliative

I'm looking for opinions on hospice EMR software. My company will be purchasing a program in a few months & I learned today that I ultimately get to pick what we will be using! Advice, opinions,...
2017 Nurse Salary

Nascar nurse replied to Darkstar1485's topic in General Nursing

Location: Midwest Experience: RN 2005-present, LPN 1986-2005 Specialty: Skilled nursing facility, Director of Nursing (5 years DON experience). Very small rural facility (ie; laid back/easy going...

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