Hello all like many the SNF/LTC facility I am working in did not offer much of an orientation like I hoped. I find it very difficult some days because nothing is written down. There are no manuals or protocols etc. We're extremely short staffed, half the time I can't find a supervisor or my GNA. I ask many questions but not all of the staff here wants to be bothered by my inquisition of questions. I work 11-7 and I miss out on a lot of the learning experiences in the facility. A couple questions I'd like to ask (and please excuse my rambling and idiocy in advance):
What medications absolutely must be given daily? I know this sounds silly, but when I first started working here, if a person's medication wasn't in yet, a nurse would "borrow" the medication from someone else. The state came and there was an issue with this of course, and the DON said that was a big no no. Also there were many times when a new order was written in the MAR, but the medication took a day or two to get to the facility. Nurses were circling that date that medication wasn't given, so the DON said the start date needs to be when the medication arrives. The day after I was told about this I pressured into working 3-11. It was crazy, I was moving the whole shift trying to do my med pass & tx's... and I got to a patient who had a new order for Warfrin. It wasn't in yet from pharmacy and I skipped over it. Looking back I realize that was a huge error on my part. I should have went to the omnicell and tried to pull that medication or even "borrow" it from another, but I was so flustered I had a massive brain fart. So what medications would you say MUST be given?
What should I be looking for before I send a patient to the ER? I really feel there should be some criteria written down here somewhere!
What would you include in a good progress note?
For the night shift workers... when your checking your charts, what kind of errors are you looking for?
Thanks in advance!