NurseMellie

NurseMellie

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All Content by NurseMellie

  1. Charting Help!!!

    NurseMellie replied to Del07's topic in Geriatric, LTC

    Call and ask the DON what they want you to do. They will probably want you to come in and chart a late note as an addendum. While this is an oops, it won't cause problems with your

  2. Advice needed! Nursing home tips

    NurseMellie replied to KimRN24's topic in Geriatric, LTC

    Definitely a tough place to start... For me it depends on what shift you work. Days you hit the ground running with blood sugars and meds. I usually do diabetics first.... then the folks who are up in...

  3. Care plans in the LTC setting

    NurseMellie replied to sheebs_'s topic in Geriatric, LTC

    All licensed staff in my building are responsible for careplans. On admit, the admission nurse starts one and puts basic items in, transfers if known, glasses, dentures, hoh etc. More of that is...

  4. grandmother with dementia

    NurseMellie replied to nurseshellyRN's topic in Geriatric, LTC

    Reorientation is often the worst thing you can do with someone with dementia. You used the example of her oldest son being deceased. Reminding her of that can open the grief process all over again for...

  5. What does "On Call" mean to you?

    NurseMellie replied to NurseQT's topic in Geriatric, LTC

    Our on call folks do work the units if there is need but not often. We are fortunate enough to have on call nurses who often will work extra. Of course our full time staff also work extra hours to...

  6. care assistant topic

    NurseMellie replied to kimcare's topic in Geriatric, LTC

    1) Care assistants can do all of the things you mentioned. They may assist with transfers, dressing, per-care, eating, bathing depending on what your patient requires. 2) The unpredictability of some...

  7. Care plans in the LTC setting

    NurseMellie replied to sheebs_'s topic in Geriatric, LTC

    I also use PCC and use the basic template as a guide not necessarily as how it will be written or turned out... You can pull items straight from the MDS after CAAs are written.... now if you import...

  8. Frustrated With New Narcotic Rules

    NurseMellie replied to Donnagg123's topic in Geriatric, LTC

    My pharmacy has always required a valid script and a authorization code to get into the ekit. They implemented this years ago. We can order meds before the resident arrives using the hospital dc...

  9. Orientation for a new grad

    NurseMellie replied to CapeCodMermaid's topic in Geriatric, LTC

    I have assisted with training new grads after noticing that they were way undertrained by the nurses who were supposed to show them the ropes. We developed a LN Packet that has the protocols that the...

  10. fecal incontinence

    NurseMellie replied to 2bnurse12341234's topic in Patient Safety Issues

    We will often test stool samples if we suspect Cdiff or some other GI issue such as a bleed. But devices for stool are rarely used. Ive seen 2 in my nursing career, one was in the hospital and one was...

  11. UA/drug test failed

    NurseMellie replied to neuron's topic in General Nursing

    She cannot deny you a copy if the results. You are entitled to them. I would be getting others involved like the others

  12. Concerned

    NurseMellie replied to Quinntb's topic in General Nursing

    As long as you tell them you take the medication and can show you have an active prescription for it, you should be

  13. fecal incontinence

    NurseMellie replied to 2bnurse12341234's topic in Patient Safety Issues

    Oh boy, you opened a can of worms in that one. I can only speak from the LTC aspect. Many of my residents are older like 80+ and they have developed incontinence over time typically. Could be for a...

  14. Pain assessments - gabapentin?????

    NurseMellie replied to martymoose's topic in Patient Medications

    Bah! It was probably someone who doesn't get the concept of how meds work in the

  15. Having to count Risperidone

    NurseMellie replied to NurseJamie8's topic in Patient Medications

    It's not a scheduled med like Ritalin. It depends on your facilities protocols. We don't count it in my

  16. Non-Pharmacological interventions prior to distribution to PRN medications

    NurseMellie replied to gamedoc14's topic in Patient Medications

    In my experience, the Centers for Medicare and Medicaid (CMS) and surveyors want to see nonpharm interventions attempted and very well documentation regarding those interventions before giving a...

  17. Pain assessments - gabapentin?????

    NurseMellie replied to martymoose's topic in Patient Medications

    In my facility, we have been using gabapentin more often for certain types of pain. We monitor the pain level at administration but not necessarily an hour after its given. Really when you think about...

  18. PICC line blood draw

    NurseMellie replied to greyL's topic in General Nursing

    It all depends on what your policy is on the issue. Each place is slightly different. But yes flushing with 10, drawing and wasting 10, drawing what you need then flushing with 10 is the usual that I...

  19. Just to express the unexpressed

    NurseMellie replied to StacyAtheNurse's topic in Nursing Career

    WOW 2 hours to drive to work?!?! That is simply too long.... It sounds like you work in another state, is that so? If it is, you may want to look into transferring your license to your state some are...

  20. How do you treat your nursing students?

    NurseMellie replied to perfexion's topic in Patient, Colleague Relations

    It really depends on where they are in their program. At the place I work, we have 1st quarter or 1 semester students who most do not have any experience at all. With those student's you have to teach...

  21. Non-Direct Care Staff

    NurseMellie replied to TigerxLiLy's topic in MDS Coordinator Information

    Im responsible for 48 beds, some of them are long term but some are medicare. Right now a big stressor is empty beds, I have quite a few due to deaths n dc's, etc. Almost every morning before I do...

  22. Non-Direct Care Staff

    NurseMellie replied to TigerxLiLy's topic in MDS Coordinator Information

    I personally handle alot of things that happen with residents and not because I have to but I want to. I get it done and know how its supposed to be done. Usually if I tell a cart nurse something...

  23. I'm Just Doing My Job...

    NurseMellie replied to Bridgid Joseph's topic in Nurses Rock

    Everyone likes to be appreciated for the hard work they do, why should we be so different? When I have residents who thank me for something I respond with something like "Anytime" or just a plain...

  24. Requirements

    NurseMellie replied to rae313's topic in MDS Coordinator Information

    Clinical experience is always a positive thing. I doubt I could have done the job as a new grad. I am still new to the position myself. Each place is different on the types of duties that are...

  25. What is the average MDS coordinator to Resident ratio?

    NurseMellie replied to louiseltc's topic in MDS Coordinator Information

    I'm responsible for 48 beds and my partner for 51. We also assist with covering the floor if needed. We have a mix of long term, Med A and insurances going at this time. I usually don't have to work...