NurseMellie

NurseMellie

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All Content by NurseMellie

  1. stasis vs.pressure

    NurseMellie replied to dianediane90's topic in MDS Coordinator Information

    That is certainly tricky. It may be both a stasis ulcer and a pressure ulcer. As Talino mentioned if there is no documentation for the previous MDS from the MD, and you have just based it on nursing...

  2. Becoming increasingly frustrated at work.

    NurseMellie replied to rpsychnurse's topic in Geriatric, LTC

    I totally get the frustration piece. As RCM I have lots to juggle on my plate. I have been accused to being threatening to my staff when I have informed them of something they need to be doing or face...

  3. Accepted job as MDS nurse but skeptical!

    NurseMellie replied to tattooednurse26's topic in MDS Coordinator Information

    It is difficult to learn the MDS especially when the training is hit and miss. I often had those same types of days in the beginning of my training. I would be pulled to do an admit or work the floor...

  4. Non surgical dressing

    NurseMellie replied to glm777's topic in MDS Coordinator Information

    You are covering a surgical site so is a surgical site, coding under nonsurgical would be inappropriate. You have to think of why you are doing the

  5. Getting started as MDS nurse

    NurseMellie replied to farmgirl2's topic in MDS Coordinator Information

    Yes, it the 14day pays for days 15-30 of the day. There are graphs in the MDS manual that show what assessments pay for which days of the

  6. indefinite suspension because of med error

    NurseMellie replied to bunbao's topic in Geriatric, LTC

    With a blood sugar of 75 some other intervention should most likely have been done. In most facilties that I am aware of a blood sugar less than 80 requires some kind of intervention and a follow up...

  7. New to mds

    NurseMellie replied to Mrs.1908's topic in MDS Coordinator Information

    I have a blank calendar that I start with, I then pencil in the OBRAs which are the quarterly and annual assessments. So you have 92 days from the previous quarterly assessment to do another...

  8. New to mds

    NurseMellie replied to Mrs.1908's topic in MDS Coordinator Information

    Open the RAI manual and go to chapter 2 page 41. There is a list of what you need to remember. You have until day 8 to set your 5day ARD. You should be doing a 5 day atleast. If the resident stays...

  9. New to mds

    NurseMellie replied to Mrs.1908's topic in MDS Coordinator Information

    I have a couple of different sources that I use. One is Point Click Care for our main charting system and then the Contracted Therapy's system. Between the two I set the dates. In your manual there...

  10. Nurses who can't give out narcotics

    NurseMellie replied to Blackcat99's topic in Geriatric, LTC

    I have helped with passing narcs for some other nurses. It can be a pain yes, hopefully they are not working at the same time. Maybe the RCMs or MDS nurses can come help pass some of those narcotics,...

  11. Dehydration CAA

    NurseMellie replied to glm777's topic in MDS Coordinator Information

    You definitely want to address their risk of dehydration. A lot of the CAAs are redundant and repetitive but they often make you think about how to care plan an

  12. HELP! Discharged 1 day after admission

    NurseMellie replied to mydoggierocks's topic in MDS Coordinator Information

    I would do a 5day and discharge. You can code some of the things in the hospital before her admission. In coding some of the ADLs make sure you ask the staff very specific questions about how much...

  13. New to mds

    NurseMellie replied to Mrs.1908's topic in MDS Coordinator Information

    Welcome to the nut house! A few resources are Home - Centers for Medicare & Medicaid Services, and Welcome to AANAC I think after you have probably 6 months of experience with the MDS, take a...

  14. Where Should I Begin with Training

    NurseMellie replied to Paula C's topic in MDS Coordinator Information

    I had on the job training for my position. Would I recommend courses or classes without some hands on? Maybe, Maybe not. It depends on how the classes are broken down. The ANAAC courses appear to be...

  15. IDT organization

    NurseMellie replied to TigerxLiLy's topic in MDS Coordinator Information

    I do keep watch over the different sections; SS, dietary. It has been my experience that things don't always get marked like they should. I have had to do modifications based on others mistakes....

  16. Restorative RUG

    NurseMellie replied to tammyloumc63's topic in MDS Coordinator Information

    Plus you have to look at the adl scores and depression scores. Those also go into determining your RUG

  17. Nuances of fluffed care plans

    NurseMellie replied to TigerxLiLy's topic in MDS Coordinator Information

    We have many separate areas that many of the DX go into for example HTN, that may be a health maintenance issue or it may even involve movement (dizziness). If the goal and intervention involve...

  18. Counting breathing treatment days/min's

    NurseMellie replied to dianediane90's topic in MDS Coordinator Information

    Documentation may be easy to come across with the skilled documentation since most of the notes include lung sounds, o2 etc. There is a big push atleast in my area to include the respiratory minutes...

  19. Thank you

    NurseMellie replied to HikingEDRN's topic in Geriatric, LTC

    It is definitely appreciated, I hope you said something to the staff or management bout the care you saw. Trust me it will brighten their day hearing

  20. what else can I do? (burned out)

    NurseMellie replied to soybeck's topic in Geriatric, LTC

    I think we all experience similar frustrations and feelings at some point in our careers. Sometimes what can help is just changing carts or units or shifts can help. When I've felt the same way you...

  21. January 2015 Caption Contest: Win $100!

    NurseMellie replied to Joe V's topic in News, Announcements

    I'll be with you in a

  22. Sending meds with family

    NurseMellie replied to GLORIAmunchkin72's topic in Geriatric, LTC

    If they are going for just a day or so, we use small envelopes that we write the meds on and what time. If they are going to be gone longer, we may send the card from the pharmacy depending on how...

  23. New RN sup still orienting but full of questions

    NurseMellie replied to britmansf18's topic in Geriatric, LTC

    We have an admission check list we use. I look at the home medications that are sometimes listed, not always accurate though. I also look at the meds from the hospital. We have standard admission...

  24. New Gad questions

    NurseMellie replied to emilyray's topic in MDS Coordinator Information

    I wouldn't recommend taking the position at this point in your career. As other posters have mentioned theres a huge responsibility level placed on your shoulders. Typically the MDS nurse makes more...

  25. The topper of all toppers!!!!!

    NurseMellie replied to lumbarpain's topic in Geriatric, LTC

    I work with lots of psych behaviors and this is a fairly common occurrence in my facility, we get a couple throughout the year. I have had only 2-3 cases where we sent them to the hospital to be...