dian57

dian57

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All Content by dian57

  1. Feeding and toileting

    At our facility, rounds are done immediately prior to all meals. Technically, all residents should have emptied their bladder, had their BMs and be clean, dry and ready to eat. The reality of it is...
  2. Need some new innovative methods ?!

    Johnson, I have been in my position as DON of a small 40 bed facility for less than a month. I attend both day and evening reports to the CNAs several times a week. I use this time to relay...
  3. This situation was handled badly from the onset. Feelings of betrayal and loss of confidence in management could have been avoided with a simple phone call to Estrogen or even a note explaining the...
  4. HELP with ALOT of problems on my unit

    I'm in the same boat as the OP. New unit, low morale, no accountability, inconsistent work results. The first thing I instituted was mass report. All staff working the shift gathers to hear report on...
  5. I work in the headquarters (we call it the Mother Ship) of a multi-facility LTC organization. I had a young-ish Parkinson's resident whose symptoms manifested more like Michael J. Foxx than your...
  6. Reward system for hardworking CNA's..need help!

    Great thread. Our facility has a "Caught in the Act" program. Anyone, from any department (even entire shifts) can be nominated. Each month we have a presentation. No one knows who was nominated or...
  7. funniest thing you saw a nurse do.......

    When I was a very young LPN, I was instructed to give a Dulcolax suppository to an Alzheimer's resident who was in her room. When I entered the room, she was sound asleep, lightly snoring. I pulled...
  8. Case Managing/Managed Care

    What sounds like basic miscommunication turned into 4 people becoming upset. What I'm hearing is frustration on all ends. Do you have a discharge planner who could have made sure the CPM was being...
  9. Started 1st job Slow as Molasses!!!

    Crystal, first stop and take a deep breath. You will conquer this problem. You were smart enough to get the job, and certainly smart enough to do it well. Give yourself a little more time. Right now...
  10. Charting/Nurses Notes

    I also have inserviced staff on LTC documentation. I can send you my Tips on Documentation sheet that is posted on all units. Email me. An important thing for new nurses to understand is the...
  11. Most common LTC meds - help with a list please:)

    A big one for awhile around here was Procrit, which is wildly expensive. Our docs changed most orders to Aranesp on pharmacy consultant recs to save costs. Fosamax has also been replaced with the...
  12. dress code policies in hospital setting

    Let's face it, nursing care aside, we're in a customer service industry. Our facility regularly has mandatory Be My Guest inservices to teach what I used to think was common sense--be polite, be...
  13. How many Pt do you take care of?

    New York, 40 bed LTC/dementia unit 7-3:30p 1 RN 2 LPNs (20 residents each meds/tx) 3 or 4 CNAs 1 unit assistant (transport/pass trays/make beds/run unit activity
  14. Low beds, falls and incident reports...

    With all the pressure-relieving pads that add height to our beds, 1/2 rails only come barely above the surface. There isn't enough room for anyone to get their fingers around the top bar to use them...
  15. Grab a CNA assignment sheet and highlight your residents. It will tell you what their bath days are, how many to transfer, are they toileted, hoyered, what their splints and devices are, if they use...
  16. All residents with an active DNR order wear blue ID bands. The bands are checked monthly and replaced if they're illegible or missing. We explain advanced directives and what a full code means to...
  17. Culture Shock! Hospital to LTC..

    No identification system for the residents is not only unsafe and disturbing, it may be illegal, depending on your state. What is the facility policy on identification? We have name bands (blue for...
  18. Care plans...what is and isn't necessary

    I do all the careplanning on my 40 bed unit. I've made a template on the computer loosely based on the GOLD book (Careplans That Work with MDS?). Over the years, we've changed our language to get the...
  19. MARS missed signing

    We had a serious problem with MAR/TAR and flowsheet omissions at my facility. As the CCC of a 40 bed unit, it was not uncommon for me to take several hours reviewing the previous month's documents and...