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Geriatrics, WCC
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noc4senuf specializes in Geriatrics, WCC.

I have always worked LTC. I have 4 wonderful kids and 6 grandkids.

noc4senuf's Latest Activity

  1. noc4senuf

    Lab Coat or No

    In AL in our area, it is frowned upon as it is to be more homelike and not facility feel.
  2. noc4senuf


    Metro of the Twin Cities in MN, smaller buildings around 70K and up to 120K for the largest buildings with 200-300 beds.
  3. noc4senuf

    Coumadin protocol

    Most buildings I have been in for the past 10 yrs or so have INR machines. We billed Medicare for the cost of the draw and strips. Faster than waiting for a lab.
  4. noc4senuf

    Really?!? That's what you think is important?

    I worked Interim for a travel company for 2-3 years. they had a corporation that kept requesting me, so I moved to their buildings only in multiple states. The corporate had about 200 buildings and were rated with only 1 and 2 stars. Many, many problems. Always the lowest paid in the area. The DON answered to a regional corporate nurse, who answered to another corporate nurse up the ladder and so on. Constant turnover in all buildings of the management positions, low moral of the staff. we always took the most acute of residents and weren't allowed to turn down any admits. Surveyors came for annual surveys right about the time I entered. I had 6 in just a little over a year. One of the buildings I was in a couple of years ago was closed by CMS last fall. Another building I used to go to meetings at was also closed about the same time. Why doesn't some gov't office take these buildings away from this company?? I feel your pain and wish you luck.
  5. noc4senuf

    State reportables

    I would not report a verbal altercation between residents; only physical that caused "serious bodily injury".
  6. noc4senuf

    A New Beginning

    After having been in LTC for over 30 years, 20 of that as a nurse, and the last 12 as a DON.... I have accepted a position as the DON at an Assisted Living facility. I have been on the road, traveling for almost 2 years as an Interim DON/Consultant. My hubby really wants me home. So, I started looking around and this happened to come up. Yea, the pay is less in AL, but it is also less regulated. It is actually something I have looked at for several years and now just seemed like the time. I hate giving up my nursing homes but, maybe somewhere down the line I may go back. For now, this seems like the right thing.
  7. There is some corporations out there that have continual turnover in management positions non-stop. having been working as an interim DON, it does keep me employed going into these buildings. Since you have now stepped down, learn your residents and routines well. Follow policies and procedures, and get the most out of this experience. You may come to find out that LTC is a wonderful place to be. Good Luck with your new position.
  8. noc4senuf

    Nursing Home VS. Assisted Living

    For the most part, unless a DON is retiring, there is a "reason" the position is open to begin with. Usually, there are issues in the building to go along with it, whether it is survey related, staffing, etc. I have been traveling and doing interim DON work in facilities that can not find a DON. Each facility has/had issues. If you decide to stay, start by looking at your staffing. How is the attendance of staff? Is it being monitored and are they held accountable? Then look at your policies and procedures. Are these current? Do they need work? Are they being followed? Does updated training for staff need to take place? Do you have a good management team under you that can be trusted to hold there own? This is not an end-all list, just a place to start. As for ALF, there is less documentation. The DON in these facilities is more hands on and not in the office as much. ALF is more of a social model, where LTC is more of a medical model. Two different ballgames.
  9. noc4senuf

    on call for nursing issues

    I have seen staff compensated for being on-call in some buildings and in others they are not. Also, some buildings where just the management staff in the nursing dept rotate call and most recently where every nurse in the building takes a one day call rotation. What works for one building, does not work for another. Training the staff to handle staffing and other issues that come up is key. Also, there are some companies that expect staff to call nursing management for each hospitalization and death when it happens. Reportable incidents are different by state. Some need to be reported ASAP due to the time requirements you have before a report goes to the state. Overall, on-call needs to be split amongst as many people as possible to prevent burnout in just the DON and ADON.
  10. noc4senuf


    If you have been in LTC for three years, is your goal to stay in LTC? If so, then try looking into learning more about the MDS, ICD-10 coding, managed care and their contracts, administration. There are so many positions within LTC that involve more of an office atmosphere than just floor work.
  11. noc4senuf

    What does a LTC weekend supervisor do?

    I have had specific duties foe weekend sups. Audits; f/u on admission paperwork; assist with admits, staffing, emergencies; give tours; dela with family and staff issues. Be visible throughout the building.
  12. noc4senuf

    A Heartfelt Apology to DON's

    I certainly hear what everyone is saying. We have all had those days that never seem to end, and the list of items you planned to do for the day did not get a dent in it. I realized years ago, that I could only perform my job if I had great staff to work with. That is why each and every day I tell them thank you for their work and also let them know i appreciate them. This just doesn't mean the nurse and CNA, but the housekeeper, dietary aide, etc. Without all of them, I would be nothing. I now work as a traveling DON, going into facilities for one to three months at a time. These are usually troubled facilities, and have many problems going on. The staff are usually leery when they see a new person, thinking change is on the horizon. My motto is, fix the problems and reinforce their current policies without trying to change everything. yes, taking complaints from staff, family, residents allows me to find out what the real issues are. I also report to the NHA or corporate what their issues are and critique key staff of their weaknesses. This is not fun, but I love my job.
  13. noc4senuf


    Most facilities I know has two people check off new orders.
  14. Make sure to check the chart to ensure the person you are talking to has the permission to have the info.
  15. Don't forget to check the chart to ensure the person you are talking to has the permission to have the info.
  16. noc4senuf

    Systems to manage as an ADNS/DON

    I don't remember seeing PAIN...