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Geriatrics, WCC

Content by noc4senuf

  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

    Nurses in trouble get second chances - Minnesota

    As a DON who previously worked at homes in MN, I reported my fair share of nurses to the BON. Only one nurse ever lost her license for my report and that was due to stealing narcs. Two nurses were identified (and proven) of not giving a tube feeder their meds consistently over a period of months. One nurse who had taken off a month and hospitalized for a mental breakdown (not told to management), came back to work and a week later during her shift did not pass any meds, did no charting, called other floors for help (she had 14 residents), upset residents with her behavior that some discharged the following day and the BON did nothing with any of these. All were fired from the facility. This is just a small example. BUT, on the otherhand, if a nurse is delinquent on her taxes or has a disorderly conduct, the license is suspended. Just no common sense with the BON in MN. In the meantime, now that I travel adn do consulting and temp DON work, I get to see what goes on outside the area. In Kentucky, a nurse is sitting in prison for 9 years for manslaughter. He was told a coupel times by a CNA that a resident had achange of condition. He did not go check the resdident until a couple of hours later. The resident was a Full Code on a rehab unit. WHen he finally went to check, the resident had expired. He did not do CPR. he later stated as his excuse was that the resident was old. Go figure.
  3. noc4senuf

    The Dirtiest Word in Chronic Health Care

    Coming from a LTC perspective, we gave up the term non-compliant several years ago. We now use "choices" or "chooses". since we have orders, care plans and a multitude of other things in place to care for our resident and then they turn around even after the education and don't follow it. They choose.
  4. noc4senuf

    State Tags

    There are some of the tags that requires specific P&P, most don't as does the state. I will have them when needed, and only then. Been doing this enough years now.
  5. noc4senuf

    Rn's are better than lpn's???

    Where I work, LPN's can not supervise, but they can be a charge nurse of the "building".
  6. noc4senuf

    HealthBridge Management

    Does your state list the actual completed 2567 online for anyone to read? Can you find out how often they change some of their key managment positions or even floor staff?
  7. noc4senuf

    State Tags

    For example... pressure ulcers. We have a formularyas to what the nurse should do for a particular wound but, the nurse can decide what type of dressing is used. we had taken the P&P book and completely revamped it. No longer does the words policy or procedure show up in it.... it a guideline. No need to monitor a guideline.
  8. noc4senuf

    Electronic MAR?

    maybe it would help if you used an open med pass timing system. For examplea 3-4 hour window... I don't use it but several facilities I know does.
  9. noc4senuf

    HealthBridge Management

    Sorry haven't heard of that one. Do you know of any of their facilities to look them up for tags?
  10. noc4senuf

    State Tags

    They always asks for P&P..... then will site you for not following them. That's why I don't use them........... they can't site me for guidelines.
  11. noc4senuf

    State Tags

    I do not have P&P for anything unless the regs state you need to have one. I do have "guidelines", which at the front of that binder is a statement that they are only guidelines and the nurses may deviate from them as they see fit.
  12. noc4senuf

    Rn's are better than lpn's???

    I am so tired of nurses "settling" for LTC because they can't find work in a hospital. I won't hire someone with that attitude. I want someone who has a strong desire and passion with work with my elderly. as I've said before and will say again, there are great LPN's out there and some pretty poor RN's. Each person is an individual and are judged accordingly. Personally, for a new grad without any experience, I would rather hire an ADN than a BSN..... more clinical work during school. A few years ago even with advertising, I couldn't find RN's to hire (unless they had issues with their licenses and nobody wanted them). Now they are coming out of the woodwork and my positions are full.
  13. noc4senuf

    Falls versus Culture Change

    Make sure your NP or MD has written in the progress notes that everything has been tried. You will not be sited if there is no solution. I have a secured unit that these things happen routinely, there comes a time (sadly) that there is nothing left to do.
  14. noc4senuf

    State Tags

    The glucometer cleaning was last year in our area. Each year they have a new focus. Keep in touch with other facilities in your area and find out what they are looking at.
  15. noc4senuf

    ADON raise - how much should I ask for?

    Do you have a state aging services board or something? Some do salary and wage information for all jobs within LTC.
  16. noc4senuf

    Why are most nurses hoarders?

    Our event reports state at the top that they are for QA purposes. Everything on them is on the chart, nothing more. I also keep a log which has everything itemized on it.
  17. noc4senuf

    Why are most nurses hoarders?

    Depends what your regs state.... never had an issue in WI or MN
  18. noc4senuf

    Why are most nurses hoarders?

    In my new facility, I have found in my office... incident reports, 24 hr reports, B&B reports, CNA set sheets, pharmacy stuff... the list goes on and back to 2004. OMG!! I got the shred bin and totally emptied on file cabinet and then some. I still have more to do, just not the time. My policy (in writing) Event reports are kept for three months and then shredded..... surveyors do not say a word when I hand it to them.
  19. noc4senuf

    DON Needs Suggestions

    Make sure to have your MD or NP document in progress notes that the resident is at high risk for falls, fx, or trauma due to the poor choices they make and the staff and facility have done everything they could. we self report to the state multiple time per month. One was a fall with a fx and death within the week. All have been cleared since we have our ducks in a row.
  20. noc4senuf

    Call schedule

    Since we closed my last facility in Dec., I am now at a different one. I no longer have a call rotation as there is not one. I have a Supervisor in the house on every shift. If they need the day off, they trade with another supervisor or call the scheduler to help them. Once in a while they will call mewith a question.
  21. noc4senuf

    lazy staff

    I agree, hold them accountable. if they are not doing their jobs, then they receive disciplinary action, up to and including termination.
  22. noc4senuf

    LTC Orientation - What is normal?

    I recently hired 3 new grads. I told each of them that orientation is really up to them as they all proceed at a different rate. One was ready in 3 weeks, the other in about a month and the 3rd is still orientating
  23. noc4senuf

    Call schedule

    The DON just can not be the charge nurse.... they can work the floor.
  24. noc4senuf

    To Staffing Coordinators,

    Do you know that they didn't try to place the 3rd CNA? Also, in my experience, the staffing coordinators take their instructions from the DON or at least someone in authority. I also know from experience, that with caller ID, staff purposefully will not answer their phones if work is calling, have said they will pickup shifts but then don't, etc.
  25. noc4senuf

    It's Time for Universal Licensing In all 50 States

    Each state has different requirements for CEU's. I hold a license in a comapctstate but, since i live close to the border and work in another state that is not compact, have a license for that state too. it took me less than a week to get the second license by endorsement.