mtjoanna

mtjoanna

psych and geriatric

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All Content by mtjoanna

  1. Advice for memory care caregiver

    mtjoanna replied to Bonnieparker22's topic in General Nursing

    In my area, a lot of the folks have grown up on ranches, so it's not uncommon for older gents (and ladies) to feel the need to get up and check the livestock. It's also very common for people,...

  2. HIPAA Violation as a student

    mtjoanna replied to Nrsng_is_life's topic in HIPAA Challenges

    Unfortunately, the best advice I can give is to tattle. Doesn't sound nice, but if this person is willing to be this blatant at this point in her career, it's better for her to be kicked out of the...

  3. One hour before and one hour after

    mtjoanna replied to Manofstone's topic in Geriatric, LTC

    I had a visit with a state surveyor a couple of years ago--our yearly visit. She was watching me at my med pass and asked why certain people were hi-lighted in red. I told her that those were late...

  4. Questions for an acute care nurse.

    mtjoanna replied to dudette10's topic in Geriatric, LTC

    Indeed it is! When you send a resident to the hospital with vomiting, a bloated, taut abdomen and NO bowel sounds whatsoever and you get yelled at by the DON (with a few expletives thrown in for...

  5. Questions for an acute care nurse.

    mtjoanna replied to dudette10's topic in Geriatric, LTC

    Pretty much not. I don't know how it is in the new place that I'm starting on Monday but in the facility I just left, for admissions we would sometimes get hundreds of pieces of paper, often...

  6. Guilty and relieved at the same time

    mtjoanna posted a topic in Geriatric, LTC

    So, I am finally leaving the SNF that I have been working at for the last 3 years. Over that time, I have seen a steady decay in the quality of care provided--mostly r/t reduced staffing, scarcity of...

  7. Guilty and relieved at the same time

    mtjoanna replied to mtjoanna's topic in Geriatric, LTC

    "A tip to the state would never hurt either." A few of you have mentioned calling the state--it is something I considered but ended up not doing as the State surveyors showed up, completely...

  8. Questions for an acute care nurse.

    mtjoanna replied to dudette10's topic in Geriatric, LTC

    I've been a noc nurse at a LTC for 3 years now. I won't rehash all of the (very accurate) details given by IsabelK above, but will add a couple other things that I have noticed during my time there....

  9. Survived Survey..

    mtjoanna replied to blessedmomma247's topic in Geriatric, LTC

    Nope--not even close! The facility that I just left had a surprise visit from the State my second-to-last day there--we'd had someone call the state and complain about the constant short-staffing and...

  10. Confused

    mtjoanna replied to smithand's topic in Geriatric, LTC

    The facility that I have just left does not allow the floor nurses to declare whether a wound is a pressure ulcer or not. We are to describe its size, shape, location and characteristics, but only the...

  11. Resident's family wanted to discharge AMA at 10:00 PM Sunday night!

    mtjoanna replied to smartypants22's topic in Geriatric, LTC

    Just to play a little bit of devil's advocate, perhaps the daughters (not knowing them or the situation) also work irregular hours and 10pm on a weekend is a normal time for them to be up and about?...

  12. AL vs. LTC

    mtjoanna replied to MsPiggy's topic in Geriatric, LTC

    Would it be possible to speak with your local nurse's union rep and get an idea of your liability here? Or possibly your state board of nursing? If you've documented unsafe conditions, addressed it...

  13. Facility refuses to give raises

    mtjoanna replied to baygrl11's topic in Geriatric, LTC

    I haven't started yet, so don't know about the CNA staffing, but the unit I'll be working in has 48 beds with 2 nurses--so I'll have 24 residents, with other nurses for back-up in cases of...

  14. Never Have I Ever Done That Before

    mtjoanna replied to JerseyTomatoMDCrab's topic in General Nursing

    I've been out of nursing school for 6 years and about 2 weeks ago, had to start my first IV catheter. On a 92-year-old dehydrated woman with veins that looked about as wide as sewing thread. She had a...

  15. Facility refuses to give raises

    mtjoanna replied to baygrl11's topic in Geriatric, LTC

    I got a $0.21 merit raise this year; last year was similar at my for-profit, multi-state facility. For other reasons, I've sought employment elsewhere and the place that hired me has my base pay going...

  16. Would love your input...

    mtjoanna replied to Loribabble's topic in Geriatric, LTC

    I concur with the gal who commented on noc shift staffing issues. I don't do blood draws during my noc shift because we have no lab facilities at my place--it all has to be transported to the local...

  17. Visitors on Working Days

    mtjoanna replied to applesxoranges's topic in General Nursing

    I'm fortunate that my husband works graveyards and so completely gets the sleep thing (I work 1800--0600), and his family isn't terribly close so they have never dropped by. My family has also been...

  18. Unhappy CNA on night shift. Help?

    mtjoanna replied to michigan94's topic in Medical Assistant, CNA/MA

    What time do you go to bed? When you get up at 1530, have you had adequate sleep? Long-term sleep deprivation can cause increased irritability with reduced ability to cope with every day...

  19. Upcoming interview in LTC; What to expect?

    mtjoanna replied to BirdieBird's topic in Geriatric, LTC

    My interview (3 years ago now) was pretty much a formality. The administrator saw an RN who was moving to the area and so my interview was basically "when can you start?" They asked a couple of...

  20. At my wits end...

    mtjoanna replied to DierkyBrewster's topic in Geriatric, LTC

    You get written up for not calling over a bad dream while I get cussed at (f-bomb) because I called the doc over a resident with a distended, taut abdomen and absolutely no bowel sounds because that...

  21. New nurse-what do I bring daily for work?

    mtjoanna replied to Kebby1016's topic in First Year After Licensure

    Pepto bismol or tums; Vicks vaporub or an essential oil of your particular chosen scent (sweet orange or lemon verbena work well) to dab under your nose when you have one of those patients with a...

  22. Any recommendations for arch pain?

    mtjoanna replied to Ankh's topic in General Nursing

    I use Keens hiking boots and knee-high compression stockings. I started using the stockings after a bad horse accident left me with some permanent damage to my leg, and without the compression I have...

  23. Tension between Nursing Home Nurses and Acute/Critical Care Nurses! Lets visit!

    mtjoanna replied to downsouthlaff's topic in LPN, LVN Corner

    The facility that I work in does not have a crash cart, an AED, a working suction machine (at this time--it worked a few decades ago I'm sure), or a requirement for staff to maintain CPR status. Most...

  24. Tension between Nursing Home Nurses and Acute/Critical Care Nurses! Lets visit!

    mtjoanna replied to downsouthlaff's topic in LPN, LVN Corner

    You are assuming that the facility will actually have a functional suction unit readily available. Ours is not; has not been for some time, DON and administrator are aware but it is still on the...

  25. oxygen in dying hospice patients

    mtjoanna replied to bmel's topic in General Nursing

    In my experience, the oxygen is occasionally helpful to the dying person. If they have been on oxygen for a long time, there sometimes seems to be an anxiety/restlessness when the tubing is...