LTC_LPN2

Tell that to the survey folks who question the Residents they interview regarding pain location, Level of pain, Nurse intervention? Effectiveness? And then have one tell them you don't give it because "you think" living with pain is doable and becomes justifiable because the risk of opioid induced constipation is far greater and because your opinion is golden...won't go to well and not how it works. Give the folks their prn pain meds for Christ sake; Tylenol, monitor, then assess for effectiveness; then go to the heavier more potent prns if pain isn't relieved, no order, get one!...I be damned If I allow a resident with cancer metastasis to suffer because of my opinion on the subject. They will get his prns as needed and pain patch q 3 days until hospice takes over...I'm not in service to me I'm in service of others! pain is a vital sign that must be charted on the Mar, pain flow sheets, and charted in their record with end result; effective or not?...repetitive entries? Even..I'm a little opinionated on that one. Sounds as if you have seekers that worry the crap out of you being at the cart every 4 or 6 hours on the dot while laughing through a voiced level 8 rating of pain....narcotic seeking is considered a behavior...notify dr, document it and follow up with POC...

Im not justifying her actions or lack thereof just to make it known that hectic shifts, high census, incidents and such do carry the risk of forgetfulness. I even at times forget to log residents out on the 24 hour report but my coworkers ask me, "who do we have out, any status changes?" It prompts me to think about what I have not done that needs doing in order to transition shift change smoothly and prevent another nurse from going behind me to fix it. That will get you a bad reputation like the one she seems to have. Pumps are cut in and off through out shifts to provide IC, flushes, med pass, and to give the tummy a rest for a couple hours. My advice...get a notebook, ask questions instead of relying on a report sheet, make your rounds and provide care as needed. You can't rely or trust that another nurse will do their jobs efficiently, they'll allow you to cover their tracks until you stop them from it...you cover your own behind. Round first, intervene when necessary, ask questions!

Thanks Mrs. Boots...In Mississippi LPNs can't write care plans. Not sure why we even had to do them in school. I really was confused until I was critiqued so many times the red from her pen had no choice but to stick out at me lol. However, at work while helping the MDS and care plan team I was asked how I'd proceed once I finished RN. A quizzer of sorts I guess. She said it was correct but I don't know how with the AEB on there....thanks for reminding me and I'll ask tomorrow why she allowed AEB. I'm curious now. í ½í¸Š

I've noticed the past couple of weeks that management and DON want to rush and fix issues last minute. After a problem is so far gone you can't snap your fingers and just get it all done in one day and do your job too. Be consistent with all nurses and your expectations daily instead of procrastinating. Med carts for instance were filthy on match back but not once did those nurses voice to the med nurse, clean the cart, make sure it's stocked, ...well I get on the cart taking ab extra shift on a different hall and was not even shocked to see meds that were dcd still on the cart, MOM and Robitussin spilled everywhere and bottles sticky...they know their duties as Med nurses however they expect the next nurse to clean up behind them. My shift is 7-3 n I got out of there at 830 at night because I was worried survey would come the next day. Embarrassing! You can't do it all by yourself but they'll definitely let you go down alone to get the monkey off their backs...

I know how you feel but CYOA if you go to higher ups...don't do anymore than you're capable of doing, and don't work off the clock...come in earlier if you can, plan your med pass...prioritize, gather supplies first thing. My place isn't lucky enough to have generous nurses that restock the cart and change the trash like team workers do...bunch of inconsiderate night nurses who use sleep deprivation and pregnancy as an excuse! As far as funds...keep a record of arrival and departure times, make a copy for HR or Staff Development as proof...you keep the original....good luck

You should really learn how to do them by having your work critiqued by an instructor...I used at risk for falls r/t altered Mental status as evidenced by abnormal urinalysis...I was wrong in nursing school but right at work...🤔

Read your post wrong...let him unclog a tube after the feed has clogged it up nicely...depending how long she stays on those feeds or if she can hydratate PO...crazy how one orde can solve a bunch of chaos for docs lol

I would say yes for both patency and hydration to prevent bigger issues like dehydration. If crush meds are being given through the tube it does require at least a 5cc to 10cc of water to administer all of the medication from the med cup...you'll end up with a clogged tube...I'm sure doc is assuming your judgment is to flush before and after meds and feedings...check facility policy for standing flush orders.