beaglelover

I just interviewed for an ADON position. I have been a charge nurse in LTC for many years, and a unit manager this year. This is a small facility and I got a very nice vibe. Any suggestions, thoughts, etc. on being a new ADON are appreciated. Thank you!

In my ltc, 75% of the residents are under 65. All of the suggestions above are needed, document...and note the time something occurred not the time of the note...start new orders without delay, actually look at DNR paperwork in chart and make sure its signed by doctor, monitor your labs and X-rays, best of luck !!

Just wondering how often unit managers are on a med cart in your facilities? In the snf I have been working on, its almost a regular thing...maybe twice a week due to call offs...I would be interested in what other facilities do. Needless to say, hard to manage a floor when you are on a cart so often.

Hi, I am a weekend supervisor at a ltc facility in the Tampa Bay area. I think we do a really good job on the weekends, we have a Baylor program for nurses and CNA's are on 8 hour shifts. There is a rumor going around that the weekend supervisor position may be eliminated ( that would be me :) and I believe its because they want to recruit me for 3 to 11. I am wondering if anyone out there has any comments on how a ltc facility functions without a nurse in charge. We have 109 beds.

I am curious how many facilities encourage communication between CNA's and nurses. I find it really helpful to give a report to my CNA's and tell them what my concerns might be with a particular resident. However, I don't see this encouraged. Are their any facilities out there where communication is encouraged?

I would love some feedback please on a situation. An elderly man was readmitted ( sent out for pneumonia) to our LTC facility Sat afternoon with a PICC in his right arm. It was assessed to be intact, no c/o pain from pt, no swelling. An order was received to D/C the PICC Sat.,( he wasnt my pt), his nurse asked me to look at it. Pt c/o a lot pain in arm, he was resistant to straightening it. MD called to d/c line and get a venous doppler. Also, I measured 11 cm of a swollen are at the PICC site We could not get anyone to come out to do the doppler, MD ordered pt to be sent out. My question is how long can it a take to develop a DVT, if he was seen Sat pm without pain or swelling to PICC area and it was observed Sunday evening Thanks!!!

Let me elaborate on this...this facility wants CPR done even if a resident meets criteria for death!!!! This happened when a resident was found with pupils fixed, mottled, very cold to touch, no resps, no pulses, etc....She was found by a CNA at change of shift who grabbed a nurse who didnt know her and asked for help. She could have been waiting for the funeral home for all anyone knew at change of shift. She happened to be a full code. But Md was called and she said dont do CPR. Anyways, all 4 nurses who saw her were fired and reportedly reported to the BON! Anyone ever hear of something like this before??? This nursing home/cya culture has gone too far.

My old facility started a policy that a code blue is to be called on all unresponsive residents. Its confusing because it says charge nurse is to get the chart and start CPR if non-responsive and full code. They also say a nurse cant assess criteria for death and then call MD for an order. Anyone have familiarity with a policy like this?

I agree, try to stay hourly. It can be an awesome task. Also due to the citations, you may have a lot of cleaning up to do. Is there anyone who is going to assist you? If there is someone helping with assessments, RAPS, and careplans be sure you have a good working relationship with them. Its also very much a team effort. What kind of citations did the facility receive?

Hi I am an RN working in ltc in Pinellas County. I am originally from NJ. I was wondering what the salary for RNs in ltc is currently. Also, when I came down here I was told that ltc paid better than hospital nursing. Any other RNs in ltc from Pinellas?

An order was received for D5 via IV or gtube for a CA pt after his radiation treatment. Has anyone out there had an order like this? We were told it was appropriate, though rare. :chuckle :)

:kiss Hope I can help a bit. I oversee the restorative dining program at my facility. Has this resident been seen by speech(for swallowing difficulties) the dietician? Antidepressants are good but make sure you have a dx for depression, which is what it really is for. Does the resident need adaptive equipment? Plate guard, scoop bowl, adaptive utensils? They have a good appetite you mentioned, but for what? Can family/friends bring in favorites? If you don't have a restorative dining program you can refer them to, try an unrushed atmosphere in a smaller dining area. Feel free to email me and let me know how things go.