Questions on State Visits

[Oranges3420]

As a new RN grad that recently started at a SNF, I am hearing horror stories from the other nurses related to the State coming for a visit: that they come and follow you around, ask you why certain patients are taking certain drugs, ask why I am giving my 8am meds at 10:30am (because there's too many patients and not enough time!)What exactly does the State searching for when they are looking at an RN and her job? How can I stay "out of trouble?"

[shah]

just tell the truth, don't try to cover up, specially if asked by the management. It is worse to be caught telling a lie.

[shah]

What us the role and duty of an admissions nurse in a nursing home?

[LockportRN]

The State assumes we as managers are supposed to know everything. "Have you told anyone" is not one of the things I've ever heard a surveyor ask. I HAVE heard them ask leading and misleading questions and I have seen them set a nurse up to fail. I've also read their reports with outrageous misquotes. Surveyors are there for one thing...to find fault. Some are reasonable, most are zealots.

There is certainly some truth here. On my first survey as an ADON, we were 'crucified' on day 1 with 15 possible tags (I had worked there just 3 months and had put into place Psych monitoring/reductions, Immunizations, a Fall Committee, and developed an education/in-service process where all staff were brought current on their annual in-services just in time). We had 7 surveyors. A new Admin, a new DON and myself.

At the end of day one, we all felt defeated but no one more than myself. I knew the hours of OT I put in just to get us to this point. Our Admin called all managers in for the final conferences. I looked at all of their faces slowly disolve into defeat. Then everyone got up to leave. I, however, HAD to turn around and asked "Isn't there anything good about our facility? Is it really that bad?" At this point, the room became completely silent...the lead surveyor sort of mumbled "Uh, oh..." Then nothing. They all looked at each other then one said "We are not here to tell you what you are doing right, but to identify your deficiencies." Wow!!!

Anyway, while that was rough I now view them as 'keeping us honest'. In the years since, many have used this time as an educational experience to which I welcome. Yes, they can be stubborn and particular and some can be very unreasonable but you just have to remember your P&P manual and follow it. If it is not in your policy even though they want something done, you don't have to do it. As DON/ADON you have to stick up for your staff and your policy and not 'change your mind' cuz you think it's what they want to hear.

That was good advice another poster gave to the floor RN, if you don't know the answer, it is absolutely ok to say that you don't know but that you can find out. Very often, when there is a question they are asking you, it is precisely for this reason...to see if you even know who to ask, or where to go to in order to find an answer to a question. They know that you ccan't possibly know the answer to every question.

Good luck to you, relax, do the best job that you can. Remember, it won't go on forever!