state is coming to ltc facility, what do i do!?

RNBearColumbus, BSN · May 18, 2011

The short answer is to do everything by the book. :)

As one of the newer nurses on the staff, there is a possibility that they will want to watch you do part of your med pass. Just remember your "5 rights" of med administration, remember to wash / gel your hands frequently, and stay with the patient while they take their meds. ( Even if Mrs. Smith is alert and oriented x3, and usually takes her meds without supervision, if the state folks are there, do it by the book and stay with her till the last pill goes down.

Remember to properly disinfect your glucometer after each use, and dispose of the lancet and the test strip in the sharps container.

If they want to watch you do a dressing change, remember to change gloves and wash your hands between taking the old dressing off, and putting the new one on. (Even if it's not a sterile dressing)

If they ask you any questions, and you don't know the answer, DON'T FAKE IT! Simply say, "I don't know, but will find out and report back to you" Most surveyors will know that you're a new nurse and will give you kudos for going to find out the right answer rather than pull one out of ... well, you know....

Be consious of what the STNAs on your unit are doing. If you notice call lights on, or things needing picked up, HELP THEM! They are just as concerned as you are about doing a good job! (If there is ever a time for team work in a LTC, this is it!)

State survey is really no big deal for a floor nurse. In fact, it will be fun to watch your nurse managers running around like chickens with their heads on fire for a week. (I know, because I'm a nurse manager. We always finish the week a few pounds lighter and a whole lot more tired than we are at the end of most other weeks!)

Stay calm, stay cool, and do the great job you normally do, and you will be fine!

mrsevans9310 · May 18, 2011

Thank you so much for your response! Helped me put things into perspective. I always over analyze but I need to remember to stay calm!

SE_BSN_RN, BSN · Dec 31, 2011

You relax, first and foremost. If they ask you a question and you don't know the answer you say you don't know because you are a new grad and you tell them you will find out the answer and let them know. If you have a good DON she will let them know you are a new grad. Help answer call lights and don't act like you are hiding something.

Long Term Care Columnist / Guide · Dec 31, 2011

What LPNBearColumbus said. :yeah:

Truly, if you do your job the way you learned in school, you'll be fine. Surveys are a walk in the park for floor staff as a general rule; if they ask you questions, answer them honestly (but don't volunteer anything; if they want more information, believe me they will ask you for it). If you don't know the answer, tell them you will find out and then make sure to get back to them. You should know where your facility's crash cart is kept and be able to show it to them; you should also familiarize yourself with the emergency preparedness manual, fire extinguishers, evacuation procedures and the MSDS (Material Safety Data Sheet) book. They probably will not ask you for the specific MSDS for the bleach solution used by housekeeping, but they may want to know that YOU know where to look for it.

:)

leslie :-D · Dec 31, 2011

if half of these facilities did it 'right' the entire year, they wouldn't sweat it when the state came.

it always amused me to see mgmt running around in a panic, trying to play catch up for all the stuff they let slide prior to annual surveys.

just do it right the first time, there'll be a lot less worries.

that's what top-rated facilities do.

as for your question op, pertaining to you...

know the meds you're giving;

know to give ea med individually through a fdg tube, preceded and followed with a flush.

and of course, to ensure ea and every resident is treated with the utmost of dignity.

none of the "sweeties, honey" endearments either.

leslie

SE_BSN_RN, BSN · Dec 31, 2011

if half of these facilities did it 'right' the entire year, they wouldn't sweat it when the state came.
it always amused me to see mgmt running around in a panic, trying to play catch up for all the stuff they let slide prior to annual surveys.
just do it right the first time, there'll be a lot less worries.
that's what top-rated facilities do.
as for your question op, pertaining to you...
know the meds you're giving;
know to give ea med individually through a fdg tube, preceded and followed with a flush.
and of course, to ensure ea and every resident is treated with the utmost of dignity.
none of the "sweeties, honey" endearments either.
leslie

LOL yeah, its funny seeing everyone running around like chickens. Those top rated facilities are sure getting harder and harder to come by.

caliotter3 · Dec 31, 2011

If you were like several of the nurses I used to work with, you would know which days to call off sick. They did this religiously, and were never disciplined for it. And they always were around to "hear" which specific days they should call off too. Then again, there was one nurse who was quite the actress. Whenever it was decided which day the surveyors were going to observe the med pass, she would be assigned to that hallway, and they would watch her act. Every year. The surveyors actually talked about her by name. They knew to expect this. She worked in two facilities and did her act in both.

LVNBSN2 · Dec 31, 2011

If you were like several of the nurses I used to work with, you would know which days to call off sick. They did this religiously, and were never disciplined for it. And they always were around to "hear" which specific days they should call off too. Then again, there was one nurse who was quite the actress. Whenever it was decided which day the surveyors were going to observe the med pass, she would be assigned to that hallway, and they would watch her act. Every year. The surveyors actually talked about her by name. They knew to expect this. She worked in two facilities and did her act in both.

LOL I would love to be a state surveyor. I bet their job is even more comical than ours!

caliotter3 · Dec 31, 2011

LOL I would love to be a state surveyor. I bet their job is even more comical than ours!

I could imagine them saying, "Oh, is Suzy Q going to do the med pass tomorrow? Then, we will just dispense with the med pass observation. She does such a good job every year!"

Blackbirdfly · Jan 2, 2012

Everything has already been said, that needs to be. But I will add this...if you are selected for doing medpass with a surveyor, I suggest choosing the residents who you know are less "difficult". Choose the ones who have less meds, and are less "grumpy" personalities. Believe me, it helps!

xoemmylouox, ASN, RN · Jan 3, 2012

:nurse:The most important thing is to remain calm. When you get flustered mistakes can happen. Take a deep breath, and know they will only be there for a short time. Good luck!