State is here and I am as cool as a cucumber...

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Specializes in LTC.

So, I am busy with my morning med pass, just minding my own p's and q's. I have a pt who is currently on hospice and is on comfort cares, turned q hr, pain meds q 2hr and RR were..oh..about 5-6 a min and a large amount of family at bedside that needs more TLC then the patient. As I am coming out of the room, I noticed my DON hustling down the hallway, checking things out. As she passed by, she whispered "State is here!" Okay, we have been expecting them, we knew this week was coming soon. I then noticed department heads popping up and looking around and then back to their offices. I continued on with my med pass. About 20 mins later, I got this strangest feeling that someone was watching me :coollook:. I turned around from my laptop and there she was. Lets just call her "Big Bertha" . She came over and introduces herself to me and tells me that I am a "natural" with my clients. Then she says she has a few questions for me, can I spare a few minutes. I explained to her that I was in the middle of my med pass, but that I would be more than happy to answer any questions in about 45mins. The look on her face was priceless. You would have thought I told her that she won the frkin lottery. She got so excited and said "Ohhh...really.. Can I watch?" I said sure, why not. I really didnt get why she was so excited and she was even more thrilled when I told her yes. I mean, she is the state, what was I going to tell her..NO?!!?! So we continued down the hall as I passed my meds as I do every day. But it was SOOOOOOO annoying having her right there..I mean so close, I could count the hair she had growing on her top lip. So close, I had to offer her a breath mint...twice. I wasn't scared or freaking out. She asked questions, I gave her an answer. I didnt know things off the top of my head, I had to look in the chart or even look at the patient themselves. I passed the meds the same way I have done every day. She asked my why some of my meds were "late". I explained that some of my clients (mostly the AA0x3) are not morning folks and do not get up until 10am. When we went in to the dining room, she watched as I gave a client their meds. When we left, she asked me why I did that. Why not give the client their meds before or after they eat. I explained to her that the client prefers to have their meds with foods. I continued to explain to her that I do not give tx, eye drops, inhalers, nasal sprays, or insulin anywhere but the client's room or our treatment room. After my med pass, she said the only problem she saw with me was that there were about 5 or 6 clients that I gave 8am meds at 10am. I explained to her that the client prefers those meds at that time. When they were at home, that is what they did. I also showed her where I would document that the client prefers what time they take their meds. I also asked her if she was on any medication and what time does she take them. She told me that she took all of her meds at bedtime. I said so if you were admitted to an LTC , would you want to continue that or what is consider "policy"? All she said was "Good Point." And then walked away. I am interested in what happens tomorrow.

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Specializes in ob/gyn med /surg.

. i would of peed my pants !!! hugs to you !!

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Specializes in medsurg, everything in LTC.

Kudos to you! well done, however we still do work within regulations, times and careplans can be tailored and reflect personal choices, once it's done there are no more "over allotted time" issues. Good luck!:yeah:

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Specializes in LTC, Home Health, Hospice.

I loved it..Yes loved it when the state came to pay us visits..you see it was then and only then were we not short staffed and had a surplus of supplies and to top it all off, all the big heads of state got off of their duff and decided that it was time to interact..ur, I mean work...

Happy Visiting with the State...Remember, don't offer any information you are not asked for..how many times have I heard that????? Y dunno

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sounds like you did a great job. I would have been really nervous in a situation like that!!

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Kudos to you! well done, however we still do work within regulations, times and careplans can be tailored and reflect personal choices, once it's done there are no more "over allotted time" issues. Good luck!:yeah:
Yep. They need their careplans updated to reflect 'personal preference' and the meds re-timed in the MAR.
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Specializes in home health, dialysis, others.

Good work. I liked that you felt comfortable taking charge of the situation.

You GO, Girl !!!

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Specializes in ER, TRAUMA, MED-SURG.

I always hate it when state shows up - not really why. Guess because when they do, the "powers that be" run around like a teenager trying to finish their homework.

They showed up yesterday at the facility where my dh is a nursing sup. It was par for the course, on all kinds of diversion.

Have fun with them this week!

Anne, RNC

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Specializes in OB.

I love that she was so close that you could see the hair on her upper lip and had to offer her a breath mint!!! You'd think she'd have gotten the point...these people really must have nothing else going on in their lives if they're that excited about following someone around and correcting/criticizing. You handled the situation beautifully.

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Specializes in medical.

It was so funny to read! You are my hero! I would be very nervous in your situation.

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Specializes in NICU,ICU,ER,MS,CHG.SUP,PSYCH,GERI.

Congratulations on you success with the state sanctioned terrorist organization known as "State". You are a noble and brave woman. I still suffer PTSD from my dealings with them! Seriously!

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Specializes in LTC.

Today was worse, but I didnt let it get to me. It didnt help that our AC quit on the hottest day of the summer. :eek:

Anyway, I worked a 12hr shift today...lucky me. When I got to work this morning, around 6am, my DON was already on the unit.. She said before the state crew left yesterday, they said they would be back today..but gave no time. So we waited and waited. I had a client that passed (the one on hospice) so I had to deal with family and all the paperwork. Then I had an in-house admission and the client was not happy about sharing a room, but after about 45mins, they got along just fine. I have another client that is very demanding and the client was extremely upset bc I gave his meds at 8:30 and not at 8:15 and wanted to know why I was late.:uhoh3:

Then low and behold here comes state. :yeah: just kidding. Anyway, I am in the middle of my noon med pass..which isnt the heaviest, but still, I am pretty busy and this guy comes up to me and starts barking questions. "Is this pt is on a supplement? Why does this pt have a cath? Do they use bedrails?" I locked my cart and closed my MAR. I looked up at him and almost choked on my gum. If you took George Clooney and Robert Pattison and combined them...there was this guy. I swear the state tried to get me to screw up. I politely asked his name and did a double gulp when he replied, "Edward, and yours?" I mean seriously? They did that on frkin purpose!! But no..I held my cool. He may have been good looking..but he was a complete a**h*l*! I was more than happy to answer his questions..but he was going have to wait until after my med pass. And I told him so very nicely I might add...but he didnt like it one bit. But he didnt have a choice either. So he decided to follow me around like a lost puppy as I did my med pass. He asked my clients questions...a few told him to go to ..well..you know..he watched as I measured insulin, poured liquid K+, mixed miralax... crushed meds, mixed with applesauce or pudding.. aksed me how I knew what meds could be crushed ..treated a few skin tears, answered my cordless phone, taking MD orders and answering family questions or pharmacy questions. Literally..he was right there..right over my shoulder...it drove me crazy!!! Then he asked to see my cart..and look at the meds..so I opened my drawer and he looked at the cards and the bottles and the creams...

After my med pass was complete, we sat down at the nurses station so he could ask me those so important questions... it was just nuts...and I am soooo glad I am off the next three days.

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