State Survey...Advice Please

[annabrooke93]

HI,

I am a recent LPN graduate working on a temporary license at a local nursing home. I have been there about a month. Anyway, I just completed my orientation and got placed on a med cart alone 2 days ago. I was off today and I was called and told that state had walked in to do the survey and that they would be there tomorrow also, (which I work).. frankly I am terrified, I do not know what to expect and cannot get anyone I work with to tell me much either. The only thing I was told was that an RN would go with me to do invasive procedures to follow the legalities of my temp license. I really do not know what is and is not acceptable to the state as far as med pass because I have had a really shotty orientation. The only thing I have been told is to be sure I was through with med pass in the one hour time frame, which is impossible for me because I have 74 residents and patient safety seems more important to me.. anyway, I am sorry this was soo long but I desparately need some advice!!!

Thanks!!

Leelee

[Bird2]

Congrats on your good survey. We definitely felt they were "out to get us" especially in the area of pressure ulcers. One of them went on for 15 minutes about how she hated our documentation form...too bad, sister, it complies with the regs. Then when she couldn't tag me on that (I'm the wound queen) she had the unmitigated gaul to ask me why I was doing a wet to dry dressing on a pressure sore which had healthy tissue. I explained to her that this particular woman had been admitted to my facility with a stage FOUR ulcer on her buttocks. It was 7 x 7 cm wide and almost 4 cm deep. Now it is less than 1x1 and about 0.2 cm deep. I told her I would NOT change my treatment plan as long as the wound continued to heal....zowie...she wouldn't even give us any credit for the almost miraculous resolution of this woman's ulcer. To top it off, one of the corporate big wigs was there to 'help'. She was rude to my staff and counter productive and then...are you ready for this...she reported something to the DPH without checking with anyone in the facility...not the DNS..not the Administrator...not me...no one!! Sorry for the rant but first it was the Joint Commission Survey...a week later DPH...I have been working 12+ hour days for more than 2 weeks and it fries my nose (thank you Mumbles Menino mayor of the great city of Boston) to have to put up with corporate snakes.

I would like to congratulate you on the "miraculous resolution" of the healing stage 4. Although the treatment is not the norm you have obviously sucessful. Good for you for knowing the regs and stating your case.

[SueNYC]

Im a new nurse and have been at the same facility for the last few months. Im the charge nurse for my floor but when staffing is short I do it all including meds. Its my first state survey and needless to say im extremely nervous. This thread has been helpful as to things to look for and expect etc. Quick question regarding finger sticks though. When you have to do them and resident is out of room, are you supposed to take the resident to a private area to do them too?

[CapeCodMermaid, RN]

Anything has to be done in a private area...fingersticks, apical pulses, eye meds. The only way to get around this is to document in the care plan that the resident does not want to have to go all the way back to his or her room for a fingerstick.