State Survey all this week.

[KRODD]

My facility is having its first survey while im on my 10 month as a new nurse was a CNA at the facility prior. I am needless to say nervous, I work 3-11 so they are pretty much wraping up when I roll in, I know thats no guareentee. My major concern is leaving the cart unlocked or messing up by breaking asepsis while putting on a tx. or some random error.

[cienurse]

State surveys are always a nervous time because everyone wants to do a good job and they want the surveyors to see that too! Believe it or not, there are some surveyors who know how difficult LTC can be and are willing to cut some slack, especially when they see the effort is there and that the residents are happy with no complaints. Did you ever hear the saying, "Never let 'em see you sweat?" This is especially true during state survey. Just relax and do all the right things that you do every single day of the year, even when the surveyors aren't there. If you are giving good care all year long, to the best of your abilities and do right by the residents every day, you have nothing to worry about! Good luck and let us know how survey turns out!

[kmarie724]

Good luck! Just stay calm and do everything the way you were taught to do it. I managed to mostly avoid the surveyors asking me too many questions the last time they were are my facility by trying my best to look like I was in a real hurry to get somewhere every time I was in the hallway!

[Blackcat99]

At my LTC, the state showed up at 8pm on a Sunday night. They observed the 3-11 shift do their med pass and stayed till 2am so they could also watch the 11-7 shift do their 12 midnight med pass too. I wish you the best of luck. I was a "nervous wreck" while doing my med pass with the state but I tried my best to just pretend I was "calm."

[AngelRN27]

Don't be fooled-- my facility just went through state and believe it or not they stayed for two 3-11 shifts (well into 8 or 9pm) not only to watch 2 or 3 med passes but also because they used these days to peruse through charts... Don't assume that you're "safe" just because you work 3-11!

And yes, those small details are usually what they catch the "good" facilities on, but also remember to check yourself on daily habits, for example, EACH med must be in its own medicine cup, each med must be crushed separately, water between each med with PEG residents, etc.

Good luck! My facility passed with flying colors!

[Kittypower123, BSN, RN]

If in doubt - wash your hands! We had our survey last month and the big thing they dinged us on was infection control, mostly not washing hands enough. Also, remember - no gloves in the hallway. If you use hand gel use it properly and only 3 times before using soap and water. When changing a dressing change gloves after taking off the old dressing (same goes for changing briefs).

On another note, know your facility's P&P for administering meds through a g-tube. Can you mix meds or does each have to be administered seperately? Two nurses had to demonstrate this task and only one of us did it correctly according to facility policy. Also, when finished, make sure you rinse and dry the syringe and store it with the plunger NOT in the syringe.

Make sure you know who your Abuse Coordinator is and where his/her phone number is.

When demonstrating something for state, take your time - don't rush yourself. Think about each step as you go and don't worry about everything else you have to do.

All that being said - take a deep breath and tell yourself "I can do this." Good luck!

[Kittypower123, BSN, RN]

One more thing - when you get on shift, go through your cart and pull any expired meds and make sure everything opened (insulin, neb meds, eye drops, etc.) has a date on it.

[Blackcat99]

I am worried about our next state inspection. Management is writing up nurses for overtime now so most of the nurses are leaving and not doing any of their required charting. Only a few nurses are actually staying over to chart these days. I am one of the few and I am expecting to receive "my overtime write-up slip" very soon.

[GLORIAmunchkin72]

So far I've only had to answer a couple random questions about fire safety and resident abuse or something like that, but I was in a mock survey and the 'surveyor' was supposed to watch me do a couple of medpass. Well, it was one of those days. Everytime we were ready to start a nearby alarm would sound, sometimes, two or three and I would have to stop and run to it. Finally she told me that we would have to move to a 'quieter' place and so we did...

[Blackcat99]

Yes, the state may want to see you do the G-tube medications. One med at a time. Review the step by step instructions on how to do it correctly. At my old job years ago, all of the nurses who had to do G-tube medications with the surveyor did it wrong.

[CloudySue]

Our facility would freak out as soon as that time window opened up in which the state would come, they went on a rampage for months, going over things like crazy every day as if the state was just pulling up out front. I was SO relieved when the state finally did show! How's that for a change in perspective!

[MountainRN53]

I wish my facility WOULD freak. I consider myself experienced since I've been in LTC for over 20 years, but P&P changes so often you never know what people are looking for. I have only been on staff at my present facility for 6 months. I too, work second shift and most times leave around 1 or 2am, due to charting, too few or lazy CNA's, or patients requiring more time. Many of us worry about the medpass in general. I think what bothers me most is the sequence of treatments. How would one handle someone who requires a CBG, insulin coverage...eye drops...inhaler...po meds...and or a possible prn pain pill. I was recently told now you have to don gloves when opening Depakote Sprinkle caps. Our in house inservices consist of many little topics I guess they expect you to remember and when you don't they can say you signed saying you did.