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time management

im an lpn mds coordinator in MA...my facility has 70 beds....very few medicare and managed care. i head the weekly UR meeting, usually have to take the floor 2-3 times a week because of call outs, attend family meetings careplan meetings etc. i am only 32 hours which they keep track of and do NOT like it when i go over my time. i make 27/hr. which is not bad from what i hear. i am new to the mds world and taking courses now to get my rac ct. my question js HOW IN THE WORLD DO YOU MANAGE YOUR TIME???? i can definetley take some tips!!!! im working 7 days a week and my mds's are still behind!!!

amoLucia specializes in LTC.

Just FYI - LTC nurses in any specialty managerial-type position (MDS, Inf Cont, Staff Dev, Unit Mgrs, etc) will most almost always find themselves falling behind when they have to 'cover' the floor.

You just can't do the the required time needed for your actual position when 1/4 to 1/2 of your time is NOT spent on your actual job duties.

(I know - been there, done that!)

And the fact that you're new to MDS is contributing to your overload.

Sounds like your facility is at fault for this occurring. It is not your fault!

Better time management will be most extremely difficult unless you can make this known to your administration. And it will be a tough feat to accomplish.

Good luck to you.

oh my goodness, THANK YOU!!! I most certainly felt like a failure!!! im going to speak with my administrator and ask that while im in my learning phase and taking my courses that they take me OFF the oncall list. i mean im on call 7 days out of the month and when i say i work 80 hours a week i mean it!! its insanity.

amoLucia specializes in LTC.

It'll be rough because positions like yours (ours) are sometimes treated like a reserved 'spare tire' in the administration's car trunk. Like you'll always be there as a 'last resort'.

Even though you has a small census, there'll still be admissions & readmits, change in status, odd-time family conferences, etc and that gets forgotten until you flub a due-date or loose 'precious' reimbursement. MDS 3.0 is more detailed & precise than in the past which can easily be overlooked. Also do you do computer MDS? That's a whole 'nother animal' unto itself! :wacky:

IF YOU CAN, volunteer and preschedule to do a RARE 'floor' shift when it's convenient and planned. (NOTE: There will be those here that will suggest NOT doing this as again you'll likely be taken advantage of. But at least, you'll be perceived as a 'team' member.)

I'd be curious why your position opened up - like was your predecessor facing the same issues??

When you speak with your PTB, come prepared with numbers and info. CAUTION: DO NOT give them ammo to crucify you that you're struggling, else they may seek to replace you and move you back to general staff. In otherwords, don't do their job for them!

Again, good luck.

thats shat i was worried about....them seeing me struggle!! and ive been doing just that picking up at least one or two shifts weekly to help. and my corporate mds boss told me not to that i need to focus on mds's but it was impossible. yes the previos mds girl was new also and she said the same thing, it was too much, but the facility said she wasnt "getting it" ughhhhh. catch 22.

amoLucia specializes in LTC.

I kind of guessed so!! Admin expects everyone to wear multiple hats but when your 'real' hat keeps falling off, there'll be fallout.

Perhaps your corp consultant can be your best ally but that 'boss' is still a boss and your performance will still be scrutinized. So be carefull!

1 - RESTRICT your floor shifts any way you can. 2 - Close your door and just stick to your MDS-es. (Easier said than done!) 3 - Can some of the process be delegated? I've known the LSW to do the scheduling and mailings. And Therapy Dir leads the meeting (Anyway, it seemed like attending people only want to hear about 'billable minutes', pt Therapy progresss (or lack of), and how long Therapy is planned before coverage gets dc'd.) I also found that Therapy Dir is very time-oriented and can keep conferences focused from time-squandering. 4 - Keep a routine standard 'agenda' for EACH resident (like a script) for meetings and keep refering to the agenda to avoid wandering all over. 5 - Who does your documented care plans? Ideally, floor staff should be contributing, not just a UM or MDS writing care plans. 6 - In your case work, if you catch something unrelated that needs followup, delegate it (like a med discrepancy).

Everybody's process is different and folk are very reluctant to change 'because that's the way we always did it'. But your position reoups reimbursement and keeps the regulatory "MDS police" happy. So you need to be doing a good job.

I really believe your biggest impediment is the time you spend NOT being MDS. And trying to unburden the load when there's somethings you might be able to delegate. Even if short-term.

Repeating, good luck!

you are amazing....THANK YOU!!!! I spoke with my corp boss and she sees whats hallening and tomorrow she is having a meeting with the admin....crossing my fingers!!! and about delegating...your right!!! alot of this CAN BE delegated!! I'll let you know what happens!!!!

Thank you!!!

amoLucia specializes in LTC.

Just be careful - your Admin/mgt likes having you (and your predecessor) as 'spare tires'. It's so difficult to do one's REAL job when you're pulled but the PTB freq don't see that (or else they 'selectively' dont want to see it). It makes their job easier not having adequate floor staff or disciplining excessive absentees. Your Admin/mgt might become a bit sensitive or 'touchy' if Corp notes it. Be careful!

As I've said, I've 'been there, done that'. YEARS of experience but never as MDS/RNAC, altho I've done tons old MDS 2.0 as UM. Been Staff Dev, Inf Ctrl, Suprv (all shifts) and UM. MDS has sounded interesting but 'NO, TY'. It's become so complicated and too risky for me to be the reason to miss reimbursement or have the MDS police unhappy and you take a deficiency hit (or worse).

Don't overburden and 'do unto others' what you're trying to delegate - you'll make them angry and they'll be lining up at the front office to complain. Try to make a transition as easy as possible.

Is there something that's needed to help staff do nsg care plans? Some inservice? What's your nsg documentation format like? I think there might be programs/documents out there that 'line up' just like the MDS sections. Does CNA documentation and care plan match, esp concerning ADLs?

Are you computerized? In MDS, is a RN signature still nec? Used to be an RNAC or the DON signed off. As DON, I would want to be as sure as poss that I trusted my MDS person to be accurate. You're still learning ...

Nurses are just having to catch so much overlapping slack - other disciplines protest 'not my job' or 'too much' and they get away with it.

I wonder what the future portends ...

its like im damned if i do damned if i dont!! if i say something im gonna look like a complainer...if i dont its going to continue this way. ughhhh

yes the RN still needs to sign off.

....stay tuned. im going to see what happens today. ill be back!!!

amoLucia specializes in LTC.

Yes - I do understand. Just tread gently.

MDS is time-consuming & quite detail-specific which why I believe the MDS/RNAC position has become so needed. Your facility DOES SEE its need to have the position filled. That's a plus for them to try to hold onto you and a plus for you to be needed.

Please check back.

i decided to take your advice and not say a word. i just closed my door and wowwwww the things accomplished with a closed door!!!


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