When the State comes in for Survey....

Has anyone out there been working in a Nursing Home/Skilled Nursing Facility when the State comes in for their Survey of the facility? The place I work is due this year between Sept and Nov and I'm just a little freaked out. I've been on the floor as an LVN about 14 months and I've heard horror stories...they follow you on the Med pass, watch techniques with G-tubes etc. If they observe a nurse making an error, whether large or small, does the facility know exactly which nurse "skrewed up?" If anyone has had any experience being through this situation....I'd like some input...what to expect...should I just quit now???? [bANANA][/bANANA]:uhoh21::uhoh21:

Hi there dcoffee!

I am also a LVN in California, and I have worked mainly in Los Angeles County too. Even though I do not have SNF experience, I have had a suprise visit from the State, when I worked in Home Health. Sure it was nerve wracking! But, if you have your documentation in order, provide nursing care correctly, and answer all questions truthfully...you should have no problems.

The nurse who conducted the inspection checked my med. and treatment records, the current physician orders, checked my meds for expiration, had me demonstrate to her how to trach suction the patient, turn on the O2 tank, etc. At first she was stern, cold in the begininning. But, once she saw that I could do my job she was pleasant. No complaints on...but, the parents of this particular peds case complained that the night nurses were sleeping on duty. I did not see this when I reported for the AM shift. This child was complete total care, with severe developmental delay, had seizure activity, and required constant suction at times.

Quit? Don't do it! Not unless you feel that this certain SNF is NOT treating you right, have non-supportive management, and the work environment is toxic. You have been there for 14 months, so you are definitely doing fine. Maybe, you can get in touch with other SNF'S in your area that have already been surveyed by the State before. Wishing you the best in whatever you decide to do. Go ahead and send me a private message if you like. Take care...let us know how it goes!

I have never been involved with the State as a nurse, but I have experienced it as an aide, and it is a pain in the rear. I do suspect that you should be fine. Read up on their policies and procedures. Most facilities sort of spoon feed you on what type of questions are usually asked, and how to respond. And, at the same time, pray them away from you. Not trying to instill fear...they can be just annoying! My affirmation usually is that they stay away from me, however, if approached, may I be well prepared.

Do everything as precisely and correctly as possible. When I've been "warned" that " state's here" upon entering the servants...oops! staff's entrance "out back" on the first day of their arrival, I think to myself, and sometimes say out loud, " so? I try to do everything by the book anyway....why shoud I act differently when the state shows up??!!

That kind of attitude has helped me mroe than anything when being quizzed and / or followed by them. They have sometimes asked me my name and my title, also....they do write it down. Just a formality or in case I should freak and do something wrong? I don't know. They are good "police" when it comes to making most folks feel intimidated. Don't let them make you overreact that way. If you do your job conscientiously, you don't have a thing to worry about.

The old rule applies here.....Do everything as if someone were watching you all the time. I have been a nurse for a long time and have been thru a few state surveys. Yes, they will follow you and watch a Med Pass with you. Most of the time you facility will help you get ready for this. They will bring in your phamacy to help you remember all the golden rules about med pass, they will coach you thru all you facility procedures. Remember that you are not alone in this. The place you work for wants everyone to pass. If you have any questions about something, go ask you nurse manager. The more confidence you have in your ability, the better you will do.

Hi,

Yes I worked the 7-3 shift in a LTC facility during a State inspection. First and foremost, the facility I worked for had previous problems, so everyone was amped up and stressed out. I was a newer nurse at the time, less than 18 months licensed. They watched my Medpass, and Yes I made some mistakes. We all know as nurses, you develop shortcuts. I was passing meds and an MD called, so I locked the cart and went to the phone. BIG NO NO....never leave your medcart unattended. Second, I gave an 8am med ( the only scheduled 8 am med) with the 9am medpass. I didnt follow the plus or minus 30 minute rule. And Third, yes, I made three errors, Since I had worked there for over a year and knew all my residents, I kept forgetting to check their namebands (This was the 90's when all pt's had to have namebands) therefore screwing up the 5 "R"s....right patient! My supervisor told me the next day what I did wrong, and I felt awful. BUT in the giant scheme of Nursing, I know nothing I did was life threatening( The 8am med was a multivite or zinc or something) and even my Supervisor told me, I did fine, just pay attention to textbook detail. The state inspector never said a word to me..just lingered around with a clipboard. It was intimidating and annoying but if you just stay calm and do what you are suppose to do..you'll be fine! And remember, we are human! Good Luck!!

Had one state guy follow me for a solid 8 hours, even went thru my garbage when I was fininshed. Do everything everytime you pass meds as if state is with you, then it will not be such a big deal,,,it will just be another med pass to you

As long as you are doing your nursing care correctly,why are you worried?I was never afraid when the state came in.I was doing the best nursing care I knew how.I suppose if you were doing it below standards they would tell you and you could take steps to rectify the situation.

State visits my facility quite often due to problems they have had.