When State comes to visit

Just ask your boss. She / he will likely know the common areas that staff needs to focus on.

Yes, the "key" issue was one for us.

Also, knowing where our "resource" manuals were, incl company policies, drug books, care plan guides, etc.

Be able to explain the reason for giving any med you are giving along with side effects, precautions, etc.

We had some pts with bizarre behaviors. I worked inpatient psych. The surveyors wanted tons of info on these pts to be sure we weren't neglecting them.

And all care plans and charting had to be updated.

The state surveyors are more so looking at your facility, than you as a nurse, as long as you aren't doing anything egregiously wrong.

Oh, I remember I had to move my badge to my chest for the state visit. I usually kept it clipped to my pants pocket. 😀

Hi! I have been a nurse in LTC for 20 years. When state comes everything is done "by the book". Just like being a student in clinicalls. You will know when state has arrived because every other department is suddenly around and helping the nursing staff. We have medical record girls that suddenly appear to help the CNAs pass lunch trays. The activity department is suddenly appearing to pay attention to the lowest functioning residents. It can, sadly, be comical to see. I have always been honest when questioned by the surveyors. I believe they see thru the "extra" help that appears. Just do your job, be honest, and don't get so nervous. State comes in to make sure residents are properly cared for. As a LTC nurse, I also am there for the same reason.

Try to remember that state isn't there to get you, they are they to make sure that rules/regs are being followed and that residents are receiving the care that they are care planned for.

If a surveyor asks to watch you do anything, it is perfectly ok to ask for a few minutes to prepare. You can refer to your policy/procedure manual or have your nurse manager/DoN go over the procedure with you. You can even request that your manager be present while you perform whatever state wants to see.

You can never wash your hands or change gloves too much, but you sure can wash/change one time less than you should have. We got tagged on our last survey as a nurse performed a dressing change to the textbook letter, but dried her hands on her scrubs after she was done. Insta-infection control tag. Remain mindful that until the surveyor in no longer in your presence, they are watching even if you're "done" with what they've asked to see.

Never ever, EVER tell a surveyor "I don't know" and leave it at that. My default response is "I'm not sure, but let me find that information and I'll get back with you." Then follow through. They know you don't know everything. What they want to see is that you know how to use your resources and find the information that they've requested. Case in point: I had worked at my current facility a whopping 2 months when state came in for full book and a surveyor asked to interview me. I grabbed a blank sheet of paper (knowing full well I was going to be asked a ton of questions) and went to the interview. Sure enough, I was asked many questions on P&P and that I was unfamiliar with and wrote down the questions. I told him the default "I'm not sure but..." and he agreed to meet back with me in 10 minutes. I gathered not only the answers, but where I found the info and answered his questions. He told me "Very good! That's exactly what you're supposed to do!" (A heartfelt thank you to my wonderful nursing instructors who pounded that nugget of advice into my head.)

Anyway, the surveyors are not beasts nor are they after your license, they just want to make sure you know how to do your job, find needed information, and know your facility policy. It's gonna be ok. :)