Admissions
You receive a call from Acute Care about a possible admission coming at 5:55pm. Charlene and James already went home for the day. The NIC is adamant that this resident needs a bed as soon as possible and the NIC knows a bed is available and the resident's orders have already been made and the resident is ready to come over to be admitted. What do you do?
Let the NIC know that the Manager will be called for approval.
You are doing a nightshift and notice that the new admissions careplan does not have current information relevant to admission re: guardianship. What do you update?
Careplan worksheet, careplan (front page) and kardex
You are the only nurse on and you are just finishing your 1800 meds before shift change. You are notified by the PCA staff that room 300 has had a fall at 1900 hours. What do you do?
a/ leave for next shift to deal with as you are tired.
b/ do not do anything
c/ let the PCA handle this
d/ do an assessment, do your post-falls report, let PCA do RL6 and do your charting after shift change, as you are getting paid until 2000.
It is Monday morning and start of your shift, a PCA comes to you and says, resident in room 505 was soiled from head to toe. What do you do?
a/ Tell them to change him and don't do anything
b/ Tell the PCA that is your job
c/ Go and assess resident to check if urine is new or old, document this, report to oncoming staff that resident in room 505 was soiled and esnure that this resident is checked during hourly rounds. If this continues to happen, will report this to Supervisor.
You are having an awesome shift. You give your meds out at the perfect times. You did not have any falls. No one needed pain meds. You even had the time to work on your cultural sensitivity course. Towards the end of the shift, 2 of your co-workers started arguing and yelling at each other, what do you do?
a/ ignore them
b/ report them to Charlene and James
c/ go and remind them of the expected behaviours policy and remind them that they need to have this discussion in a private area and if they could not work on this that you as the NIC could assist.
You received an admission at 1800 hours from Acute Care and you are the only nurse on. No charts have been made, no orders have been completed and you still have not given your medication for 1800. The resident is waiting to be admitted from Acute Care and the AC nurse said that they are ready to admit the resident and the orders can be done by the night doctor. What do you do?
Inform the Acute care nurse that you are the only nurse on and there is only 1 nursing staff on nights and that the admission will have to wait until 11pm once the PM meds have been given and We can only admit the resident when the orders have been completed. Or we can wait until dayshift when there is the Team Leader on duty.
You receive orders for labs and CXR for a new admission. What do you do with this information?
ReQ for lab and CXR, document this in the careplan, not the careplan worksheet and pass this on in report.
At 0700, it is reported to you that room 410 has had a fall and hit his head and is bleeding profusely. What do you do?
Call ER and notify them that we are sending our resident down asap for a head lac and that his BP is up and we are sending the resident down with a PCA as the resident needs to be seen as soon as possible for this head injury. Make a note prior to report and hand this information off to the NIC at shift change for a follow-up.
You are starting your shift and two PCA staff are seen arguing in front of a resident who is cognitively intact, what do you do.
a/ watch and do nothing
b/ Let Charlene and James deal with this
c/ Go to both the PCA's and tell them that this needs to be done privately and let them know that if this continues, then you can assist them with working out issue before going to James or Charlene.
You are completing your shift and you and another co-worker have a disagreement and the PCA starts yelling at you, what do you do?
a/ do an RL6
b/ do an RL6, send an email to James and Charlene
c/ talk to the PCA after she has calmed down and remind her of the Expected Behaviours policy. If this continues, talk to the Supervisor and explain that you discussed this with the co-worker and that her behaviour is still the same and ask for their assistance with the matter.
James and Charlene is off work and it is a weekend and you receive an admission. This client is under Public Guardian, no family to sign consents, what do you do?
Sign for resident and scan and send admission forms to Team Leader for James to send to Public Guardian after weekend.
You receive a complaint from a family member that he/she has not been notified about a fall that recently happened. What do you do?
The NIC can deal with concerns at anytime. Which is why the NIC is called the NIC. The NIC needs to check the chart and see when was the fall, then see who was working and who was notified. Normally there are 2 designated people on our residents files of who to notify for emergencies. This 2nd designate may have been notified if the 1st contact could not be reached. Then the NIC needs to call that person and explain what had happened.
Do an incident report at what he states and make a note in the chart of same.
You are finishing your shift and you hear two PCA's gossiping about a staff member, what do you do?
a/ go and listen
b/ join the conversation
c/ tell them that this is not the appropriate place to have this discussion and this should be only during alloted breaks and remind them of the Expected Behaviours policy
You receive lunch from the kitchen and find there are only enough meals for 20 residents and you call the kitchen and they start yelling at you, what do you do?
a/ do an RL6
b/ tell James
c/ tell Charlene
d/ ask for their name, tell them that this behaviour is not tolerated and if they do not calm down then you will have to speak to their supervisor.
You get a call re: new resident who was admitted for palliative care. You get a call from John Doe asking for his status stating that he was his brother. What do you do?
Check his careplan to see who is his next of kin and direct him to his next of kin.
You receive a consult for John Doe to downgrade his regular diet to a soft from SLP. This is signed as an order. What do you do?
Take this off as an order, then leave a sticky for the physican to sign order. Then update his kardex for a soft diet.
A resident comes to you and says he fell yesterday and hit his head, what do you do?
Assess the residents for any injuries and do GCS score, this is post 24 hours, so if GCS is fine and VSS, then do a note in the chart and do an RL6 and report this to the family.
You are shopping at IDA and overhear 2 people talking about a resident and they ask you if this is true, what do you do?
Tell them that you cannot discuss concerns about any resident in public and if they have any concerns they can call the floor.
Laundry services has brought down the laundry and picked up soiled linen to go wash and saw how much laundry they need to do and started crying to staff and telling them how understaffed they are, the PCA reported this to you, what do you do?
a/ don't do anything
b/ do an RL6
c/ let James know to talk to Supervisor
d/ let James and Charlene know to talk to Manager
You are receiving an admission from the Sahtu region for a 2 week respite admission. The client comes alone and answers your questions very well during admission and signs all consents and the admission goes beautifully. You later find out that the resident has dementia, what do you do?
Find out if the client is under Public Guardian. If she is not, then you make a note stating his mental status during admission (A+O x 3 during admission, no POA).
You receive a new admission for a resident who is 2 person assist. The careplans are not reviewed by staff after his first day after admission and the PCA does not follow the careplan and hurts herself doing 1 person assist with care and comes to you and reports this to you, what do you do?
Inform them they need to follow the careplan. Inform them they need to go to ER for tx and inform the supervisor of same to fill out a WSCC form. Ensure staff are reviewing careplans on a daily basis after report.
A resident had an unwitnessed fall at 0700 and reports this to you at 1900 what do you do?
a/ report this to your manager for negligence, as this was not reported last shift
b/ send an email to Charlene and James re: complaint that NIC did not do her job
c/ ask the resident if he reported this to the NIC last shift, check for injuries. Do an RL6 and report this to the family, as well as do a nursing note.
You are on your break and went to cafeteria to get a sandwich. One of the kitchen staff asked in front of a customer, I heard John Doe died, what do you do?
Apologize to the customer and tell them that you cannot discuss private information in front of public and tell the staff member that if they have any questions, they can call the floor.
You are having a beautiful day and your shift is almost done. Before shift change, a PCA comes to tell you that a resident in room 502 reported to her that she was enjoying her meal that the family brought in which included dry meat and dry fish and then you realized she was soft diet. The PCA did not have a clue which diet she was on as they did not review the careplans in the morning. What do you do?
a/ think how nice the family brought in traditional foods for her and thank them
b/ report this to James
c/ do an RL6, talk to the PCA about the proper diet. Call the family and let them know that the resident is on a soft diet and thank them for brining the food in, but to let staff know prior to brining food in the next time.