Admits
The tech is responsible for which parts of the admit:
- Intake Forms
- UA completion and send off
- Second signature on intake forms
- Personal Inventory completion and second signature (including pictures)
- Intake photo (even for re-admit)
- Setting up client personal boxes
When a patient leaves Detox we should let them pack all of their stuff on their own?
False. Patients should be with a staff member while packing their stuff to ensure they are not taking items that belong to the facility with them. All to ensure that ALL belongings were packed and the clients are not leaving anything behind.
Is it appropriate for me to let the client go outside and smoke prior to completing body search, obtaining all bags, and completion of UA?
False, the client should be completing all intake forms, UA, body search and obtain bags prior to going outside for any reason.
Unless it is an emergency, or you are dying, you should be giving plenty of notice. Schedules are posted on the 15th on the month prior to ensure time for correction or changes. You are responsible post the final schedule, to get your shifts covered if you cannot make it. In case of an emergency your manager is ALWAYS willing to jump in and help you work something out. EVERYONE HAS BEEN SO AMAZING AND HELPFUL TO EACH OTHER SO THANK YOU!
When I get labs on the fax machine I should, leave them in the folder for the doctor to see?
False. Please send Blake all labs as they come through and PLEASE point out the labs that are out of range. He doesn't always see this.
The Nurse is Responsible for which parts of the admit
- Ordering all medication for each patient: PRN, OTC, Taper Medication, Home medication
- Nursing Assessment for ALL Detox Intakes and Veterans (even if they are straight to RTC) and Medical Intake on all other straight to RTC
- TB Test, follow-up, blood draw, IV administration
How do we know what we need to improve on?
Detox client satisfaction survey
Please when a client is starting to talk about discharge, especially for referrals and VA clients, please touch base with Julie and or myself PRIOR to having that conversation so a client doesn't get their hopes up that they can leave long before they can actually discharge. (I will talk to Blake about this as well) A lot plays into this when it comes to insurance authorization and open bed availability.
How early/late should I be for my shift?
You should arrive 10-15 minutes prior to your shift to set up (not earlier). Do not show up late unless you have communicated with the previous staff that they are okay with staying longer. This is to respect every one else's time.
I know that when I get to the label printing page, I need to scroll down ALL the way and click Save & Send and ensure on the next screen that it changes from Pending to Sent
When a patient admits and their BAC is over 0.3, what should I do?
Notify the Dr. and Intake thread (admissions team) of current BAC. IF client is cooperating, wait 20 minutes to see if BAC is trending up, or decreasing to make decision for admission.
When I clean an apartment, in addition to normal cleaning responsibilities I should:
Check under the beds to ensure they have been swept and mopped, ensure the coffee pots have been emptied and cleaned, discard past clients food, and the dryer vents are emptied.
How important is shift change report?
Shift change report is SO important. We should not be trying to rush out of there or give report that has missing information. Please ensure that throughout your shift you are writing things down so the next staff coming on is VERY informed on the status of every patient.
I am allowed to leave early on my shift if they Detox is chill?
No - The director is the only person that should be giving staff permission to leave early or come in late for a shift. The person you are working with, does not have the authority to send you home. If are needing accommodations please send me a direct message, so the team member you are working doesn't have to feel awkward.
Should labs be called in every shift for pickup?
Yes, labs should be called in every shift for pickup. The phone call does not have to wait for day shift.
When a client admits the staff should ensure in the intake and residential nursing tab that:
The TB test information is filled out.
Follow up date for TB is on the board
Second signature is on - admissions vital signs, initial drug screen & breathalyzer, and personal inventory
It is the nurses responsibility to ensure that all medication is cleared through the Dr. that is being sent with the patient and ensuring they take it with them?
Can a client use their phone prior to 72 hour blackout?
The admissions team will tell you upon admit if someone has special permission to use their phone prior to the 72 hour blackout ending. If not, please assume they are on their black out until the 72 hours is up. If they didn't take care of something before coming to detox, they can wait until their blackout is complete to take care of it.
How often should I be cleaning the staff fridge out?
Night shift on Monday, Wednesday, and Friday, night shift needs to look in the staff fridge and clean it out. Food that is left in there for 7 days or more, will be discarded without questions.
How do I correct the missing boxes when a UA needs to be sent if the admissions team is not available?
When a patient admits, on their face sheet (the information tab) I an scroll down to the UA section and if the patient is any insurance EXCEPT BCBS, I put insurance for billing and their name and insurance, and if the patient is BCBS or cash pay, I will put facility for billing.
What should I go over with the patient when arrive?
- phone policy
- help them get numbers from their phone for after blackout
- smoking policy
- questions about intake forms
True, clients need to sign that they have all their stuff before they leave.
TRUE!!!! TB Testing is so important. (We recently had a client in St. G that was positive, luckily it was a false positive but we never would've have known to follow-up if we didn't do our check 48 hours later)
I must be willing to help with weekends/holidays even if I am part-time or PRN?
Yes, we have a lot of PRN and part-time staff, and not a lot of full time. This means that everyone needs to be able to jump in and help on rotating weekends so one staff member isn't left to work all the weekends just because they are full time.
How often do I need to follow up with the Dr?
Even if you are making a change, Blake needs to be notified. Night shift, unless it's an emergency Blake can be notified right before you leave your shift in the morning. I.e John Doe was experiencing intense withdrawal symptoms last night, extra Valium was given at 0300. Jane Does BP was elevated, gave an extra clonidine at 0100.
THE DETOX INTAKES & UPDATES THREAD must be used for all communication with Blake aside from phone calls. Other staff members needs to be able to follow along.