You are lucky that you work w/S.W. that is able to talk to families or the
patient about changing conditions, permissions for restraints or specific meds
singed................If I am not doing it the DON or ADON does. Our s.w.
doens't have a clue about medications, what a restraint is for much less how
it is determined how/why/what is used by regulations. A DNR. S.w. doesn't even
understand exactly what it is for, and a frightened _expression_ of dead silence
is the reaction. She then will go back to her office and stay until either
Myself, DON or ADON or gone for the day. She comes in a 11 AM, doesn't even
face a family or issue until we are all gone. None of the floor staff ever
send a communication form or call her, they ALL know it is just like shooting
a dart in the dark. Again, consider yourself
lucky.....
Claudia
>From: "Corey Ali" <[EMAIL PROTECTED]>
>Reply-To: [EMAIL PROTECTED]
>To: <[EMAIL PROTECTED]>
>Subject: Re: RNAC per facility numbers
>Date: Wed, 7 Jan 2004 19:29:33 -0500
>
>My point was ONLY about the delirium RAP. Soc.
Services does all of the other stuff, including explaining the DNR's,
discussing the changes in conditions, getting the DNR's & Permissions for
Restraints or specific meds signed. They spend so much time
tracking down families, they barely have time to spend actually talking with
the residents!
> ----- Original Message -----
> From: claudia farrell
> To: [EMAIL PROTECTED]
> Sent: Tuesday, January 06, 2004 6:59 PM
> Subject: Re: RNAC per facility numbers
>
>
> Ok, I didn't mean to start an issue w/Delirium
rap. I agree. But the other sections are not unreasonable for a S.W. to
complete..............Who in your facility discusses w/the families about an
DNR? And for the record, having been a Hospice RN for years, I couldn't of
done my job w/o the support and strength of the social workers I had the
privelage to work with.
>
>
>
>
>
>
> Claudia
> >From: C Hannant
> >Reply-To: [EMAIL PROTECTED]
> >To: [EMAIL PROTECTED]
> >Subject: Re: RNAC per facility numbers
> >Date: Tue, 06 Jan 2004 09:57:22 -0500
> >
> >I agree since it is possibly the sign of an
acute medical condition
> >and needs thorough review...cher
> >
> >Holly Sox, RN, RAC-C wrote:
> >
> >>I think Corey's point was that the
Delirium RAP is often related to
> >>other complex medical issues that
are more likely to be in the
> >>nurse's body of knowledge than a social
worker's. I do the
> >>Delirium RAP for my residents for that
reason as well. I am fairly
> >>certain Corey wasn't slamming social
workers, or indicating that
> >>they weren't capable of completing any
RAPs. Just that in her
> >>experience (and mine), the Delirium RAP
seems more in the nursing
> >>domain.
> >> Holly
> >>Holly F. Sox, RN, RAC-C Clinical Editor,
Careplans.com
> >>www.careplans.com
> >>[EMAIL PROTECTED]
> >>
> >> ----- Original
Message -----
> >> From:
[EMAIL PROTECTED]
> >> To:
[EMAIL PROTECTED]
> >> Sent: Tuesday,
January 06, 2004 7:26 AM
> >> Subject: Re: RNAC
per facility numbers
> >>
> >> These are folks
with BSW's and/or MSW's? Gosh I think at that
> >> level they'd be
more than able to understand and do a RAP.
> >>After
> >> all the MSW had
to do a thesis and that be much more
> >>complicated. And
they have more education than I do as a
> >>diploma nurse. Every
> >> social worker
I've had the pleasure of working with did both
> >>the
> >> MDS sections as
previously indicated and their RAPs. Some
> >>needed
> >> my help, seminars
or help from their consultants but they did
> >>the
> >> RAPs and
well. I have had some resist doing the RAPs
> >>foreigning
> >> ignorance, but
once it became clear it was part of their job
> >>and
> >> needed to be done
or another social worker who could do the
> >>RAPs
> >> would be sought
the problem cleared up. Yes, we often do the
> >> nursing aspect of
the MDS, but ideally we should be
> >>coordinating
> >> the team that
deals directly with the resident to complete the
> >> assessment and
care planning process. I think we need to aim
> >>for
> >> that as much as
possible.
>
>>
In a message dated 1/5/2004 10:09:38 PM Eastern
> >>Standard Time,
> >>
[EMAIL PROTECTED] writes:
> >>
>
>> With all due respect
to the many overworked, underpaid SNF
>
>> social workers out
there (and there are many), I do not
> >>think
>
>> it reasonable to have
a non-medical person work on a
> >>delirium
>
>> RAP. There
are too many complex items in the mix:
> >>medicines,
>
>> illness, change of
psychosocial status, loss of home,
> >>pain,
>
>> and then mix in a
possibly pre-existing dementia. It's
>
>> unreasonable to
expect a BSW, or even an MSW w/o special
>
>> medical training to
work their way thru that RAP. I think
>
>> they can do cognition
(most of them), mood & behaviour,
> >>but
>
>> have often found the
Activities person to be much more
> >>capable
>
>> of doing psychosocial
than social workers, although they
> >>are
>
>> almost always the
ones assigned to it.
> >>
>
>>
Susann Irwin, RN
> >> MDS Coordinator
> >> Garner, NC
> >>
>
>
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