Re: significant change assessment-Dolores Galias responded - Critical thinking-

[dfrias]

AMEN Dolores! My opinion.... More MDS and floor Nurses need to assess (as you just explained) and not worry about the paper as much as what is really going on with their resident.  I think many MDS nurses feel change of conditions are a burden....but in fact this burden is part of a job description!  That captured change of condition may save a life or stop a particular problem from worsening. I do admit I am a change of condition freak.  I find it hard to believe that the majority of residents in the 80-100 year old range do not experience some type of a decline in one years time.  Rena has wonderful word and saying... I love using it..."Critical Thinking"is being lost today."  A follow-up statement I have to Rena's statement is:  I believe the Critical Thinking skills taught are being lost due to the nurse attempting paper compliance and the admistration (higher ups)  putting the MDS Nurse on the floor for duty rather than straight forward MDS assessment responsibilities.  These assessments include an in-depth RAP (I love the global narrative) and follow-up care plan for each resident.  I personally believe that the MDS Nurse is the driver of the assessment and should be  over-seeing all IDT care plans to the point of changing such care plans if needed.   Well enough of my soap box The Nose ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] Sent: Monday, March 29, 2004 11:14 AM Subject: Re: significant change assessment-Dolores Galias responded Thank you Debbie,  I am an old ICU/CCU nurse.  I never treat symptoms, I always look for the underlying cause.  Once you observe the symptoms and identify the underlying cause you usually have TWO changes that lead to a SCSA MDS. Care planning for treatment of the underlying cause resolves the problem. No matter what single change you observe, assess for the underlying cause.  Never treat symptoms alone my favorite example is to have my audience sit properly in their chairs, put the right arm in their lap bent at a right angle at the elbow.  Turn the hand up with the palm up and the thumb pointing away from the body.  See how long you can sit that way without developing pain.  DO NOT MOVE THE HAND UNTIL YOU FEEL PAIN.  Then I instruct them to just take hold of the thumb and turn the hand over  so it is pointing toward the body.  AWWWW, pain relieved--no medication needed. See, we did not treat the pain, we treated the underlying cause and the condition was resolved with positioning.  Now--care plan it. Delores A very wise consultant once lectured on this very issue, she said.... "Why was there weight loss?  A person does not start losing weight unless something else is going on somewhere...."   Find that somewhere. Thank you Dolores Galias...that mode of thought kept our facility free of MDS deficiencies for 8 years. The Nose Delores L. Galias, RN, RHIT STATEMENT OF CONFIDENTIALITY: The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify D. Galias, RN, RHIT immediately at [EMAIL PROTECTED] and destroy all copies of this message and any attachments.  Thank you for your cooperation IF YOU WISH TO BE REMOVED FROM MY MAIL LIST PLEASE SEND A BLANK E-MAIL TO [EMAIL PROTECTED].com WITH THE WORD 'REMOVE' IN THE SUBJECT LINE.  THANK YOU.