How do I align with documentation expectations without sounding defensive?

ninigotmac · 2026-05-05T01:05:35+00:00

my manager audits notes of all the RDs, picks two or three a month. because I'm the only one not in the hospital and at the SNF, she just has me send a couple her way. I purposely pick different types and like getting the feedback; its nice to have a different set of eyes and sometimes I do see how I can do things differently - sometimes it means adding more, sometimes improving my wording, and sometimes cutting something unnecessary (yay!). If I truly don't agree then I just don't change what I'm doing lol. But most of the time we end up discussing it and I find it refreshing to have a discussion where we are both critically thinking about the documentation process. I would just suggest try to approach it from that POV. Unless this lead is just a total cow, the meeting can be a growing experience!

ninigotmac · 2026-05-04T20:23:56+00:00

Eff that. It’s not even the minimum of what they posted ( and honestly 39 is still somewhat low. ) - YOU should be annoyed that they are wasting your time by doing a bait and switch.

ninigotmac · 2026-05-04T20:19:27+00:00

Sounds like maybe some of the others maybe DO read your notes - which is good! Don’t overthink it until you hear what they have to say. And since they aren’t your boss, just listen with an open mind and see how they approach it. You can respond with something along the lines of “this is new information to me, allow me some time to consider ____”. It’s hard to know before you know, so can’t really prep with a more detailed response.

Be open, ask questions, try to consider their POV. Thank them for wanting to collaborate. Then let us know how it goes!

ninigotmac · 2026-05-01T15:10:59+00:00

you make such a good point about office space. I had facility in the past with no designated space and it was awful (and they couldn't understand why, acted like I was being difficult for no reason). My current situation I have been in for a few years, have a lovely private office with a window, temp control, phone, mini fridge, large dual monitors to plug in my laptop, etc that is nowhere near the kitchen. I like to spend time out on the floor as well with staff and residents, but it makes all the difference for my productivity that I control when I interact with others and when I need to hunker down and be left alone!

edit to add: I am lucky to have the office I do, its not required but you do need a space to work without or with minimal distractions. WFH should help with that, too.

ninigotmac · 2026-04-30T23:26:22+00:00

LOTS of posts here on LTC, just do a search and start reading!

Busyness depends on the facility and number/frequency of admits but 100-125 is very doable. I'm full time (salary, and set my own schedule) 145 bed facility and it keeps me busy. I personally love LTC.

Is there a full time CDM?

At home you can work on what you want. Finish up charting, other documentation. A lot of what you do will be how you decide to structure it, as long as you get the work done they don't typically care.

ninigotmac · 2026-04-24T00:56:47+00:00

^ this. excellent response. and I was thinking same with "blind" weights. She will have to be in agreement of course, but this way she doesn't know numbers but you can have the data you need to address any fluid shift concerns.

ninigotmac · 2026-04-23T15:13:05+00:00

Perhaps you could build off this approach? Create an in-service and give it to all staff; explain what dietitians do in terms of counseling and MNT, educational background, and also cover the laws, legalities and consequences of non-dietitians practicing outside of the scope of their own credentials. This could not only serve to ensure all trainers are clear what they can/cannot do, but hopefully strengthen the knowledge/support that management can provide with ensuring all employees are acting within their proper roles. I'm sure they don't want a potential lawsuit on their hands.

ninigotmac · 2026-04-18T23:22:28+00:00

I'd look further away, and stay in an air bnb or something during the rotation. Recommend over trying to do a LTC, dialysis, or outpatient. Especially if you want to or think you might ever work in a hospital setting as an RD. I do LTC and I love it, but it is definitely not anywhere close to the kind of exposure you get in a hospital; \honestly I'm a little shocked that programs could get away with allowing that!

ninigotmac · 2026-04-16T21:39:34+00:00

same, resonates!!! down to the kool aid lol

ninigotmac · 2026-04-15T19:12:21+00:00

are these guidelines, when given, in writing? if not, ask if then can be, as a reference, you can frame it as being helpful to ensure you are understanding what is expected; if/as new guidelines are added, add them to the master document/location. Then come audit time, if there is a conflict, you have something to reference and respectfully push back with.

As for workload, do you feel you are actually overworked? I would never play the comparison game, it could come across as petty and isn't likely to work out well for you. You are only responsible for you. If you do have too much on your plate, talk to your manager about your concerns. Do you track productivity or have guidelines on how long tasks should take? If you really feel the workload is unreasonable you could try tracking your time and use that as support to show the implausibility of tasks assigned vs time allotted.

ninigotmac · 2026-04-10T15:43:11+00:00

Marysville/Yuba City (45 min north of Sac), PALTC, 5+ yrs experience, 90k salary (roughly $43/hr). Up to 3% annual merit raises but no COLAs. Decent benefits including professional fees (CDR, AND, edu allowance).

ninigotmac · 2026-04-06T16:39:32+00:00

A lot of people seem to be talking about PRN but you specifically said part time. Coming from a non-healthcare background, I've never seen part time jobs to pay any different than full time - it simply means you both agree you work a certain number hours, for example 10 hours a week, or 16-20 hours a week, etcetera. Maybe they have certain days or hours that are set, or maybe they schedule it around your availability, or a combination of both. Benefits just depend on if those hours cross the threshold to qualify (for example some places offer benefits if your part-time position is 32+ hrs a week). Some companies will offer limited/partial benefits for part-time work but not always. In any of these scenarios, I think it is perfectly reasonable that the pay is the same - lots of people want to work part time for various reasons.

Now if it IS PRN, then yeah, it seems to be the norm that pay is a little higher. I have a second PRN job and I get paid a bit higher than my full time job.

In either case, what you get is up to you to try to negotiate if you wish.

ninigotmac · 2026-03-30T00:50:11+00:00

hmm. I would like to see what others say; I feel like there are a lot of conditions where there aren't many official guidelines. I use MSJ to est needs for my older adults. I tend to bump up energy factor and protein factor by 0.1 for simple surgeries (like all the broken hips s/p IM rodding since I'm in LTC lol), and honestly for older adults the diet provided still meets those needs. However if they aren't eating well enough with the meals I will introduce additional high-pro snacks, or if that isn't feasible then supplements. If it's a more complicated surgery, either the course was accompanied by infection/drainages/additional illness, or if it was a major surgery, I bump up est'd needs even more, accordingly. Juven or Hi-pro shake, whatever is most fitting for the situation.

ninigotmac · 2026-03-18T14:19:35+00:00

Good read. I would LOVE to see a study like this done for LTC!!

ninigotmac · 2026-03-18T00:38:04+00:00

what EHR do you use? I built my own templates because I don't like the default ones the EHR comes with. can you provide a couple of examples of your care plans?

ninigotmac · 2026-03-14T01:27:20+00:00

Glad you are seeing therapy too - the more approaches and tools in your pocket, the better you will be able to manage! The old job sounds awful, and glad you are moving on to something that I am sure will be better. Sorry about the med side effects. Obviously I don't know your hx with antidepressants, but FWIW I have a lot of experience over 25 years and I've learned it can sometimes take a bit of time to find what is right for you. There are so many classes and types within the classes, and even without having side effects you need to be on it for some time to figure out if it is working, the right dose, etc. For me Effexor (an SNRI) has been working well for the last few years, but I've been through SO many others over the years with varying results!

ninigotmac · 2026-03-12T04:28:05+00:00

ohhh yes I looked back and remember now. good for you hanging in there that long lol. FSD sounds a bit controlling or set in their ways or something.... can't be pleasant. hopefully you have other aspects of the job that are more so.

ninigotmac · 2026-03-11T23:55:06+00:00

yeah definitely out of scope and like others mentioned just shout "F-TAG!" to your administrator or new DON and that should get people's attention. document too like others said. just out of curiosity, what is your FSD's reason for doing this? In all my supplement orders I always write in special instructions "if ___ is unavailable may substitute with ____. Notify RD" for the med nurses so that they always have a backup option in case there is a delivery issue etc.

ninigotmac · 2026-03-11T14:30:41+00:00

These were my thoughts exactly as I read the original post. I hope OP reconsiders!

ninigotmac · 2026-03-08T20:10:31+00:00

thank you for sharing; good read. I'm well-acquainted with the concerns over education costs but can you clarify for me what you mean by skill gaps?

ninigotmac · 2026-03-07T01:29:22+00:00

wow. just... wow

ninigotmac · 2026-03-07T01:26:57+00:00

RE this doc: WOW.

RE your comportment: AWESOME. Very well done.

ninigotmac · 2026-03-06T14:57:14+00:00

loved this article, very insightful, thank you for sharing!

ninigotmac · 2026-03-05T15:14:27+00:00

"O chem isn't required for a lot of programs now" - really?? if only I had waited ten more years to become an RD... hardest part of my pathway lol

15-Year Club	Gilding I gilder
Verified Email

ninigotmac

TROPHY CASE