Calling all HH Nurses, roll call - page 37

Hi, as a newly appointed moderator, I want to live this forum up a bit. I just resigned my position as a HH supervisor, to go back to the field. I have been a nurse 20 years, 17 in critical care,... Read More

  1. by   LuLu2008
    Question for HH nurses: A doctor orders a medication po/sl. The pharmacist at a SNF fills it and supplies a special kind of soft flat syringe for administration with the medication. The SNF lists it in the MAR as route: po/sl. The label on the medication reads po/sl. Yet, when I write down in the patient's list of meds that the route is po/sl I am told it is either one or the other, cannot be both. What do you think?
  2. by   annaedRN
    Could you write it as 2 separate orders for your agency/records. One for PO and one for SL PRN if not able to take PO. Just a thought. Don't know why it should be a big deal either way though. For us, as long as the doctor orders and signs it, it stands.
  3. by   LuLu2008
    Quote from annaedRN
    Could you write it as 2 separate orders for your agency/records. One for PO and one for SL PRN if not able to take PO. Just a thought. Don't know why it should be a big deal either way though. For us, as long as the doctor orders and signs it, it stands.
    I had the same thought: the doctor ordered it! But of course, doctors do make mistakes......
  4. by   ernursechic
    Hi Yall,
    I graduated last May with my assiocates degree in nursing. I went and tried a Med-Surg floor. I absolutely hated every minute of it, much less 12 hours of it. I left the hospital and landed a job doing Home Health. Being a new nurse I depended on myself alot! This taught me so much. Having no one around, I learned to trust myself and insticts. I did this for about 6 months. Then I decided I need more skills! I went back to the hospital this time to the ER at our local indigent hospital. Boy it was a ride. One that I will not take again. I have the skills to deal with anything now, but sure made me miss homecare.
    So...
    I just landed a new job with another Home Care company and will start in the next 2 weeks. I know now my calling is in the Home Health industry!
    Shelly
  5. by   lamazeteacher
    ernursechic:

    congratulations on your return to hh.

    now on a serious note, i just read about home care medicare fraud, and would like to refer you and other hh nurses to this site:

    www.hhs.gov/stopmedicarefraud

    we are mandated reporters of fraud, as well as abuseand since reading the article about the agencies in fla i became aware that we need to be on the lookout for that sort of thing. it seems that our responsibilities don't stop with providing care to our patients at home or in facilities where we visit them.....

    i once worked at a hh agency that provided health insurance through a company that charged $325./ month (about 6 years ago). upon inquiring about the cap on the benefit, i learned that the maximum that insurance would pay yearly, was $1350. you have to look into everything! :angryfire
    ###
  6. by   AnnemRN
    Quote from lamazeteacher
    ernursechic:

    congratulations on your return to hh.

    now on a serious note, i just read about home care medicare fraud, and would like to refer you and other hh nurses to this site:

    www.hhs.gov/stopmedicarefraud

    we are mandated reporters of fraud, as well as abuseand since reading the article about the agencies in fla i became aware that we need to be on the lookout for that sort of thing. it seems that our responsibilities don't stop with providing care to our patients at home or in facilities where we visit them.....

    i once worked at a hh agency that provided health insurance through a company that charged $325./ month (about 6 years ago). upon inquiring about the cap on the benefit, i learned that the maximum that insurance would pay yearly, was $1350. you have to look into everything! :angryfire

    ###
    unfortunately, home care agencies have been dealing with the after effects of medicare fraud for years. many changes have taken place in an effort to eliminate fraud, but obviously it still continues. thanks for the link.
  7. by   tabby224
    Hi, I am a HH nurse for over 20 years. Let me explain. I lived in CA in the mid 80'sd and went to LVN school. I went back to Indiana, and as an LPN, started HH care, I have worked on and off for over 20 years for the same company as a HH nurse. I have tried nursing home, hospital, doctors office, and I keep coming back. I have decided (hopefully) I will retire as a HH nurse. I went back to school in 1990 and became an RN, I now am back in CA and working again for the same company as an RN case manager. I love home health, I keep coming back to it. I love the flexibility, I love the fact that one day is never like the last, I love that I do not have a supervisor "looking over my shoulder", the paperwork sucks of course, but the positives outweigh the negative by far. I am hoping the newest medicare cuts don't make it to the board, but we will do what is necessary to take care of our patients. I just found this board, and just wanted to say hi to everyone.
  8. by   MzCool
    Hi enursechic;

    I am a recent graduate who has been working on a med/surg unit for about 6 months now. l am absolutely miserable there. I started looking into home care about 2 months ago and finally received a call from a local agency. I was surprised they even considered interviewing me since I had less than 1 year of acute care experience. I can't wait to get out of the hospital. If you don't mind me asking, what is your typical day of working in home care? Do you get paid by the hour? or by assessments? Thanks in advance =)

    -strugglin rn


    Quote from ernursechic
    Hi Yall,
    I graduated last May with my assiocates degree in nursing. I went and tried a Med-Surg floor. I absolutely hated every minute of it, much less 12 hours of it. I left the hospital and landed a job doing Home Health. Being a new nurse I depended on myself alot! This taught me so much. Having no one around, I learned to trust myself and insticts. I did this for about 6 months. Then I decided I need more skills! I went back to the hospital this time to the ER at our local indigent hospital. Boy it was a ride. One that I will not take again. I have the skills to deal with anything now, but sure made me miss homecare.
    So...
    I just landed a new job with another Home Care company and will start in the next 2 weeks. I know now my calling is in the Home Health industry!
    Shelly
  9. by   MzCool
    Hello All,

    I was wondering if anyone can tell me what the starting rate of a home care nurse in central/north jersey is.
    Thanks you =)
  10. by   kaydv1
    I'm a home care nurse in the Phoenix area and I have been struggling with this for the last few years. Employers want you to use your own car to do visits and my weekly milleage is 500-700 miles per week. I feel this is excessive and a car should be supplied for this kind of driving, after all they aren't going to buy me a new car when this one wears out. I'm very interested in hearing from others as to how milleage is handled where you work.
  11. by   AnnemRN
    Quote from kaydv1
    i'm a home care nurse in the phoenix area and i have been struggling with this for the last few years. employers want you to use your own car to do visits and my weekly milleage is 500-700 miles per week. i feel this is excessive and a car should be supplied for this kind of driving, after all they aren't going to buy me a new car when this one wears out. i'm very interested in hearing from others as to how milleage is handled where you work.
    you're right, that is excessive mileage. my weekly mileage ranges from 200 to 400 weekly. some agencies are supplying cars for their staff, mine is not one of them. i remember a few years ago i had bought a new car with a 2 year/50,000 mile warranty. i had put on over 50,000 miles in less than 2 years and when i had a few problems with the car the warranty was no longer in effect because of the excessive mileage. even though we get paid mileage a mechanic told me it does not come close to covering the wear and tear we put on our cars.
  12. by   mah09
    Hello! I just accepted a homecare RN position. I'm a new grad and worked with this agency during my community health clinical rotation. I'm excited and think I will really like this. Looking forward to reading the posts here!
  13. by   kaslRN
    Congratulations! Most HH companies do not hire new grads, but I say go for it if you know that is what you want to do! I started in HH as a new grad 2 yrs ago & it has worked out just fine. DON'T be discouraged by more experienced nurses who say you need to work in a hospital first. I learned more by being out on my own and having to rely on my own instincts. I would suggest finding a positive , experienced coworker who doesn't mind answering your "stupid" questions. That helped me gain a ton of knowledge in those first few months.

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