So confused about SOC?

[Malina9559]

Hi I am totally new to home care, had 3 day orientation. I do mostly weekends and lots of SOC's. My question is besides filling out all the paperwork and charting, how do I get the orders? If I recommend the pt needs PT and OT eval, we have a special paper that we fill out and leave for the office staff who puts in in the computer. But Im still confused if this is right. Do I call the doctor? Some pts have a million doctors, which one to call?

Im confused about the whole thing, I can't even look up lab results which I drew a week ago, don't know where my actual orders are. Help! Can someone please explain this stuff to me? Thanks

[KelRN215, BSN, RN]

What doctor is signing your 485? That would be who I would call unless your question is something specific for a specialist. If the office staff is using your paper charting as a guide to build the 485, I'd gather they will enter the orders for PT/OT before sending the 485 to the MD.

If you don't have orders on your patient, how do you know what you're seeing him/her for? When I get new orders on a patient, I immediately send them to the patient's primary nurse.

[paradiseboundRN]

If you are working a weekend, call on Monday morning to get orders. Call the doctor that is going to sign the 485, which is either the doctor that signed the original order from the hospital or the patients family doctor. Ask him if you can add PT/OT and give the reason. You should be calling him/her anyway to let him know that the patient has been opened and what the plan of care is (this is a Medicare regulation). If you can't speak to the doctor directly, leave a message with his staff, but be sure to get the staff's name so you can put it in your charting. Request a call back from the staff member that he said the additional services were ok to add. Regarding the lab work, the home care office should get a copy of all the labs. You're going to ask about that. The other option is the call the lab yourself, they might give you a verbal or will fax a copy to the office. A lot of questions are going to come up as you move along in this new position. You will need to find someone at the agency to ask these questions to. If you don't feel comfortable with your manager, maybe one of the other nurses will help you. These questions are normal for a new home care nurse, you shouldn't be embarrassed to ask them. Hope this helps.

[Malina9559]

Thanks that helps a lot