SDALPN 13,370 Views
Joined Apr 10, '07.
Posts: 1,043 (50% Liked)
I started in home health. I wish I could have started differently, but the hospitals in the area don't hire LPN's. I was lucky though. The agency that I started with had a daycare for medically fragile kids that I was able to learn needed skills at. But I only got a week there to learn trach changes, replacing Mic-key buttons, etc. Then I was on my own. But again I got lucky. The daycare for medically fragile kids was inside a regular daycare. They child I was assigned to was in the regular part of the daycare. So even though I was on my own, I could go to the other daycare if I had questions.
Looking back, I see all the things that still could have gone wrong. The agency wasn't supposed to hire me. But they lied to who they needed to and told them I had a year of experience. I didn't find that out until after a year with that agency. At that point it didn't matter. I also never took a case that I wasn't comfortable with. But with the lack of experience I had, how did I know enough to know if it was an "easier case" or if there was something underlying that I wouldn't realize that I didn't know how to deal with.
As time went on, I took some classes on ventilators. Unfortunately in doing private duty, you don't get much time with another experienced nurse with a real patient on a vent. Taking a class and working with a patient are 2 different things. Again, I was lucky. My first couple of vent patients weren't vent dependent. I was able to use what I learned in the classes to apply to working with a real patient without as much danger as a patient that was vent dependent. As I became more familiar with vents and how to handle situations with patients on vents I moved on to vent dependent patients. During that time I was also exposed to all sorts of feeding tubes, types of trachs, types of vents, TPN, IV/ports, etc.
All I can say is that I was lucky considering how much I didn't know. I had no idea what I had gotten in to until I gained experience. In the little bit of time I had with more experienced nurses on the cases I worked, I'd try to learn as much as I could. I would read their notes to learn interventions that I may not have known.
The agencies don't care about their nurses. Most (not all) just want a warm body with a license. The agencies want to make as much as a they can and some of the nurses don't care about the risk because they want to make as much as they can. Its a bad mix. They agencies will try to pressure you in to taking cases you aren't ready for. Its unsafe, but happens all the time.
If you still decide to go with an agency. Ask questions. Don't let them pressure you in to taking a case you aren't comfortable with. Learn as much as you can from whoever you can. If you do peds, quickly figure out if the parent has a clue or not. Some parents are wonderful and very knowledgable. That can be good or bad. If you come across as incompetent those parents will let you go. If you can learn from the parent or have a parent that is a nurse/doctor it will help. If the parent is one who basically stops caring for their child and leaves the child for the nurses then be careful. Sometimes the challenge isn't the nursing skills needed on the case. Sometimes its the skills in dealing with the family. Some family members want you to do things that are against what you are trained to do or request that things are done in a way that is different from what you know. Then there is the drama in the family. All families have drama. If you do choose to do home health, get to know some nurses who have been with the agency for a while or float quite a bit. They will be able to tell you which cases are better for you and which ones to run from. Don't trust the agency to tell you the truth. The agencies will look out for themselves and do everything they can to get you to work the bad cases or fill in for shifts on cases you aren't ready to do. Good luck!
I am new to PD. I work a pediatric case. The agency that I work for pays all LPN's $18/hr. No shift diff. They do add a few hours each week PTO that is suppose to make up for holidays through out the year. There are benefits offered. I have been lurking around and learning a lot from you all. Thanks!
Are you guys using assessment sheets also?I keep getting told there isn't a reason to write all that when there are checkboxes.As a matter of fact,the supervisor said its really not neccessary to write beyond the 5 lines they give us on the combined assessment sheet/nursing notes.
Hi! I am currently working for a HH agency that deals with pediatric patients. I have worked for them for 8 months. I consider myself to be a "new" nurse as I have only been practicing since November 2011. I am with the same patient on a full time basis. My patient is medically stable, but at risk. His primary caregivers are wonderful but are his grandparents so there is the mom and dad that are divorced involved as well. I'm needing advice on my charting, etc. My patient is 7 and has state and federal agencies that are involved in his care who are stating they want more charting. I chart every 2 hours as required, but also when we do walks etc. I do not chart his every move, and he is an active little boy. But apparently they feel that all he does is sit around watching TV and playing games. Any advice I can get on charting would be appreciated!!! Thanks in advance!
Oh yeah, I will add that I document when the parents are attentive to the patient. Great for cases where there are questions about the parents involvement or if something comes up in the future. You can remind the parents that you are also documenting to help them.
I have had some parents who think nurses chart too much, including me. Two have said so, and another made it as difficult as she could. (No table, no time. Here, fold these clothes instead....! )
It was ludicrous, and I ignored their "preference" in this matter. LOL
Please post if you are an LPN doing a job that isn't the typical clinic, hospital, LTC, PDN type job.
I'm thinking of changing my area of nursing. I have no interest in the typical jobs. I'm getting burned out with PDN. I prefer working alone or with a few people. I don't want the risk and pressure of LTC. I don't want to work in a clinic doing vital signs all day. And I'm sick of the nutty families in PDN...dealing with them in short bursts instead of constantly is fine and I'm tired of them having control over my hours. I prefer a job where I can wear scrubs. I hate dressing up for work.
So far I have applied to 2 plasma centers as I'd enjoy doing assessments all day. And I have applied to an assisted living facility for management experience.
So what do you do that is different from the typical LPN job? What is your day like? If you are comfortable discussing it, what is the pay like? Any other job suggestions? I'm in NC if that makes a difference. Thanks!
That requires lots of money. A friend of mine used to own an agency. She said at minimum you need 6 months salary for you and any other employees because reimbursement can take a long time. On your own, you will need an RN if you are an LPN. Its not easy. I've chosen to work for agencies because there is too much involved.
Ok, so I just graduated nursing school then passed the NCLEX... I got hired over the phone with a "home health agency" although I actually am a private duty nurse doing 8-12 hour shifts. The service is paid for by medicaid. Medicaid pays my company and then the company pays me. I clock in and out using the clients mothers phone (my client is pediatric).
On 2 separate instances (once in August and once in September) the clients phone was unavailable, so as instructed by my supervisors, I called management, with the fathers phone, and they were supposed to clock me out. In BOTH cases the managers never clocked me out and I received a call from the office the following mornings wanting to know why I had not clocked out. I never got paid for these two days. I spoke with the owner of the company numerous times and she insisted they would be on my next paycheck. But paycheck after paycheck came and the hours were never added.
Then, the owner calls me just last week and tells me she will not be paying me for those two days as she had just found out I have been taking a lunch break. I was told by the woman who hired me, the pt's mother and the nurse who has been working for this company that lunch breaks were allowed. There is NOTHING in my contract that says we are not allowed a lunch and I have not even taken a lunch everyday. I might get to take a lunch 2 days out of 5 that I work. I spoke with the medicaid case manager about it and she said the company was paid for all of my days, including the two where the office had to manually enter my departure time the next day. The owner of the company said that the only way she will pay me for the two days is if she goes back from my start day (over 6 months ago) and takes 1 hour lunch out for every day... Which would make me owe her money!!!!
So just to summarize, the company was paid during every lunch I took, and was also paid for the two days where my managers did not clock me out, but I was not paid for the two days because "of the lunches" i have taken. I am no longer taking lunches now that I know that it is not allowed, but I was counting on that money and I feel its not fair that the company was paid for doing nothing while I am being shorted for almost 25 hours of work! I am still a new nurse, this is my first nursing job and I just feel like it isnt right.
They have hired 7 nurses total for this case and I am the only nurse who has stuck with it. The rest of the nurses quit due to pay issues as well, but this has been my first negative experience. I have had several people tell me they are not allowed to just take my pay like that. Does anyone know legally or from any aspect how all this works?
Thanks in advance for your help!
Its interesting that the nurses posting haven't worked private duty or have only worked a few cases. Not all parents are like that. But the ones that are like that act entitled and unappreciative. It does make a nurse frustrated. A lot of parents like this type if parent are the ones living off the system and taking advantage. Then they get mad if they don't get their free services. Some of these parents get 20 hours a day. 4 hours is not too much to ask the parent to do. If they can't handle that, they need to out the child in a facility. Saying these parents are scared is an excuse. I've seen the type. They aren't scared, they are lazy. If they are that scared, they have no business taking care if their child. I watched 2 parents in a case who stayed home all day with 20 hours of care. They also took a nap every afternoon after an exhausting day of watching TV. Then they got up and watched more TV. Then would sleep for 12 hours. As long as they slept they were happy. If they were interrupted from even watching TV, they let the nurse go.
That behavior is common. Nobody tells these parents how things should work because the agencies are scared if running the parents off to another agency. Right now I'm lucky that I have a parent that is involved without being over the top. But she is home all day, sleeps til 2p. Then watches tv the rest of the day. She whines about how hard the work is to take care of the patient. But acknowledges the hard work we do. She complains about how hard 4 hours is with the patient while we do 12 hour shifts. But I've seen worse. We enable these parents to avoid being parents sometimes. We do need to be there so they can go out at times. A babysitter wouldn't be able to do what we do and give the parents peace of mind. However, so many take advantage that it ruins our view of things. I have some parents that refuse to change a diaper. They walk in and tell the nurse to do it. But then they don't change the kids diaper and wait for the next nurse to arrive hours later. We are there to be nurses and give the parents a chance to work our take a break. But so many get greedy and take advantage. Then they go through nurses quickly and complain they can't keep nurses. The good families keep nurses for years. Sometimes I wonder if these parents with special needs kids weren't meant to be parents but our medical technology saved the kid. I had another case where the parents flipped out if they didn't get a nurse on Fri nights so they could go out. They both were home all day living off the system. But they couldn't be flexible to choose a night when they had nurses and be appreciative of that. They act like its owed to them. Luckily not all parents are like that. Its just hard to find the good ones. But yes, it can be extremely frustrating dealing with that day in and day out. It may be time to find a new case or float for a while so you can find greener grass!
Yep, I understand totally. Just recently found out the state took a child that I reported. Many reports had been made by others, so I acted as a mandatory reporter and thought nothing would happen. But my experience/observation for what I reported on was bad enough that they went to court and the child was taken away. I felt bad, but it was best for the child. I just heard the child is now gaining weight and starting to reach developmental goals. I even got to see a picture and that made it all worth it. The child looks so much better. So now I know I did the right thing even when it didn't feel good at the time.
I've reported other situations as well. Its never easy. I guess if you are in this job long enough, you will have to make a report at some point.
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