Latest Comments by Jolly

Jolly 1,496 Views

Joined: Jul 5, '02; Posts: 24 (4% Liked) ; Likes: 1

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    I'm not educated on the Medicaid system, since I've never had to deal with it in any of my roles as a nurse. I understand, however, there are many regulations, and that recently, at least here in New Jersey, changes occurred in January that resulted in more regs and more cutbacks - which, I am sure, has created more work on behalf of the nurse.

    As far as how one is paid, the position I interviewed for is per diem and pays per-visit - there is a $10 difference between an admission and a repeat visit.


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    Quote from renerian
    lots of phone time with outside case managers.

    Can you please clarify 'outside case managers' - do you mean other services that may be in the household such as skilled nursing, PT?

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    Hi Ann,

    Thanks for your response. I'll try to clarify my original post.

    I recently interviewed at a facility that provides home health aide services only - the RN's role in this facility is to first, assess the need for HHA services, and then, once the HHA is in the household, the RN supervises the care given by that HHA. If I'm not mistaken, this facility accepts Medicaid only. The RNs do not perform skilled nursing - if the RN assesses that the individual is in need of a nursing skill, a phone call is made to that individual's MD, and a facility that provides skilled nursing is brought into that individual's home.

    As you can probably already tell, the paperwork is minimal; it seems like a good opportunity for someone who is employed full-time and needs to supplement their income - as is my case. Any thoughts?


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    Anyone familiar with facilities that utilize RNs for supervisory visits of home health aides ONLY and NOT to provide nursing skills/patient care?

    Can anyone give me information about this?

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    I'm in need of information on the various types of IV fluids. Specifically, I'm looking for a description of them (chemical composures, osmolarities, pH levels . . .).

    Anyone know of a website or book with this info?


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    Adults - the majority of the clients are chronic, and their illnesses run from A to Z. Currently on the unit are people diagnosed with major depressive disorder with psychosis and suicide ideation, bipolar (admitted in the manic phase and is now stabilizing), schizophrenia, and dual diagnosis with heroin/ETOH/cocaine addiction.

    All ideas will be greatly appreciated.

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    lindaholder likes this.

    I just started a new position with an acute mental health facility. One of my responsibilities is to hold an educational group for one hour each day.

    What are some ways you have held groups and taught your patients?

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    Thanks for the responses!

    Orientation began last week - hospital policy information, HIPAA guidelines, corporate compliance, safety issues, and a day-long class on "Handle with Care", which is the facility's method in crisis intervention (code call); the next two days consist of introductions to the different diagnosises (sp?) and medications/interventions. I will begin orienting to the unit itself in a couple of days.
    Am a little frightened, but very enthusiastic.

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    Originally posted by sjoe
    Frankly, as a patient, I would take ANY healthcare advice and/or suggestions with a very large grain of salt, coming from any healthcare provider who reeked of cigarette smoke, marijuana, alcohol, was obese, etc. Why should I listen to them and act on their words when they don't do so themselves?

    Actions speak louder.... [/B]

    When I was a nursing student, I had an instructor that taught us then-nurses-to-be to start thinking of ourselves as role models of, and advocates for, a healthy lifestyle. That made a big impression on me, kind of like a shot right between the eyes - she made me realize that nursing is more than giving a patient good care. Nursing is also showing and teaching a patient how to give good care to themselves - and, if I don't project a healthy lifestyle, then why the heck should anyone take any credence in what I have to say or teach?

    It's been six years since then - I am a work in progress, yet, I'm constantly moving forward (with a setback here and there, naturally). And, when I teach my patients, I can honestly say to them that I know the difficulties they have in making changes, because I, too, have experienced them - HOWEVER, it can be done!

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    Thanks to all of you for your responses.

    I worked 3 - 11 several years ago, and, as I stated earlier, I had a very difficult time adjusting - getting home after midnight, raiding the refrigerator till 2 AM, sleeping till 11 AM or 12 noon, and then getting ready for work - I felt like all I was doing was working, eating, sleeping, working, eating, sleeping, working, eating, sleeping, working . . . . after about a year, I switched to 7 - 3 - - but that wasn't great either 'cause I, too, hate alarm clocks, and I really can't get rolling at that hour of the day. I now work an 8 - 4:30 nursing research position, but I am so out of my element due to very minimal patient care and contact -


    I applied for and was offered a psych nursing position on the 3 - 11 shift -- am so excited about the position and the facility (great working environment, great behaviorial-care unit, excellent reputation -- NO WEEKENDS! -- and psych is the reason I went into nursing), but I have been concerned about the hours and the fact that it is an hour's drive (was glad to read that two of you drive an hour each way - really am impressed by the one who has a change in time zones - that is different!).

    You know, I guess it's all in how you look at things - attitude.

    I AM in a different place with myself than I was several years ago, therefore, I think I can discipline myself to make the change.
    If not, I can always bid for the day shift after a year (and go back to an alarm clock? -- no way!!).

    Again, thanks - your input has helped.

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    I interviewed for a position on a 16-bed unit for residents with dual-diagnosis this past week. It is for the 3 - 11 shift, and the opportunity for being hired looks promising, just as long as my background checks are cleared.
    I am new to psych nursing, am incredibly excited about this opportunity, and I'd like to hear from those of you who have experience with the 3 - 11 shift -

    - what's your routine?
    - any pattern to the residents' behaviors?


    can you give a new gal any tips?

    Thanks for your help.

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    Would really like to hear from those who work the 3 - 11 with regard to how you plan your days prior to going to work -

    do you sleep until late morning?
    do you do your errands?
    do you get the kids off to school and are home for their lunch?

    And, after work, do you find you can't get into bed and fall asleep until 2 in the morning, or do you crash as soon as you get home?

    I just want to know how other people handle this schedule . . . I find it quite difficult and somewhat disorienting, and just wanted some tips on how others handle it.


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    Thanks so much for your responses - they are very encouraging.

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    Am very interested in knowing the amount of paperwork hospice nurses are confronted with in comparison to homecare nursing (Oasis forms, insurance papers and authorizations, documentation of necessity of services such as HHAs and medical equipment).
    My reason for asking this is as follows:
    I love homecare nursing, but absolutely despise the paperwork - the amount of time I spent on paperwork was probably 3 times the amount I did actual caring for my patients - 3, 4, 5 hours at home every night, and on weekends - and this was utilizing a laptop!. Needless to say, I left homecare because of this. I am in the line of research nursing now, and I am so very much missing the patient interaction and nursing skills that this position lacks. I am considering hospice, but, quite frankly, if the paperwork is anywhere near the amount as homecare, I will have to look elsewhere.

    Please tell my about your paper workload. Thanks so much.


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    Thanks Minty! That was very helpful.