Latest Comments by anangelsmommy

anangelsmommy, ADN, BSN, RN 6,324 Views

Joined: Jan 3, '08; Posts: 238 (22% Liked) ; Likes: 89
Nursing Supervisor/ Case Mgr; from US
Specialty: Peds, Home Care, Public Health, DD Healt

Sorted By Last Comment (Max 500)
  • 0

    I meant supervising the caregivers, sorry, misspelled. So in this case it would be a CNA. We are a home health company but we are able to provide everything from a sitter, a caregiver, a companion, or hospice care. We do not do "visits" we will provide a minimum of 2 hours of care, there are some other services provided as well for private pay. The majority of our clients are private pay but we do have medicare patients. I don't do any billing or authorizations etc.
    The hospice patient went on intensive hospice care for a few days to manage agression but everything was the same when returned to our care and MANY phone calls, and we had another CNA leave her shift because of being attacked and hospice nurse did nothing - not sure why. Multi-supervisor discussion, no resolution, client was transferred to a facility. I hope she finds peace.
    I did a few things this weekend that I realized I could not do if I was on call. I don't know what to think about that. I did this activity course that involved rapelling and zip lining and being up off the ground about 100 ft at least - not exactly a place you can stop and take a call, and look up client information and make a note! lol! or would you want to! And it took several hours, so I couldn't call back for at least 3 hours! I do a lot of things on weekends that are really active.
    This week I was told, "it was in your contract when you were hired, you signed it, you have to do it." but I never signed anything! And I would have definately questioned a contract that said I had to do on call 7 days a week when I only work 3. Because at that point I was still working a second job. And I am still thinking about going back with the other company at least one evening a week.

  • 2

    our administrative staff does not take clinical calls either. Our supervisors (BSN and above nurses) take these calls, to deal with issues in the field with caregivers taking care of clients. This particular issue was not a upset patient, she was agitated and aggressive toward the caretaker and risking her safety. Since this is a case we share with hospice, they are responsible for client assessment, PRN medications, educating the family and obtaining medical orders among other things. There has been no support from the family or hospice, clients behavior escalated and she became irrational and abusive. Multiple caregiver phone calls. Guess who didn't call, the patients family because they didn't care, they figured we had someone there that was taking the abuse and getting paid for it, and the patient didn't call because she is not able to.
    So while I think what you are referring to works in a different industry (do you work in visiting nurse capacity?), this is more of the home health realm and I am not only visiting the patients and supervising their caregivers in the field but taking calls from these same caregivers when there is a situation that they cannot handle or have any questions. The families or patients do tend to call during the day if they are going to call, unless it is an emergency.

  • 2

    I probably should add that even though I only work 3 days a week, I am on call for a full week. I logged multiple calls, and two nights with no sleep.

  • 2

    Thank you HeySis! I do not have to deal the staffing, they have on-call staffers for that. I only have to deal with issues such such as an aid has an issue with a patient, a patient falls for instance, has chest pain, gets locked out of the house by a pt with dementia, or an abusive/agitated patient such as I had for the last two days! As for having any disgruntled call going to admin - I am considered admin but I am new at this. I did call my supervisor several times and then called the director finally because it had escalated to such a point that I felt she had to know the situation. I recommended that we have a patient meeting to discuss and then call family and hospice with all administration.
    I documented everything, I am all about document document document! Especially since hospice was not supportive at all and would not go back out to see the patient when that is the protocol!
    Thank you for the info, I will look up our state laws. And luckily with cell phone and all documentation on computer, I have times for everything. Thanks again.

  • 1
    WKShadowRN likes this.

    If a patient or even a co-worker brings up the election, I try to find a way to stay positive and bring it around to something that everyone can talk about without getting upset such as "I am keeping my fingers crossed for better healthcare changes in the future for everyone" or something like that, But we will have to wait and see and then talk about the weather or something neutral cause it seems that everyone would like better healthcare options!

  • 2

    I love my job as a part time nursing supervisor/case manager for a home health company. I work whenever I want, making visits to the home, paperwork/computer can be done at home or in the office and I generally work about 3 days a week. I am only paid per case and the hours I work on each case. Its a great job but then they told me I would be added to the on call schedule. It is administrative, I do not go out to clients homes. I thought it wouldn't be too bad, but I am not paid anything for this. I have gotten called multiple times, during the day AND night, no sleep two nights - missed a movie with my children, called out of an outing with my family, last night I only got an hour of sleep after 5 calls. I realize that this week may have been an extreme case because I of an abusive client, who is not one of my patients, and so I am not too familiar and was not getting the support I should from hospice - a whole other issue, but after the second night of no sleep I started wondering why I am doing this for no pay! I could have worked a shift at an agency and made great money last night for way less stress! I felt ineffective as well due to the circumstances - abusive client, unsupportive family and hospice nurse who told me she couldn't do anything, caregiver who was extremely frustrated - and rightly so.
    I have set a meeting today with supervisors/director, care team and then hospice team.
    But my husband thinks I am crazy to even stay with this job. I need to ask for pay for being on call but not sure what would even be reasonable. Am I crazy to even do this?

  • 5
    poppycat, KelRN215, AliNajaCat, and 2 others like this.

    Quote from NICUismylife
    Oh hell no! I would not administer anything I didn't draw up myself. I don't care who is doing it, how qualified they are. Too much room for error.

    I worked a PDN case where mom was an ER nurse, first day mom had drawn up the meds and I told her I couldn't give meds that had been drawn up by someone else. Doesn't matter who they are, I drew up my own meds, set hers aside, she gave at a different time. She totally understood and never drew them up again when I was coming. Its my license and I am responsible for everything I give. I agree with Justbeachynurse, if they were in blister packs, and portioned into cups, and I could still check against the MAR, that is the only way I would administer the medication, its the only way to insure its the right med, right dose etc.

  • 2
    Kitiger and MrNurse(x2) like this.

    Don't hate me cause I LOOVE Snow!! No where near this week but I love the sight of it, not afraid to drive in it, love when everything else is closed and the kids are home, warm fire in the hearth and the kids play outside! And get ready to ski!!
    BUUT for those of you that don't like it or are traveling, I hope you are safe and snow free!! Happy Turkey Day!

  • 0

    By the way, thank you both for your feedback, it helps to hear from others!!

  • 0

    I am getting the feeling that they do more and more. I already made them give me a raise. But it doesn't cover this. Everyone I know gets either a phone or money toward their phone bill and pay for the on call. Even if it is just a nominal amount. Especially since I have expressed to them that I am OFF several days a week, I am part time and that is my time. But now I feel very much tethered to the job that is supposed to be part time. We had a nurse that slept through a call and missed another, she has little kids, she was just let go. I think it will just take some time for me to adjust to the situation.

  • 0

    I am am not salary because I am part time. I am a supervisor. This is exactly why I was asking. husband has a different position - not nursing but makes many times what I make - he is salary plus bonus and on top of that gets paid for on call. And if he has to go in for an emergency he gets "on call" pay which is a nice chunk of money. And they pay his phone bill. I am using my own phone. Nothing additional for on-call, nothing toward my phone. NADA. To be honest, I wasn't sure how this was going to work, but I am realizing it isn't that horrible, I am not getting tons and tons of calls. And I can let the service know if I go to church, I may have to call them back in a few minutes, but the other nurses don't want to take calls for me if I am in church. We had a nurse get in trouble for not answering a call, she slept through it. I do NOT do on call visits. It is all admin, emergencies that need handling, notifying families, depending on the situation. I think as I have done it a while I will be less bothered by it or afraid I will miss a call but I am bothered that I am not paid for it or get a phone. Literally everyone else on call in the company has a phone.

  • 0

    I recently switched jobs to a PT position with a home health agency as a supervisor/case manager. I really love it. They just added one week of on-call every third week. I don't get paid anything for on call. I am a little freaked out by the disruption of time that I normally claimed as "me time" such as church, or work out classes and not sure how to handle it
    I normally put my cell phone away when I got home, and now I am so afraid that I will forget to keep it with me. I don't know how I am going to do some of the things I normally do without missing a call. What do you do if you are in a really intense workout class, packed with people and loud music, I take classes like this at least 5 times a week.
    How do you attend church if having a phone with you is frowned upon? Please share your tips!
    An angels Mommy

  • 0

    I work for several agencies do some home but mostly school nursing. I had purchased one of the new no touch infra red thermometers and it seemed wonderful until after a few days of use when I got started getting inaccurate readings and I sent home a child that may not have had the fever I reported. I tried replacing the batteries etc but this is totally unacceptable!
    I usually work with developmentally disabled individuals so I prefer to use a something easy and quick, but none of the reviews say they are accurate. And I love the Exergen Tat 5000 but I can't afford the price! I would love to hear what you all use and love! please recommend a thermometer to me, and maybe I can find one that works! thanks!

  • 1
    SororAKS likes this.

    [QUOTE=jrwest;8814229]dumb question- why didnt the pt's nurse get an order for IM or SQ dilaudid, or at least PO??? usually when I have some one who is having acute pain we have a backup available. If not, we call the doc ,explain the situation, and they rarely give us a hard time about modifying the order , or giving a 1x order until access is reestablished.

    I really wonder about the competency of the pts assigned nurse. "oh, I forgot?????"]

    THANK YOU!! I was wondering this myself while reading through all these posts! How do you forget for 6 hours and not at least get an order for a patch or injection or PO med???

    And I have to say that I am very surprised that you allowed this to go on for such a long time. There would never be an excuse that I can think of for it to go on longer than 30 to 60 minutes, if they are really busy and had to get another nurse to stick. I have had one child who basically lived in the hospital for three years and then was a frequent flyer for the next 11 years before he died, and another that has had a few surgeries. I have had pain medication take a while before and my child was screaming in pain, and I went off "terms of endearment" style! I could never allow a family member to be in pain for a long time, I would insist that if they are not getting the meds or the IV now, that I speak to the supervisor NOW....and go from there.

    Sincerely hope that you do not get in trouble, would love an update. But I agree with all those that have said that you should contact a lawyer/insurance. information is your best defense right now.

  • 0

    "Med reconciliation not done upon discharge, or in the ED. "
    Do you already use electronic health records? If so, is there not a place to do this, or does it not prompt you to do this?
    Forgive my ignorance as I do not work with them. But I will in my new job!