Latest Comments by jbudrick - page 5

jbudrick, MSN Pro 3,377 Views

Joined: Aug 18, '08; Posts: 74 (61% Liked) ; Likes: 113
Nurse Practice Educator; from CT , US
Specialty: 15 year(s) of experience in Certified Nurse Educator

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  • 6

    I am a nurse in home care. When we have a patient who is morbidly obese and has difficulty performing hygiene, we call in an Occupational Therapist. There are toileting sticks and other devices and procedures patient's can learn to enable them to perform their own hygiene. Good luck with your patients.

  • 0

    Nursing jobs seem appealing to job seekers because they do offer better salaries and there are a lot of jobs out there. It is one of the few degrees that practically "guarantee" a pretty good job after graduation and passing the NCLEX. The reality is that it is one of the more difficult degrees to obtain. Most students take much longer than the listed time to complete a "2" year community college associates program or a "4" year degree. If you are looking for an easy way out, I would suggest another subject. Perhaps the guidance office at the colleges you are considering could give you testing to determine which careers would be a good match for you.

    In any event, best wishes on your path to a new career.

  • 0

    You could split the care plan up into learning objectives and assessment objectives.

    "Pt will verbalize s/s of infection and how to report s/s to nurse or MD. Fever, increased pain, increased redness, swelling, foul odor, etc."

    The pt is probably receiving antibiotic therapy so you will want to make sure she is using meds as ordered and has no negative side effects.

    "Pt will be compliant with med regime. Pt will verbalize s/s to report to nurse or MD: itching, rash, SOB." Also include any dietary restrictions, med interactions, etc., that may be relevant for the ordered med.

    The pt probably has an underlying health problem contributing to the cellulitis that will require teaching and assessment.

    You will need to see the pt to teach the disease process, assess compliance with and response to treatment, and assess for complications. There might also be something you can teach or implement that can prevent this from happening again. Since the pt needs home care, they may have home safety issues and might even need physical therapy for impaired mobility. I find most insurance companies only want a general idea of what you plan to do at each nursing visit. Most pts are not able to absorb more than one main point per nursing visit.

    You might want to check one of your old textbooks for more ideas.

    Good luck.

  • 1
    lindarn likes this.

    It is my belief that Unit Secretaries earn a significantly higher salary than a nurse extender. You would also have more opportunities to interact with other professionals and patient families. I have never seen a doctor or family member go to a nurse extender for information, but it is common for them to communicate with a Unit Secretary.

    Good luck in your new job and in your pursuit for a nursing degree.

  • 2
    tarty/sweet and lindarn like this.

    I received my ADN in 2001 and completed my BSN in 2007. The main difference is a well-rounded education. Most of the courses required were not nursing, such as advanced english and writing courses, statistics, history and other liberal arts. Because of the additional education in areas other than nursing, I have a greater knowledge base and have more iof the knowledge common with other professionals.

    From a nursing perspective, the BSN course requirements provided education in the areas of nursing families and populations, transcultural nursing, teaching and management. These aspects of nursing knowledge have been invaluable to me as a case manager in home care.

    The main reason I went for the BSN was the fact that many positions require a BSN, and most other professions require a bachelors degree to be considered a professional. I am not looking for another job at this time, but it is nice to know that I have more options available to me.

    Good luck.

  • 0

    I had carpal tunnel and a gangliion in my right wrist. The pain was excruciating and I had significant reduced mobility. I suffered for two years before I got the surgery in August, 2008, because I was afraid of complications. I think that writing nursing notes and taking blood pressure with a manual cuff caused the carpal tunnel. I am so glad I got the surgery. I now have complete mobility and strength with no pain. The scar is a pencil line in my wrist folds. Unfortuantely I had to have a horizontal incision across the inside of my wrist. I was out of work for one month. Go to a hand specialist. Talk to your colleagues for referrals.

  • 1
    LvHaloRN likes this.

    I recently completed a web course Nurses on the Front Line: Preparing for and Responding to Emergencies and Disasters. It was very good. It was an overview of scenarios involving chemical, biological and explosive disasters and how to triage. It covered possible health problems and treatments that might happen and what a nurse may be expected to do. I took the free version but there is also a CEU version with a fee. You have to register on the George Washington University website. Here is the link:

    http://learning.nnepi.org/

    Good luck.

  • 0

    What happens to the patient who experiences one of these events. It seems there is no remedy for the patient. Is the facility who "causes" the negative outcome required to provide free care? As we all know, some events cannot be prevented. Pressure ulcers can occur in spite of attentive care in those patients that are compromised by old age or disease. In some cases, moving the patient around can be life threatening. What about UTIs in patients that need to be cathed? Who will provide the free care? What if the patient wants care at another facility due to problem that developed? It sounds like if the patient gets one of the "never event," the patient is out of luck.

    Diana

  • 0

    It is very likely that the pressure ulcer developed between the time you did your assessment and the time it was discovered. The condition of a patient can change rapidly. Always stand by your assessment. You did not see a pressure ulcer on admission. Also, always assess your patients carefully on admission. It could be that blaming you for missing a pressure ulcer on admission is easier than admitting that the patient developed a pressure ulcer under the care of your facility.

    Diana

  • 1
    honeybee08 likes this.

    Yes it is possible to go to HH as a new grad. I did it. I graduated from a community college ASN program. After I graduated I received several terrific job offers. I quickly discovered there was no daycare available for my daughter to cover the hours that the hospitals and LTC expected me to work. I did not think homecare was an option until I saw an advertisement in the local paper asking for new grads to apply for a home care agency. I landed a job at the most prestigious local agency. They hired one new grad every year. The orientation was extensive. I went out on visits with other nurses for several week and had extensive "classes". I worked there six months before I was "on call." Help was a phone call away. The supervisors were always supportive and encouraged my questions.

    Most skills needed in home care are taught in service since the equipment and supplies change periodically. Basics like catheterizations, blood draws and injections can be done with another nurse a time or two.

    No clinical job can prepare you for the pyschosocial aspects of home care. The teaching aspect in the home is very challenging. You will want to find out about the demographics of the community you will serve. In home care for medical patients I see a lot of wounds, urinary catheters, chronic and stable elderly, diabetes, CHF and everything else under the sun. The agency I work with now has pyschiatric patients also. I couldn't make up the stuff I see everyday.

    The job is very satisfying. I work with the patient/family group one on one and I have actually helped patients and families.

    Last year I completed my BSN through Excelsior. The classes were relevant for what I am doing in home care and have enhanced my practice.

    Good luck.

    Diana

  • 1
    Valerie Salva likes this.

    I graduated from Excelsior RN to BSN in 2007 and I would definitely do it again. It took me about three years part-time at my own pace. I worked on it when I had time. The academic advisors were very helpful. The courses were relevant to my position as an RN/Case Manager in home care. The on-line courses were just starting to be offered during the time I was working on my degree. I got many of my credits through testing. I really enjoyed the on-line courses I did take. The Wound Carecourse and Death, Dyingand Bereavement electives were terrific. I still refer to some of the materials used in those courses in my practice. The tests cost less, but the on-line courses were a much more enjoyable and useful learning experience.

    Good luck in your pursuit of your BSN.

    Diana

  • 0

    I graduated from the Excelsior RN to BSN in June 2007. It was a terrific program. The counselors are very knowledgeable and helpful. You can choose to do your clinical teaching and assessment projects at one of their sites or do a video tape. I did the videos which were very challenging. It almost seems easier to go to their site. There is no easy way out I took several of their on line courses instead of tests. There courses are really good and I enjoyed the interaction on line with classmates. The courses gave me a connection with other nuirses going through the same program and more structure, but were still very flexible as far as timing. I am actually considering an Excelsior MSN.

    Good luck in your pursuit of your BSN.

    Diana

  • 0

    Hi:

    I graduated from a community college with an ADN in 2001. I graduated from Excelsior College with a BSN in 2007.

    I work as a home care nurse full-time in Connecticut.


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