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MissRigg's Latest Activity

  1. MissRigg

    Injury in the patients home?

    Yes, it’s care provided in the patients home
  2. MissRigg

    Injury in the patients home?

    So luckily I’m not wondering about an incident that actually happened. but I was asked by a patient today and wasn’t quite sure what the answer was or how to address it, if a CNA who is an independent contractor, Goes into a patient’s home and is injured can that aid sue the patient? I feel like there should be some sort of legal standard that says that in accidental injury while working with the patient in their home would not be the liability of the patient but I’m not even sure how to go about finding out that type of information if anyone could help
  3. MissRigg

    How/Where to market

    Hello, I'm trying to market my home health agency, I was wondering if anyone had any tips or knew of any web portals to market a home health agency?
  4. MissRigg

    PT's and Medication....

    Hey daisy, I know my question is kinda of strange, but my agency is small, we have 3 RNs, so the nurse can't open all the cases, and we are educating the PT's to do a comprehensive medication review, I am just scheptical about the review they are doing, ( based on patient survey results) I'm just looking for a check and balance system that can help me to ensure that an appropriate review is being done... I don't know if such a thing exists.
  5. MissRigg

    PT's and Medication....

    So I am the clinical manager at my agency, and we are trying to problem solve Medication education for our patients. My overall thought it that our nursing staff is doing this task, but I am concerned our therapist are just writing down a list of meds. We have had an in-service on this point... But I'm not confident they will be able to effectively correct the problem. is there any other way to fix the issue other than having a nurse open all cases? Or hoping the therapist will pick up on how to do the task?
  6. MissRigg

    How to find Nursing resumes

    Does anyone know of a good website/ or method of recruiting nurses for home health? I think I have gotten all my agency can from indeed.
  7. MissRigg

    Lvn/Pn vs RN

    This is an issue I have run into more and more frequently, and I am a little confused as well... And upset that because of my experience I'm feeling mistrust towards LPNs. I have worked with wonderful lpns who offered me alot of knowledge and different view points on how to treat and manage my patients care, and on the flips side I have met LPNs who when pressed demonstrated they didn't really have any idea what they were doing (like listening to a patient's heart on the wrong side) I'm sure this is true for RNs as well, I just haven't experienced it yet, even with new RNs. I have been wondering if it has anything to do with the graduate program they are coming from and amount of education received there? (I only suggest that because in VA it feels to me like there are alot of 14week long programs where as the registers Nursing programs in this area are well know and established and have really strict curriculums) ... I'm afraid that maybe in my area in particular there is a hit or miss system of education? ... I would love to have insight into a typical lpn course program
  8. MissRigg

    How to find Nursing resumes

    I am the manager of a home health agency, currently I use Indeed to find resumes and contact potential employees...but I would like to branch out. Does anyone have any recommendations? Thank you!
  9. MissRigg

    The reality is home health care is where the jobs are.

    I think this thread has a really interesting point for myself. I'm a fairly new grad, ive been a nurse for 2 years now. When I graduated I couldnt get into a hospital, which is where i thought I belonged, and worked for about 6 months in a neurologist office, while part-time doing home health. My DON was always available to me, and because I was new i asked her regularly to talk with me post visit to make sure I was on the right track with my careplan, but low and behold, with a little less than a year nursing experience my DON retired and I was promoted to clinical manager. I totally get the experience required aspect of home health as a manager, when looking a potential hires, but also when i hire a nurse, i am really looking for someone who is active and interested. My motto is something like when I was in nursing school, I tell all my nurses this: you don't have to know everything, but you absolutely must know when there is a problem, and know to call me in the patients home if you note it. That way I can help the nurse to make the right interventions. I will say, I took to homehealth REALLY well. This is a dream come true job for me, before being a nurse i was a home aide, so I'm familiar with care in the home, and the MAIN reason i wanted to work in a hospital was because I wanted to teach patients health management, which I always felt was lacking- i feel like the areas I was interested in in school, play very well with the things I do as a home nurse.... I think the ultimate issue is this; if a new grad is hired, the agency needs to plan for inexperience in judgement, and plan to offset this by regular and diligent follow up. My DON only made one joint visit with me, and then I had several here and there joint visits to learn specific skills with other nurses, but she was 110% available to talk to me about my concerns and the issues i noticed during a visit, and in turn she helped me learn how to solve them
  10. MissRigg

    Work load concern for clinical manager

    Our agency started in 2014 butt there have been some pretty significant changes made since December of 2016. Rdio end left the company suddenly and I was promoted to a position that encompassed most of what she was responsible for. Our agency went to electronic medical records which means that our policy and procedure needs to be updated. And our patient census has increased. The LPN case manager who works with me is very goal oriented and has been a nurse for 30 years so I trust her clinical skills but I don't trust her to make decisions regarding the care planning process or evaluation of a patient's needs, so there are a few things in the office that I feel I cannot ask her to do for me. We are averaging between 30 and 40 patients a month
  11. So I am the Clinical manager for a home health agency, and I love every part of my job... the thing is I feel like my job is super overwhelming, i feel like im doing the jobs of 2 people. I'm really just looking for advice on if this is normal and if its not, how can I make things better? So, Our agency averages 5-10 admissions per week, and we have about 90 patients in our census. We have one full time RN and a case manager, LPN who assists with QA review. My Office roles include chart reviews, which I do bi-weekly if I can, the CM does half. I complete all 485s and approve the rap, and review the end of episode and review for billing, to do both those items I have to ensure all oasis and evals are completed, and add the eval orders and goals to the 485. I am the person in charge of making sure and following up with staff for documentation completion. For end of episode I ensure all orders are signed and all documentation is complete, If we need orders signed I make sure the calls are placed to pcp for orders. I am the point of contact for our staff, so when there is a problem during the Home visit I assist staff to make appropriate contact with PCP and problem solve the issue if possible. I initiate all case conferences, well most of them, and help guide staff on how to address needs or concerns for recertification. I am also the point of contact for our patients, if they have a concern or a question that is specific to their clinical care they come to me. I do not review the Oasis or Code, but these Items are not done without me providing a report to those who do this documentation, and requesting that it be completed. Since we only have one Nurse, outside of myself and an LPN I do follow up visits and SOC... I have been averaging about 10 visits a week, but for example, this week I have done 5 start of Care assessments, and it typically takes me about an hour and a half to an hour to complete that. I am new to my position, and our previous DON was awesome... but disorganized and I have had to revamp alot of our orientation process, review standards of intervention and create procedures because we did not have them...Im not done with that. I had not previous HH experience before this I love my job, i love making visits and i love how much i can help patients.... Alot of my patients tell their therapist that they feel so much more confident in their disease management after my discharge, and our therapist are always thanking me and complementing our agency on the nursing follow up provided (I get the feeling that in other agencies the Nurse is not as heavily involved in care, or doesn't focus on patient needs as heavily as we do) In some cases I will follow up with patients - pcps and case managers that are not personally seen by myself to re-inforce teaching or assist with medicare guideline education and plan of care information. But I am so crazy over whelmed... I feel like I'm always making a compromise about what important this is most important, and i keep asking to hire another nurse on, but i feel like the administration is stalling is this normal? what should I do?