brockclan3

I work home health in Texas for a government program taking care of nuclear and uranium workers in their home, most patients with around the clock care in 12 hour shifts. I have noticed that there have been staffing issues and regularly see nurses being asked to work 24 hour shifts to provide coverage for their patients. After working the night shift recently I was informed that the day nurse had called off and they were trying to find a replacement and I could not leave my patient until a replacement was found. Patient safety is the highest importance but what are my rights here? The NPA states in Texas nurses may refuse mandatory overtime in a hospital setting but is it different in a home health setting?

The company is KetaMD. I will be honest with you, it has been a slow start. From the updates we get from the company they are still working out kinks with pharmacies in each state. I haven't had a patient session as of yet. When we do start up we have to commit to (via zoom remote sessions) at least 4 patient sessions per month but can do as many sessions as you want. It is contract work and it pays per session ($40) which each session is around 1-1 1/2 hours. Roles are making sure the client has a sitter in the same location and you have access to them via phone, confirming the client has the right dosage of ketamine (ketamelt) that is mailed to them, make sure you can see them during the session and document their progress.

I just accepted an offer as a telehealth RN administering ketamine and assisting patients through their sessions. ANYTHING IS POSSIBLE!

I am involved with several psychedelic therapy groups on FB, MAPS, and a member of Cannabis Nurses Network. I have watched several great lectures on the subject - how psychedelics reset the brain, ect. I just think of so many patients who have had deep, life altering trauma in their lives who this could help them by allowing themselves to step back from the trauma and view it from the outside looking in. The trauma becomes so ingrained in who we are, just like the ego, we have to separate the two to have clarity and healing. This is a job for psychedelics! I have got my feelers out there for sure. I know in order to pursue what I really want to do I will need to leave where I am living right now and the thought of that gets me excited. Thank you for all of your advice, I will keep on the path that I am on now.

Girl, this is so encouraging and gets me fired up! Thank you so much for your post! How do we get involved at this point? I am in school right now for my ADN and will graduate in May with my eye on psych. I am doing my preceptership later this semester with the director of geriatric psyche at my local hospital. I live in rual Texas and when I talk about psychedelic therapies in a mental health setting most other nurses give me a dear in the headlights look lol. These therapies are helping patients to HEAL not just manage symptoms. One avenue I thought about pursing after graduation is becoming a nurse psychotherapist? Do you see a future for this? ADN to BSN to NP? What about PA's...do you see a model for this? This is a field I feel really pulled to but other than just continuing my education I am not sure how to get my foot in the door when I graduate. Should I just continue pursing psyche nursing for now while I get my ducks in a row as far as advanced schooling (so to speak)? I believe 100% this is the future of mental health I just feel lost in podunk Texas lol.

I know this post is from August, but I am highly interested in psychedelic therapies as well. I will graduate with my RN in May and I am looking to branch out in alternative therapies. I have been watching TED talks from psychiatrists and physicians that are making breakthroughs in patient trials. But, just as you guys, I have no idea how to start. But just knowing there are others that are interested in this makes me excited!

My supervisor told me that JC would be reviewing my file and she had concerns in regards of my past mistakes/write-ups. I asked her if there was a possibility that I would lose my job and she said she didn't think so. But I know that might be a possibility. Since I changed departments everything has been REALLY good. I haven't made any errors and everyone says I am doing great.

Well, in all actuality, when I was trained and in clinicals I was just handed a glucometer and asked to go check the blood sugar. I don't know of any co-workers that check blood sugars like joint commission says we need to. But now we will be wiser.

Joint commission has been at our facility this week and watched me do a blood glucose check on a patient. I failed to wipe the first drop of blood before obtaining the sample for the stick so our department was cited. My supervisor told me about the citing and that Joint Commission would be reviewing my personnel file. I am a newer nurse (a year and a half) and while working in the department I started in I received several write ups for errors I have made. My question is, given my previous write ups, what does this mean for me and the facility I work at given this error?

Hello guys! Just reaching out to any hospice nurses out there. I am currently an LVN and working my way toward RN. I have been considering hospice nursing (I am currently a tech at an ER) and was wondering how you got into hospice care? As in, what type of education, work history, special training, etc. one would need to get into hospice care. I am currently in the process of becoming a volunteer for a hospice home health agency where I live. I just wanted some pointers of how to get me in this line of nursing. TIA

This is all so helpful. This is great insight here and I appreciate the information and your encouragement!

Here is the list unsafe practices that is up for my peer review (it is alot): 1) When I first started work (ED) I was assisting another nurse in starting an IV and NS fluids. The nurse asked for a J-loop; I attached it to the saline flush but I did not flush it because I assumed she would do it. Same with IV tubing and the bag of fluids. One of the first things I learned in school is to prime the line and the flush. I knew how dangerous air in the line is. My mistake is assuming the other nurse would do that. 2) order for a patient was for fentanyl and I gave morphine (morphine had already administered previously). My mistake was not double checking the order. 3) I had inserted a foley and withdrew a urine sample from the port. My mistake is that I withdrew from the bulb inflation port instead. I placed it in a cup ready to send to the lab and another nurse commented how clear it was. When she said that, I realized what I had done. I threw out the sample, re-inflated the bulb, and collected the urine correctly. 4) the vanc incident (read my last post about this because there were other factors involved). My mistake was was not checking with the nurse and the order to verify what was in the bag before I attached tubing. 5) I figured a pediatric dose of Benadryl incorrectly and another nurse caught it before I administered it. I was going too fast and did not recheck the dose. 6) I used the wrong syringe to draw up insulin...I used a TB syringe instead. Thankfully my supervisor was there when I drew it up hoping I would realize what I had done. I did not and she pointed it out. I injected the insulin back into the vial, discarded the wrong syringe, and drew it up with the insulin syringe. I have gone through a second orientation with a preceptor on med administration and it was great. I am a LVN/Tech in the ED. I received adequate orientation on the tech side when I started but minimal orientation on the nursing side. That 6 weeks I did on re-orientation with meds was what I needed and it went very well. But obviously I have a pattern here that scares me about patient safety. Using the 5 (6,7,8) is obviously where I missed the mark.

I found an online pharmacology certification course through NAPNES.ORG. I am looking into this.

I will look into this for sure and see what is available. Thank you for the advice.

hherrn, this is great advice. My supervisor went over the fact that I graduated with honors, 3.5GPA, excelled in clinicals (several of rotations were in this department) and she wondered where the disconnect is. I honestly don't have an answer to give her. I have been very forthcoming with the errors I have made, self reported, etc. I want to further my career to be an RN but this pattern of unsafe practice has me shook. I want to be a good nurse, a safe nurse. I want my patients and my co-workers to be able to trust me. I am thankful for my supervisor 'going to bat' for me...the hospital could have fired me but instead she knows I am trying to better my life for me and my kids and said she doesn't want these incidents to affect my career. This will be a difficult time but if it gets me to where I want to be then so be it. I am so thankful for the opportunity but I know it won't be easy.