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BarrelOfMonkeys BSN, RN

Enjoying life, one day at a time.

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Still enjoying life, one day at a time! 📸

BarrelOfMonkeys's Latest Activity

  1. BarrelOfMonkeys

    LGBT Nurses

    I’ve never personally experienced being treated any differently d/t sexual orientation or being a member of the LGBTQ+ community in nursing. I have experienced degradation because I was a male nurse many times when I first started, however (“You’re a male, pick it up...”, “Get the male to lift them...”, “Get the male nurse to do the compressions...”, “We will just leave it for the male nurse to do because he’s faster...”, etc). I think the bigger picture is how you treat the patient. That being said I remember a colleague who identified as gay would go into a particular patients room (LTC) and you’d hear the patient screaming for him to not come in to his room ever again. The patient would call and request me instead but apparently never realized we were of the same community.
  2. BarrelOfMonkeys

    EVV (Electronic Visit Verification) experience?

    Same here.
  3. BarrelOfMonkeys

    EVV (Electronic Visit Verification) experience?

    From what I’m reading in the Medicaid link above this isn’t optional. Or are we taking about the same thing here? It *could* be a device much like a phone but used in the clients home for any in-home services provided and even taken with client to services outside the home. It would require voice verification (not simply tablet or e-tracking devices)of client name, date, time in, time out, location, and who is providing care. It looks like this will be mandatory by 2020. Again, I’m getting this from the link above and clients showing me their letters with similar info.
  4. I just discovered this will become a requirement in HH. Anyone have any experience training on it yet? Heres a link that explains it in depth: https://www.medicaid.gov/medicaid/hcbs/guidance/electronic-visit-verification/index.html
  5. BarrelOfMonkeys

    Home Health Interview!?

    One thing I’d ask would be how compensation is structured (pay per visit, hourly, salary, and then mileage reimbursement, company car?). -Company compensation does vary greatly so if it’s not clear then ASK! Also if it’s hourly are you getting paid for the time at the clients home AND commute time or just home time? Depending on how compensation is structured this may or may not work for you driving 100 miles (just an arbitrary example) to see the client Other things that come to mind: 1. Expected geography coverage (do they expect you to cover an entire county, district, etc will it be expected to cover 100 miles round trip to see a client, for example)? - I drive 75 miles today just to reach my first client. Though, I knew that beforehand. 2. What is average case load expectation and acuity (hospice, psych, med-surg, new moms/baby, etc)? -I work with adult and pedi med-surg and psych. 3. What is expected for full time versus part time as far as case load/benefits? -In my company I have to build up caseload to acquire FT status. Everyone’s different though 4. What supplies can you expect the company to provide and what supplies do they expect you to provide (bag, steth, BP cuff, sharps, etc)? -Many companies vary on supplies offered so always good to ask. 5. What kind of company support can you expect when you’re out in the field and you need assistance? -For example in my office I can contact someone any time I’m in the field and run across something I need help with which was VERY helpful in the beginning! I hope you’re experience is like mine and you end up really enjoying this. Best of luck to you!
  6. BarrelOfMonkeys

    Advice for floor nurse moving to home health

    Things I wasn't used to: 1. Pee breaks. Whenever you want. 2. Lunch breaks. Whenever you want. 3. Roaches. Whether you like it or not. 4. Bed bugs. Whether you like it or not. 5. 1:1 patient care. Without interruption from staff/call lights. 6. Documentation. Yes, still. 7. The feeling you're really making a difference in someones life. Many times you very well may be the only healthcare professional in their homes on a weekly basis. You also may be their only visitor on a weekly basis. 8. Compensation varies widely, company to company. So check out the details before signing the dotted line. 9. Working when I want. No overtime. No holidays. No weekends. No evenings. 10. Having a life again. 11. Not having everything ready and easily available like in a facility. There is no med room, no clean supply room, no stock person, no maintenance person. 12. The amount of calling to get a hold of PCP, clients (especially my psych clients), other healthcare professionals. 13. Learning so much about insurance it made my head spin. 14. The freedom of taking vacation, making an appointment, with the ability to move my clients around them (as appropriate). 15. HH was the last place I ever wanted to work. Now, I can't imagine doing anything else. I mostly enjoy the uninterrupted 1:1 care I can provide.
  7. I know there are several ways HH will compensate and they seem to vary quite a bit. I'm not in your state but I get PPV (pay per visit) + mileage. Period. No car. No MVP status. No free pen. PPV varies in my area from $35-$75. My visits per day vary widely depending on if I have a missed visit one day etc. I average 6 visits a day. Again, average isn't very telling. Some days I end up with only 3 and other days I end up with more. I average 500 miles a week. Last week was 700, however. My first client out of the gate every day is usually 1.5hrs from me. I'm totally okay with that, too. I'm sure others will chime and provide information as well.
  8. BarrelOfMonkeys

    Any tips or advice for a new grad/new HH nurse?

    One thing that I wasn’t exactly prepared for when going in to HH was the scheduling. I started out part time and slowly picked up more and more clients so the case load wasn’t a problem. Scheduling in advance was a challenge with psych clients. I work with adult/pedi psych and some medical adult/psych. Psych clients are not always the most reliable (forgetting they had an existing appointment, forgetting all about yours, outright refusing, etc). It took me a while to get a routine down and to be able to manage my daily schedules with sometimes changing them by the hour. If I missed a client on Monday and had to reschedule them then I’d have to fit them in another day that week which changes my schedule for that coming day. So I’d tell you to be flexible with schedules (again this is from a psych client perspective) and to realize it will take time to find your groove. That’s been the biggest challenge for me going from a facility to HH. It was the last place I ever wanted to work when I was in school and now I have never been happier in my career.
  9. BarrelOfMonkeys

    Failed NCLEX first time

    What helped me was consistency. I treated studying like I was being paid to do it: same time(s) every day, followed whatever recommended questions per day, took a local live review course, studied woth friends same time each week, etc. I kept at it and was nervous as well. Yet, when it came time for my exam it went fast and I felt like I knew some of the answers. I tried to be prepared by going a long with what my local review course recommended with question banks and info review. Good luck on your next exam!!
  10. BarrelOfMonkeys

    "Recently Browsing"

    It reminds me of the old DOS boards from the 90’s people developed for chatting. I don’t find it worth anything now but it’s retro. #bringingbackthedead
  11. BarrelOfMonkeys

    Yes Ma'am, I mean Yes sir

    I’ve certainly been referenced as a female before, like many others. It was clearly by accident/habit even when I’m standing in front of them. Other times they automatically think I’m the doctor because I’m male. It’s in these times I politely stare and watch their mouth and face contort while their brain catches up and they recognize their “oops”. it’s a great profession, we can all be in on it!
  12. BarrelOfMonkeys

    Would you be insulted?

    Might I just say, I’m sure that it feels awful to some degree. Who wouldn’t feel slightly uncomfortable in your exact situation knowing the history you two have. Then again, I’m sure many have felt slighted in some manner. Justly or not. If I were you I’d leave it alone. As you’ve mentioned you’ll be changing your work load there and likely moving on to another unit/facility during/after grad school. What I’d suggest is JUST before you actually leave (if you do) that place is ask this person for their feedback on where they saw me then and now. IF you even care to by then. IF you even have any respect for their opinion. In the end what they think doesn’t change how you practice, if it’s going to be non constructive feedback.
  13. BarrelOfMonkeys

    12 patients for a new grad to much?

    As others have suggested, that’s a light load for SNF. Also working longer shifts (say, 16) will make it seem more stressful. I might suggest NOT picking up extra hours until you feel more comfortable. Finding a routine that works for you will help. That only comes with time, however. Hang tough!
  14. BarrelOfMonkeys

    Sign On Bonuses

    Great question. I don’t have an answer. Like you, I’ve only noticed them in those same facilities. In the facilities known in my area as “bad” they all have sign on bonuses.
  15. BarrelOfMonkeys

    HELP!!!!! PANICKING! Career change??

    I’d look at my facility policy on time in position before recommending a move. You definitely don’t want to burn your bridges.
  16. BarrelOfMonkeys

    Medical Marijuana: Understanding the Six Principles of Essential Knowledge

    Great overview, thank you!! I don’t have experience with it but dispensing has just started here and some patients are asking about it. This article gives me a quick overview and a direction for more info.
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