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hlfpnt BSN, RN

LTAC, Homehealth, Hospice Case Manager

Content by hlfpnt

  1. I've been a hospice nurse for almost 2 years & I have to say it's the best career choice I've ever made...I love what I do. I have both inpatient and homecare (Case Management) experience. I much prefer CM. It's not an easy job by any means. Your car will become your "office". You have to be flexible, your schedule may change 2-3 times in one day, hour, minute...no, that's not an exaggeration. There's a great deal of autonomy, you have to be able to work independently. There's also the interdisciplinary team, so you also have to be able to communicate effectively. Sharp all-around (physical as well as emotional) assessment skills are an absolute must in hospice care, especially CM where you're on your own so much, you are the relied on eyes & ears of the team. One of the main differences between hospice & hospital care is "family care". Many times your care will be more centered around the family than the pt, especially in the home setting. Family dynamics will sometimes dictate much of the pt care. Teaching is a huge part of hospice. Also, CM requires good organizational skills. Hospice nursing is often much more emotionally draining than hospital nursing. You can't allow yourself to take personal hits in hospice nursing. It's a difficult time & many times people will say/do things that they ordinarily would not say/do. You must learn to take care of yourself as well. Just remember that your Chaplain's are there for you, too, & it is confidential. It is a specialty all it's own &, in it's own way, it is a very rewarding job. Through all the ups & downs, ins & outs, & sometimes roller coaster type days I have to say...."I'm a hospice nurse, & I love what I do!". I hope you find it as rewarding as I do, all my best to you. :redbeathe
  2. hlfpnt

    3rd Nursing Caption Contest - Win $100

    "Excuse me, sir, but I need to go find my instructor!"
  3. My Great-grandmother was a hypochondriac & when she couldn't think of anything specific, she'd say she had "the eggeries"!
  4. hlfpnt

    home health nursing job

    Home health agencies vary in employment status. Some hire as independent contractor's (which puts you dealing with your own taxes) & some as direct employees. The pay is also variable. Some agencies are pay-per-visit, which means your income will vary with the census & how much a specific type of visit pays, and some are salary. So far in my experience, I've found the salary positions to be the most reliable income-wise. There's also an awful lot of "off the clock" work with the per-visit situations...you don't get paid for "chart time"...this goes toward what's called "productivity", but doesn't have any financial benefit for you. I've not seen any agencies that don't reimburse for mileage, but the rate for that & how it's paid also varies by agency. As far as what you'll be doing as a HH nurse it's called "case management". You are responsible for the coordination of the pts care...lots of teaching & education, direct care, calling docs, collaborating with other team members such as physical/occupational therapy, ordering supplies, med management, drawing labs, IV therapy, wound care...the whole 9 yards. Homehealth requires exceptional nursing skills as there is a great deal of autonomy with this job...more times than not, you're very much on your own in the field. It's a very difficult, but rewarding job that requires a great deal of critical thinking & being on your toes. Personally, and because of the amount of autonomy & responsibility, I would not recommend homecare to a new grad. Get some floor experience (get comfortable in your new role as a nurse), even just 6 months, & then give it some thought. Congrats on passing NCLEX & all my best to you! :) P.S. A good GPS is a nice little investment for the HH nurse!
  5. hlfpnt

    Homebound

    Considering his circumstances, I think he's as homebound as he can possibly be...if he were my pt, I'd definitely continue services. His life circumstances are what they are & he's doing his best to be as compliant as possible. :)
  6. You might wanna practice the "mouth breathing" technique carefully, my friend, things do tend to splatter, spray, leak, or otherwise explode...there may come a day when you really will "taste the smell"!
  7. In the last couple of years, I've seen many changes in my local area that I think contributes to new grad discouragement & the nursing shortage. For one thing, 3/4 of the hospitals in this area will not hire anything less than a BSN & the bulk of nursing education is ASN. I have heard soooo many ASN students ask where they can get a job. It's an awful thing to spend that much time, effort, & money on an education that can't be used. In watching the students in clinicals, I also believe there is too much emphasis placed on the academics & not enough on the necessary skills. The students just aren't properly prepared by educational institutions to make it on the floor. I think nursing programs would be better if moved back into the actual hospital setting. When faced with the reality of nursing, they get discouraged, scared, & burned very quickly. Facilities also don't offer good GN programs anymore. On the average (here at least), most GN programs are 6-8 weeks....then it's sink or swim. It's a horrible thing to only have 6 weeks orientation then be by yourself with 7 acute pts. For myself, I've had the unfortunate experience of being with a bad preceptor & did end up leaving the job after only 3 1/2 months--a job I wanted & knew I could do; so I'm also of the opinion that it would be helpful if facilities would offer preceptor training programs on a voluntary basis. I've seen coworkers get thrown into the position that really didn't want it & had no interest in teaching a new grad. Not everybody's cut out to teach. Unfortunately, the only advice I can give to any new grad right now is that if you really want to be a nurse just always do your best, stay focused on the reason, stay determined, learn all you can, & keep on keepin' on.
  8. All these are just too funny! Mine's not quite as humorous, but I gotta throw it in anyway... A couple of years ago I had this pleasantly confused little old lady with a colostomy. She didn't have a clue what it was & we had fussed back & forth all day over this ostomy bag. She was determined to pull it off & I was determined she wasn't gonna! Finally, on my last rounds, I walk in & my sweet little angel, with the biggest ear to ear grin I've ever seen, is covered from head to toe in poo & is waving her ostomy bag over her head like it was the American flag....through all her confusion just as plain as day she says, "I won"!
  9. All I can say is...EEEWWWWWW!!!!!
  10. hlfpnt

    Sanford Brown Jacksonville

    Thank you for sharing the web site...I'm sure others will find it quite helpful. It's only been 2 years since I worked at OPMC & it was more than I cared to deal with. I felt that not only were my pts in jeopardy, but my license as well, so I found something better. Lol...I agree , Shands is a scary experience! Congrats & all my best to you! :)
  11. hlfpnt

    Best hospital in JAX (not paywise, experience)

    Flagler is the best of the 3.
  12. hlfpnt

    Florida Hospital--"faith-based" school?

    Yes, I worked full time while going for my BSN. It was stressful, but doable...I managed to pull my GPA up from a 3.75 to a 3.98 & maintain it. However, I loaded myself with 9-10 credit hrs every single semester...not something I really recommend doing. Lol...in other words, I had no life! A few words of wisdom...I wouldn't combine (double up on) any religions course (Dr. Bursey is excellent, but tough) or world civ with any other courses. I also wouldn't recommend combining pharm with pathophysiology. The capstone course, Seminar, is also better in the full 14 weeks than in the accelerated 7 weeks. It's not so much a difficult course as it is an extremely busy course. Healing Words, Health & Wellbeing, & Aging & Society are great courses to combine with the other core nursing courses. I would also consider it best to take stats the semester before taking Nursing Research. Stats wasn't as bad as it sounds...it wasn't the actual math that was taught, but how to read and understand the various statistical symbols & such. Anyway, hope this helps...all my best to you! :)
  13. hlfpnt

    Florida Hospital--"faith-based" school?

    I just graduated from FHC's BSN program this past December. My beliefs are Nondenominational Christian & I didn't find that they pushed the Seventh Day Adventist's specific beliefs in any way. I actually found the required religions courses to be quite interesting. It's not geared towards trying to change or raise conflict with one's own personal beliefs at all. They simply teach the foundations of the different religions & how it applies to healthcare. I thought it to be a good thing because of my greater understanding of a person's beliefs, I can now take a more holistic approach in my practice. All of FHC's course work & exams are on line as well...the only thing that isn't is a required 8 hrs shadowing a Dr. or ARNP & a return demo head to toe to the person you shadowed. I really don't think they'd "penalize" anyone for their personal beliefs...several of my courses had students that were either agnostic or didn't believe in God at all. It wasn't an easy program by any means, but I thought it to be a very good program that left me with a greater understanding of what nursing actually is as well as more confidence in myself and my practice.
  14. Jamie, What's your first class? Mine is Healthcare Policy.
  15. hlfpnt

    Sanford Brown Jacksonville

    I've attended this school & know of other's that are currently attending. I also taught at this school as well. My personal opinions are formed from mine & their experiences. Not saying you're wrong, but I find it kinda interesting that they couldn't post the same info on their web site that you have provided. I think accreditation info is necessary to make an informed choice. College is an important decision. In light of my own experience, I think SBI makes it's own fair share of financial gains from this community...I also believe that there are better programs available. Also, the web site is obviously very misleading...I didn't directly state that the Jax campus does have an LPN program...I just stated that SBI's LPN program is approved by the FL Bon, but didn't see anything about an RN program. Maybe SBI needs to revamp their site! I have also worked at OPMC & of course they love new grads...almost anybody who puts in an app will get a call because the working conditions are so poor that they can't keep good, experienced nurses. The picture that the recruiter paints & what's reality is usually 2 completely different things. IMHO, an 8-9 pt load is extremely dangerous & very exhausting...
  16. Thank you & all my best to you, Lunah!
  17. I have a quick question for everybody that is going through or has graduated from Chamberlain's BSN program...are or were you satisfied enough with this program that you would consider going through their MSN program? I have been accepted into the MSN program & will be starting in July. Since there hasn't been a graduating class from the MSN program yet, there's no real feedback on it. The admissions & finance process went very smooth & my adviser has been awesome. After looking at the curriculum & taking the orientation, I believe I'll be very pleased with this program. Thanks in advance for your input!
  18. Marlene Hurst has a pretty good NCLEX review.
  19. hlfpnt

    Sanford Brown Jacksonville

    Looking on the school's web site, it says that the LPN program is approved by the Florida Board of Nursing & that the Jacksonville campus is institutionally accredited by the Accrediting Council for Independent Colleges and Schools...meaning it's curriculum is acceptable to award certificates & degrees. I didn't see anything in regards to accreditation of the RN or BSN programs. Due to it's lack of regional & national accreditation, it's quite possible that any credits gained from this school may not transfer to a higher level institution. I went through their Medical Assisting program in '97 when it was Ultrasound Diagnostic School & nothing transferred. I currently know one person who was originally wanting to go through the cardiovascular sonography program & they made her take the MA program first. I don't really understand the reasoning behind this & pretty well think they're just soaking her GI bill. Maybe the PearsonVue or Florida Board of Nursing sites can give you more NCLEX info on this school. The best advise I can give is to think a little more on this one & maybe try applying to St. John's, Lake City, or maybe even Kaiser. A good way to get basic info is to look at the colleges web site...alot of your questions about the school itself can be answered this way & there's no commitment. It's best, even if you have to wait, to get into a program that's good enough to transfer in the future than it would be to make do & get into one just to fast track it into the nursing work force. Hope this helps...all my best to you!
  20. klocl, I'm looking forward to it! :) suni, I'm not very computer savvy & can't really answer your questions on that. All I know on that is I have a HP Pavilion dv7-3160us laptop & it supports the program. I'm running windows 7 with all the necessary plugins to support an online learning program & Chamberlain does have a tech support. Compared to others, the cost is reasonable for a graduate program. As to whether or not your UOP credits will be accepted, you'd probably have to call the college & talk to someone. They're really nice & I'm sure they can help get you all the answers you need. All my best to you.
  21. You're welcome. My first course is Health Care Policy...I don't see a Policy & Politics on my curriculum, but I'm assuming it's the same. Maybe I'll "see" you! All my best to you!
  22. I just found out I've been accepted in Chamberlain's online MSN program so I can't give you any feedback on the courses or instructors yet. I can tell you that the admissions and finance peeps have been awesome in helping me through the entry process. It went very smoothly. I have also done an intro for the online delivery system & it's so easy, very user friendly. No closing windows or logging out...everything you need is right there in all the tabs. I can also tell you that the curriculum is very much geared toward the working nurse with a family. There is a limit to the amount of credit hrs one can take per semester...the basic idea is to learn without being so stressed over it. I think it's gonna be an awesome experience...I'm excited & really looking forward to starting classes in July. :)
  23. Chamberlain College of Nursing does not require GRE's.
  24. hlfpnt

    Yesterday's and Today's Nurses

    Myself, I picture someone in a starched, full-length white dress with matching stockings, shoes and hat. I can see her carrying a medicine tray loaded with brown bottles and a mercury thermometer. That's a pretty stereotypical thought, huh? What a blast from the past! Modern day nurses are a far cry from the old-fashioned starch and hat days. The professionals I am about to introduce you to, yesterday's nurses and today's nurses, are very different but remain one and the same. Since education is the first step, this is where we'll begin. Yesterday's nurses were actually educated and trained by the physician's themselves. They learned nursing in the field, with real patients and real-life situations. When the physician's felt they had sufficient training, these nurses were put into practice. They were very fortunate to have hands-on, real-world training. In contrast, today's nurses are taught mostly by nurses. The bulk of their educational setting consists of mundane classrooms, filled with books and simulated situations. The amount of time spent in the clinical setting with actual hands-on training is small in comparison to the amount of time spent in the classroom. Before modern nurses can practice, they must pass a state board exam to prove their competency. Today's nurses are taught what is referred to as Ivory Tower book nursing, meaning what is ideal, not what is real. The next major difference is the conditions under which each of these professionals practice. Yesterday's nurses were forced to practice under very crude conditions. Hand washing, sterility, and personal protection were unknown concepts. Body fluids, germs, and dirt were transferred from one patient to the next. Proper and adequate supplies were a rare commodity and there was no such thing as a private room. They dealt with uncontrolled sepsis and unclean critters roaming the floors of their domain. On the contrary, today's nurses have it made in the shade! Modern technology has produced some very nice benefits. Hand washing is highly promoted and antibacterial soaps are readily available. Procedures are performed following very strict guidelines for sterility and cleanliness. If proper procedures and protocols are followed, the transfer of micro-organisms is almost nonexistent. Stocked supply rooms are also a handy little item. If something's not there, one phone call to central supply will get you what you need. Since most modern facilities have private and semi-private rooms, today's nurses can care for their patient's in a comfortable atmosphere where cleanliness is promoted and visiting critters are strictly prohibited. The third issue I would like to discuss is the differences in the amount of autonomy possessed by each professional. Yesterday's nurses were not allowed to have a voice. The articles I have read concerning this remind me of a scolded puppy with its tail tucked between its legs. But, this wasn't the nurse's fault, that's just the way it was at the time. The physicians were considered to be the truly educated ones and were always right. Any nurse who contradicted his decisions also faced his wrath. Quite often a patient's true needs were not met because of this. Yesterday's nurses were taught to follow the physician and stick to tasks such as dressing changes and activities of daily living. The scope of practice has grown considerably and today's nurses have a great deal of independence and responsibility. Since they are the front line of care, they are expected to speak up and voice their concerns. Patient advocacy is a huge part of modern nursing practice. It is the nurses' duty to see to it that their patient's needs and goals are met. Nursing judgment calls can be made concerning some medications, procedures, and activities. There is even a great deal of difference in the appearance between yesterday and today. Of course, the mode of dress for each fits the day and time, but yesterday's nurses were much more restricted in their choices. Their uniforms consisted of a full length starched white dress with wrist length sleeves and an apron, white stockings and shoes. It was topped off with that timeless symbol of nursing, the starched little white hat. I can only imagine how bulky and uncomfortable this must have been. The fitted bodice had to have been hot and quite restricting of movement while the full skirt and apron just simply got in the way. Today's nurses' uniforms are fashioned for looks and functionality. They are available in a wide variety of colors and prints. The scrub tops are loose, lightweight, and comfortable and allow for ease of movement. The uniform pants are designed in the same manner and most have pockets deep enough for today's nurses to carry around five pounds of needed stuff such as scissors and tape. In addition, the private lives of these two professionals also hold notable differences. Yesterday's nurses were expected to lead a solitary lifestyle. They did not marry nor did they have children. These individuals were expected to be dedicated to their life's work and were on call 24 hours a day, seven days a week. Can you imagine being called out in the middle of the night and having to hook up a horse and buggy in frigid temperatures with three feet of snow on the frozen ground? I know I would have a cow, to say the least! Conversely, today's nurses do have families and a life of their own. No longer is their job their life. Most employers place an emphasis on the importance of home and family. On-call status for today's nurses means hanging out around a phone for the duration of their shift and nothing more. They also have the comforts of an engine powered vehicle with heat! Indeed there are a vast amount of differences in the professional and personal lives of Yesterday and Today. The practice of yesterday's nurses would make any one of today's nurses cringe in horror. I have the utmost respect and admiration for the nurses of days gone by. They were tenacious, tireless and believed every bit as much in what they did as modern nurses do. Even though the differences in the way of practice are great, yesterday's nurses and today's nurses are one and the same in that our purpose was/is to care for our fellow human beings and help them achieve the highest possible quality of life. This will never change and I think, for the most part, Miss Florence Nightingale would be proud of what her profession has become. One of my essays for English class. I'm not much of a writer, but I did enjoy this assignment & I just wanted to share.
  25. It varies with each course...some courses will have a paper due every week, some will have at least 2 major papers, some have projects with papers, but all (so far that I've had) will have weekly postings on a discussion board with peer responses. However, the postings aren't as bad as it sounds...it's just a matter of keeping up with them. I usually print out the course schedules, make a "due date" calendar and check things off as I get them done...makes it easier to keep up with in my opinion.
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