Ruth E. Raleigh

Absolutely agree with this response.

Ask yourself whether your unhappiness at this new position is causing you to make errors in your patient care. If so, then you would want to leave. Other nurses have recommended sticking it out but in reality, you have to be true to yourself and if this is not for you, then you would need to make a change and leave.

Travel nursing pays wonderfully higher rates, much higher than you would be able to get just being a regular staff employee. You get paid for your housing costs provided you are a certain distance from the facility you are assigned to. Yes, you can get health insurance, usually a PPO and also you can get a healthcare savings account. The downside to travel nursing is that your contract can be cancelled at any time and without warning. Just like when you were called in and lost that job, the travel nursing facilities hold all the cards. I did two tours of duty at a large HMO facility, 2 separate locations. They were very difficult to work for, both facilities. Here in California, employment is considered at will, so that means leaving a job is mutual between worker and employer. Just keep in mind that the employer can always change their mind for no reason. Both times this happened, I was placed by two different employment agencies. Both employment counselors received NO complaints against me, yet I was let go.

After more than 45 years in nursing, this is how it is done, just saying. Unfortunately, trying to take the time to show and correct another nurse's behavior may not always be taken the way for which it was intended. Management often frowns on other colleagues trying to correct each other in healthcare settings.

In order for a note to be billable to insurances, copy and paste should NEVER be used, not in the hospital, and not in home care settings.

Talk to your immediate supervisor about it as to what to do. Let them handle it from there. Knowing about it and not saying something is just as detrimental as being complicit. Get that monkey off your back. The reason I am saying this is because not if, but WHEN things come down, ANYONE working with this person will be taken down along with the guilty party. Do not be co-dependent. Report this behavior.

What was interesting to note is that for each location, I was placed by a different nursing agency. In both instances when I called the agency to let them know that I was called in, both agencies who were not at all linked, told me that they never got a complaint about me. Both placement counselors were shocked. I didn't fight it because the particular HMO outfit was very difficult to work for.

I have had approximately 30 years of experience in doing home health/hospice nursing care. In 2016 I had 2 contracts for the same large HMO company here in California. I was at 2 different locations. In California, employment is at will. At both locations, my contract was terminated suddenly and without warning. With the last position, that particular director was a very strange and foreboding person. She called me in and told me that she had had a physician complaint and told me that I had not properly assessed this physician's patient. I knew it was baloney and for whatever reason she wanted to get rid of me. When I let a couple of the people who worked there know, they told me that I was awesome and that they couldn't see why this happened. No could I. I chalked it up to experience. I since then finally found my niche again at another home health agency where I am in demand not only for my skills but for my bedside manner. After the second termination of a contract through the same health care entity, I decided it was the company and NOT me. Hold your head high. There are definitely better things that await you. BTW, I stopped doing contract nursing as after this second experience, I realized that these companies that have contract employees are just too darned difficult to work for. Best to you.

ALWAYS A GOOD IDEA TO HAVE LEGAL REPRESENTATION, NO MATTER WHAT. ALWAYS is a good idea to have malpractice insurance. Yes, they will cancel you if you have aclaim, despite years of faithfully paying your premiums and not having any claims, but jjust like automobile insurance, it IS THERE WHEN YOU NEED IT!

Not being fully aware of the situation, you DID hire a lawyer, didn't you? Please say yes. Do NOT engage with BON without a lawyer.

Maybe a one-inch needle only for a thin person. Sounds like the medication was absorbed either subcutaneously or IM. Still should be okay.

As a nurse who has done home health for approximately 30 years, I concur with ALL of the nurse's above written statements regarding home health. Once upon a time, nurses working in home health really brought home a good and excellent income, but with OASIS, that really choked the income making capacities for many of us still in home health. I have looked at 2007 which was the last year that I EVER made decent money in home health. Of course, the cost of living was not then, like it is now. In 18 years, there has been ZERO INCREASE in the wages and compensation on home health visits. I work Tuesday through Saturday, but my two "off" days, Saturday and Sunday, are spent completing paperwork. I figured that even with all of my years of nursing experience, I come in to under $30.00 per hour. It really sucks. I would LOVE to do something else, but like everyone else says, the flexibility of the job, the autonomy and independence, you will NOT find anywhere else.

While it is so difficult to say a definite "yes" or "no" answer, many states could have different labor laws and pay rules. Home Health as always had its own unique pay structure. If I am correct, any agency by law should offer at least minimum wage for meetings/orientation. I would definitely ask human resources personnel about this pay scale/structure. DO NOT EVER COMPROMISE YOUR MONETARY AND SELF-WORTH. Any company that asks you to do so will have other hidden untruths underneath their sleeves. Be pro-active and stand up to this policy.

Definitely long-term care setting! You will learn organizational skills, treatments, your clinical skills, especially wound and skin care will be gained by working in long-term care. Although very difficult to work in, long-term care is an excellent place to start. Stick it out for 2-3 years and then you go and branch into something else, such as case management, that might be more satisfying for you.

Yosemite RN is absolutely right in his/her statements. Absolutely EVERY visit must be justified. Over-utilization will NOT be reimbursed by Medicare/Insurances. The much-maligned OASIS Documentation was implemented in 1998 to help curb fraud and abuse of Medicare where home health visits were padded with untrue data by agencies and clinicians. When home health nursing and therapies in home health first started coming into place in mid 1980's those who worked in home health care earned a lot of money. In many instances just as much, if not more than physicians earned in a year. Well, no doubt that was not going to last long, and here we are. In TWENTY YEARS the pay rate has NOT increased. Medicare keeps taking money away. I finally figured out that I am earning probably just under $30.00 an hour when I factor in ALL of my documentation time spent on my days off to complete the necessary documentation required for my job. I am definitely looking for something else with higher pay and not such a daunting documentation requirement.