cookie102

i agree with the above post,,,get some good med-surg under your belt, home health is a whole different ball game., you have to have the skills, knowledge base before you can start. there are so many HH regulations and paper work to learn , it is very hard to do that along with learning nursing out side of a classroom. best of luck to you.

can you get your MSW involved?

WOW!!!! that's excellent pay compared to our per visit rate of regular visit anywhere in the 32-35 range, add $50 to that for admission! what area of the country are you in, was wondering it that makes a difference.

that caregiver needs to be educated, she needs to know about infection etc.

just wondering how many of you are on a computer system if so , what program do you use, could you share the likes and dislikes thanks in advance, our agency is "soon" to be going paperless and will be using UNITY software thanks in advance

i know i couldn't sign a doctors order that i didn't write,!! i imagine MD offices have med-tech that do this often, but i have never heard of it in HH, whether or not it is legal, i don't know, but i know i would not be able to do it. best wishes

i agree, if you are looking for a new car, get one that is comfortable!!!!!!!!!! in HH we spend sooooo much time in the car it needs to be comfortable, at one time i bought a car because i thought it would be fun to drive, well i kept it for 2 months as it was the most uncomfortable car i could of bought!!! so i say comfortable, and fair to good on gas are the important factors, for me have to have that trip odometer, and i like compartments....now i am driving an Altima and love it...happy shopping!

can you direct your question to KCI,,,i do believe you can't put the vac directly over bone, you have to put adaptic first then the foam.

how about just applying for PRN and when you interview tell them your preference to do admissions?

sorry if this comes up as a repeat, you know how your computer just sends things!!! ok...what i was saying is that i have heard that amedysis has this system in place,,,now i am NOT trying to cheat any system, but i don't want to be track for every move i make,,,if i choose to run home to use the bathroom or stop at a store on my way to next visit, i think we should be able to do that, most agencies are paid per-visit anyway, so as long as you get you patients seen, paperwork in on time etc...let us be!!!!!!!!!!!!!!!

i believe the regulations state that if a patient can't be d/c'd with a visit the oasis is completed based on the information from the last skilled visit.

i don't have any direct info on your question, but i can tell you that if you go and interview you may find that they are sssooooo very happy to have someone that wants to do admissions only....give it a shot.! good luck

how are the patients blood sugars? is what he is saying making sense that the dose is too high? how about trying to get a sliding scale order from the MD, would that help? document, document, document is the best advise

i would of already started orientation!!!! sounds great!!!!!

we don't have "field charts" , the only thing we will find in the patients homes is a copy of the med sheet 99.9% of agencies are on computer so when the admission nurse completes the oasis that is what generates the 485, you might try pulling a chart, looking at the oasis and 485 and you will see how it was "put together",,,thumb thru the nurses notes and you will see what is written, you will develop your own style of charting, as long as you are following policy. give yourself a good 6 months to get a goot understanding of HH,,,you will get there...best wishes

i agree, equal pay for equal work,,,getting paid more because you get called in more makes NO sense!!!!!!!!!!! sounds like a HR issue!! on call is on call---lucky ones that don't get called in regardless of the dept.

Home Health is not a "slow pace" environment,,,here was my day today, 8 visits, 103 miles finished up with paperwork at 8pm, took approx 10 minutes to eat dinner...off to bed soon to start it all over in the morning... i don't want to discourage you, but i also don't want you going into HH thinking it is something it isn't, also our agency is involved in a PAC study, which to all of us doing it means ----much more paperwork!!!

the best advise i could give you at this point would be as you are a new nurse with minimal experience, i would recommend you getting some good med-surg under your belt, HH is a whole different world and you need to have a solid base to work from, see if there is a hospital that also has a HH dept that way you could start at the hospital and transition to HH, best of luck!!!

i can remember one time on one of these type tests having to know if certain meds were compatible with NS, questions about PICC dsg, not sure about the verbal never had one of those, but you can be assured they will like an answer like obtaining the best patient outcome at the least expensive way when it comes to wounds best of luck, let us know

sometimes what i have done is when i call the PCP with a situation that you are describing is i make them an appointment, hopefully within the next day or two....some patients you will never keep out of the hospital, what i try to use as a goal for those with the end-stage diseases is that ---i can't keep them out of the hospital but i will try and lengthen the time between hospitalizations,,,for example if they were in the hospital monthly perhaps i can extend that to every two months,,,go with your gut feeling, it usually is right.

i have only found that medicare patients need to follow the homebound criteria,,,private insurances are different, some require it some don't, medicare HMO follow the medicare guidelines. never heard of the situation you are describing....me being me would have to see that in the state policy.

i used to work at the milford VNA and absolutley loved that job,,,only reason i left was to relocate to another state, there is alot of longevity there, people just don't leave,,,best home health job i ever had, and i hear they are restarting the hospice program

sad attitude isn't it!!!!! i find most docs like HH as it decreases the patient phone calls they get,,,none of us likes the paperwork and i do believe the MD's get a stipend from medicare for managing the POC (485),,i hope they never need HH, but i guess if they did, they sure would change their attitudes.

the med list that is complied on the first visit is in turn put onto the POC (485) that the MD signs, if the pt is d/c'd from the hospital they will send a list with the pt (maybe) otherwise you are using your knowledge, like it was stated a patient with double of the same med, if you have a real concern you do the best you can, call the MD office explain it to them and i would make a visit back the next day. hope that helps

hope some of this helps!!! it does get easier