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angshallad's Latest Activity

  1. angshallad

    changing g-tube

    Hi I am a hospice nurse with an ALS pt with a balloon style g-tube that needs to changed (the tip is disintegrating) I haven't changed a g-tube in many years. Does anyone know of a good website that has step-by-step directions? Or if anyone can talk me through it I would appreciate it. Thanks in advance!
  2. angshallad

    pt. load for case managers

    Hi, We do have a separate admission nurse, although I may do 1 or 2 openings a week just because of overload. I manage anywhere from 14 to 17 patients at a time. The agency likes us to see 5 patients a day (less if we do an admission). 5 patients a day is usually manageable for me. Hope this helps.
  3. angshallad

    Home Health--Does this sound right

    The quoted rate seems a little low to me also, but I have only done home health in the northeast. I got paid $47.50 for a revisit, $60.00 for recert/resumption/opening. Mileage was .55 cents a mile. It depends a lot on where you live, just do some comparison shopping with other agencies in your area. I loved the flexibility of home health nursing, beats shift work any day. Good Luck with your decision
  4. angshallad

    New RN

    I would recommend getting your initial experience at a hospital, mostly because you will see a wider variety of diagnoses/patients/procedures/meds etc. I got my first experience on a med-surg floor and although it was very difficult at times (too many patients, too little time), the experience was invaluable. The big thing you will get from your hospital experience is feeling comfortable with your assessment skills which is what you will rely on heavily in hospice as often you will be on your own. Good luck with your career
  5. angshallad

    question about a g-tube

    I am a hospice nurse looking after an ALS patient. He recently had his mushroom style tube replaced with a balloon style g-tube. Everything was good for the first few days. When I visited today his wife said that over the last couple of days there has been increased pressure when she removes the tip to feed him. It is flushing fine and the feeding is going in without any problem. She said the pressure has gotten bad enough that it forced the feeding connector out while his feeding was going through the night. Any ideas on what might be causing this?
  6. angshallad

    sharps disposal in home

    If diabetics etc. use hard plastic containters to dispose of used sharps (like milk bottles) can they can throw the closed containers in the trash? thanks in advance, Angela
  7. angshallad

    Drexel Online Program

    Hi, I was just accepted into Drexel's online MSN program in Contemporary Nursing Faculty, was wondering if anyone had done this program, thoughts, opinions? good or bad appreciated, thanks in advance, Angela
  8. angshallad


    Personally, I would have found it difficult. There is a lot of autonomy as a home health nurse. I worked for four years in a hospital before going into home health nurse. I spent the first few years in the hospital picking the brains of other nurses on the floor. You just don't have that resource as a home health nurse. Even after a couple of years of home health nurse, I still pull on the resources I learnt working in the hospital. The agency I work for does not hire new nurses simply because they do not have enough nurses available to act as mentors. Best of luck.
  9. angshallad

    Questions about hospice nursing

    Hi, I presently work in home health at the VNA as a per-deim case manager. I usually see 3 to 4 patients a day which works well for me. I am thinking of switching over hospice and was wondering it is common practice to have per-diem case managers in hospice? Also I have been toying with the idea of becoming a nurse practitioner. Are NP's used much in hospice? Thanks in advance
  10. angshallad

    Is this for me?

    Hi again, our agency has two types of per-diem staff, one in which the per diem nurse fills in for case managers on an as needed basis and then the per diem case manager. I choose to case manage simply because I wanted the certainty of knowing I would have work each day. of course no benefits, our agency pays $45 per revisit and $54 for an opening or recert. i moved from the south (where i worked in a hospital) to the north (where i am doing homecare) - pay is definitely better up here. anything else just let me know. the transition in nursing has been easy, the laptop charting was more difficult to learn than i expected, but now that i am familar w/ it, i wouldn't trade it for anything, no papers, all the information right where you need it - great. best of luck angela
  11. angshallad

    Is this for me?

    Hi, I moved from hospital work to home health about a year ago for pretty much the same reasons you are thinking about. For me it has really worked out well. Our agency does all charting on laptop, I do most of my charting after I get home and transfer it to the office when I am done each night. I do have an advantage in that I am a per-diem case manager which means I follow the same patients, but can decide on the number of patients I want to follow. I usually see 5 a day which has me getting home at the same time the children are getting home from school. hope this helps, let me know if you have any questions Angela
  12. angshallad

    Mercy Hospital - West Philly

    gun shot wound

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