camrave

Hi mz.free, Looks like no answered your question. I am also interested in cm. I am currently in home health and we are considered case managers. I plan to take classes through Kaplan on line to become certified but I live in MD and depending on where you are, some employers want you to be certified, others don't require it. I applied for an rn/cm position that was advertised on career builders in my area, and I am hoping my 2 years in home health and the fact i plan to get my cert will help. I will keep you posted. In addition some employers like to see that a nurse is bilingual but usually they clearly state this when they advertise, so I figure it won't hurt to take a spanish communication class at my local health dept.

What a relief, I thought I was the only one that felt this way. I had my interview with the local health department almost 4 weeks ago and haven't heard anything yet. The whole hiring process takes entirely too long here and dumb me was so eager to get out of HHN that i quit my job right after my interview thinking I would hear something sooner. I know stupid, right. I was just stressed physically and mentally and on top of all of that I was dx with MS last Fri. Well now I'm broke and Christmas is coming so I started a a job with a different HHA but its a per diem position and I can work how much or how little I want and the agency itself a good place to work, the nurses seem happy and the supervisors are really supportive. Its different from the previous HHA I was with. The nurses don't take call, there are 3 supervisors that rotate call. They only call us if absolutely necessary and we only do as many visits as we want for salary i think their productivity is 5 or 6 visits a day. I am praying that I hear from the health dept soon! I need the money right now so I have to do what i have to do but in case I don't get the job with the health dept I'm definitely getting out of home health! Good luck to all of you.

That MD sounds like a jerk. Just make sure to include in your documentation what the patient told you and the conversation with the MD and MA. It probably won't do any good to put in the MD's attitude. You did everything right because you followed the orders that were given to the agency. After the patient was admitted were these orders confirmed, because sometimes I find the hospital sends the patient home with different set of orders then the MD that will be following their care. I've had this happen a couple of times. We usually draw PT/INR's on Mon and Thurs or once a week depending on the MD and the results. One pt we had came home with PT/INR to be drawn Mon, Wed, and Fri which I called the surgeon and it was supposed to be mon and Thurs because if there was a change in the dose it wouldn't have taken affect until at least 2 days later.

Hi berlowd, I sent you a pm. Hope it helps.

I've worked for 2 different HHA and we don't do late visits. If its an IV patient and they need to get a 9pm or 10pm we let the hospitals know we don't do visits that last but we open them the following morning so usually the hospital gives them the late dose and d/cs the pt the next am. Occasionally we make exceptions and the nurse on call that day see's that admission but usually anything after 5pm they get admitted the next day. The LPN's never took call unless they were backing up a RN on a holiday.

I think it also depends on if a nurse worked as a CNA before becoming a nurse. I did and it was the hardest job I ever had. CNA's do the "dirty" work and don't get paid enough for what they do. It takes a special person. Don't get me wrong, there are some CNA's who are lazy but then again so are some nurses....

I personally, think some nurses do eat their young. When I graduated from nursing school, 4 of us new grads started on the same med-surg floor (they were really, really short) and if we had questions for the older, more experienced nurses they would look at us like we were crazy and shouldn't be asking any questions, we were picked on if we did make a small mistake, not anything life threatening. I would think they would be happy to have some help. I stayed 6 months, that's all I could take. I think some of it is a lot of the older nurses are pissed because these new grads are coming in making what it took them 15-20 years to start making, which if you think about it, most people would be pissed about that but they shouldn't take it out on the new nurses, they should go to management.

As a previous HHN we had many total hips and knee replacements. We've never had a bad experience. After surgery, the pt would come home and we, the HHA would take over care as far as Physical Therapy and Nursing, drawing the PT/INR's as often as ordered by the MD and wound checks, as well as pain management teaching, bowel teaching. PT would see the pt for about 3-4 weeks then d/c them to outpatient therapy. It really depends on the pt and what other health needs he may need. If he's pretty much healthy or his health is being maintained, and he's normally an independent person, I think he would be fine at home. I would check into the HHA's around your area. The agency makes a difference also because you want their nurses to be efficient with his care and f/u with his Coumadin level, and provide effective teaching regarding s/s DVT's, s/s infection. Hope this helps if he's really against going to a NH, besides some pts heal better at home and it helps having the therapy in the home in case they have steps in the home or outside, they will know what precautions to take in the home once they get there as far as safety.

I would ask what are their on call, weekend, and holiday requirements. 1 agency I worked for, we took call about 1-2 times a week. We had a weekend nurse so we only had to work if she requested off or sick. We had to take call on holidays but the agency tried their best not to take admissions that day. The agency I'm with now is different in that we work every third weekend, the nurses are required to work 1 winter and 1 summer holiday, even though you may work more than 1 and also if you work on a holiday its the same as a regular work day. So we are to expect at least 4-5 visits and if it works out there is no one to see you have to use PTO time. Also with this agency, if its your weekend to work/be on call, you also have to take call the rest of the week. The first agency you were paid regardless if you saw people or not and you did not have to use pto time.The reason I left the first agency is because our pt load dropped and we all got scared they were going to close down as another branch in another state had done ( same company ). Its amazing how different 2 HH agencies can be. Also ask if you have to use your pto time to be off on a holiday you are scheduled to be off, how often you have to do late visits, and if they keep in a general area or will you be driving all over the place, also whats their productivity. Some are 25 visits, others are 30 visits a week. Good luck with which ever one you choose.

Hi all, I've been in HHN for 2 years. I love the flexibility, teaching, and the rewards I get from helping my patients, but there are some things I am getting tired of. Things like being in and out of cold, rainy weather, and just running around all of the time is getting to me. Sometimes you go to admit a patient get everything together to prepare and find out you can't admit for some reason, or you get an IV patient who has been sent home but the pharmacy will not get to their house until 7 or 8 that night among many other things in HH that make it hard to do our jobs sometimes.Then we have the patients who we, the nurses, are on their time, who I might add are supposed to be home bound anyway. I'm sorry, just needed to vent. I have an interview with my county for a public health position, where i may have to go out sometimes but that I don't mind. Its a state job, all the state and federal holidays off, no on call weekends or holidays, Mon-Fri 8-5. If they offer I will accept. Just wondering if any other HHN out there are getting tired of it.

I've been in HHN for 2 years and recently switched home health agencies. Well, after being at my new job for 1 week, I received a letter to interview with my local health department for a Community Health Nurse position. I really want to accept the position if offered, but I feel bad leaving a job so soon after starting. Since I started nursing 6 years ago, I've always wanted to be a Community Health Nurse. So if there are any community health nurses out there please give your input if this is the right move and how to tell my new job I am leaving after 2 weeks.