lc177985

I too would be nervous. Having worked in private duty for the last 1 1/2 years I have noticed that private duty is very creative. Patients don't have the money or resources to get the proper equipment and you are often making do with something less than optimal. Being able to document my issues and then referring the client to the agency I work through has been a lifesaver. They carry the liability and make the decisions as to what is appropriate or not. The agency I work for is private duty and I am able to choose my own patients and work a schedule that is agreeable to us both. My suggestion would be to find a smaller agency in your area. They are usually willing to work with you and give you the experience that you want.

I agree with live, you need to note time differential between intervention and positive results. Sao2 would be nice and if the pt is on a ventilator, any information that would be pertinent. Also, I would note amount. ex. small amount, scant amount, moderate amount, copious amount. I know it is not concrete but would be helpful to next nurse. If the secretions are in any way colored - yellow, blood-tinged, green, I would add a temp too. Hope this helps. L

I am in Montana and would be able to work 40 hours a week if I wanted to with my company. I am very fortunate to be a "transitioning working mother" I have been at home with the boys for 12 years and decided to go to school and get a certificate LPN and start working. I currently work anywhere from 8 to 15 hours a week and more on the 8 side. I have schedule 8 to 10 hours and pick up some on the side when it works for me. This is my decision to work so few hours, the company would love me to work more. The company I work for offers benefits for full-time employees only and I don't think there is tuition reimbursement. When I started nursing school I thought I would ONLY work in ICU highly technical nursing but found that I really like the one on one of private duty and am currently working on my Rn through excelsior. I plan to work in Home Health. I have talked with one of my professors who is also in home health and she said that the experience in private duty will benefit me when it comes time to look for a job in home health. I have friends who work at the hospital and while you have more benefits, and longer hours, it's stressful and hard to coordinate study time and testing time around. I think hospital experience if very valuable and if you can swing doing both, you would really benefit from it but it's also very stressful and difficult to do both. Good Luck

I have lived in missoula for over 5 years and recently became a licensed LPN. I am not sure what the salary is for RNs but I do believe it's lower than most of the country. On the flip side of that is that we have many opportunities for medical careers here in missoula. In addition to St. Patrick's hospital and Community medical center, there is the INternational Heart Institute and numerous private practices, home health agencies and clinics/surgery centers. The cost of living is higher here than where we have lived elsewhere but from what I hear, less expensive than CA. Victor is about 45 minutes to 1 hour from Missoula and sometimes more depending on the weather/traffic. It's cheaper to live in the bitterroot (victor, stevensville, hamilton, lolo) than in Missoula so alot of people do live there and commute but the road "highway" 93 is often 2 lanes and runs through the small town stoplights so it can be slow going. There is also a hospital in Hamilton, Marcus Daly, that is closer to Victor. You should look at the Community Medical Center and St. Patrick's Hospital websites for job postings and contact them about salaries. We have heard it from many people and believe it ourselves, you have to want to live here. It takes some work and sacrifice but the quality of life is definitely worth it. Good Luck!

I agree with everyone, as an LPN studying for the RN I am really now understanding everything. I know I learned that stuff before but now it is actually "clicking" and showing it's usefulness. An idea about working, I work as a private duty nurse and take care of one client who is asleep about 1/2 of my shift. That's when I study. I have a friend who is an LPN at the hospital, with 7 + patients and up to 32 hours a week of work and she only makes $1 per hour more than me. I also have some flexibility with my schedule, telling my boss when I can work according to classes, children, family, etc. I am also doing a lot of care, planning, and skills (ex. JG tubes, traches, ventilators, skin assessment, diabetic management) so it's not just babysitting but it definitely isn't as stressful as hospital work. I think it's a good fit for a RN student.

I work home health with someone who is on a vent continuously and can't stress enough the importance of knowing what to do in the event of a power failure. Don't let the client lull you in to a false sense of security with "this never happens". It happened to me during my orientation with a nurse who had taken care of this client for 10 years and we were able to hook up to an outside power source. Know where the battery/generator is, make sure it is on a treatment order to be maintained/charged and checked for power. You don't want to be caught alone with no plan. As for the rest, I agree that the vent is set by the company and you simply have to make sure it is running according to their numbers. Good luck!

There are other areas in Montana that have hospitals too. Billings has a large hospital as well as Kalispell and Polson. I work home health because this is such a medical town and being an lpn (working on my RN) they don't hire lpns at the hospital except in a few circumstances. I don't know about the hospital ers but we do have helicopters at each hospital and they do deal with a lot of trauma. The hospital in Spokane, WA is where they send most of the pediatric cases and transplants (heart, etc.). The hospitals here are St. Patricks and Community Medical Center. They both have websites that will help if you need more info. Missoula is a college town so that makes it a little more expensive but also adds a lot of opportunities for jobs and activities. Good luck. L

Let me know if you need any more information. We don't have smog, it's actually a weather inversion caused by being in the valley. The clouds get trapped in the valley causing cloudiness and increased pollution in the town from cars. They require an additive to be put in gasoline sold in the town from november to february because of that. We live on the outskirts of town, up the hill and don't have that problem, but they do in the city. One word on hamilton, it's the "in place" to be for the rich and famous wanting to live the ranch life. People like huey lewis, hank williams, jr., the family who owns costco and such have huge ranches there that are "vacation homes". There is also a community called "the stockfarm club" which is a gated community with multi-million dollar homes for the people like Charles Schwab and such. This being so, the cost of living and housing there is pretty high. Good luck in school and let me know if I can help you further.

I am an lpn that does home health and has not worked in med-surg before but had 100+ hours of clinicals in that area. I do quite a bit of skilled nursing - suprapubic catheter changes, suctioning, trache care, wound care, skin integrity assessment and problem solving, diabetic care, physical therapy, etc. I only work part-time and love it but it is more involved than I thought. I had a wonderful med-surg teacher and have a great RN team in the office who are always available for advice. I also had a few shifts of orientation before I started. I was able to review the cases/shifts available and pick the ones that worked for me. If you can do that then it may work out just fine.

I work home health in Missoula as an lpn and there are a number of companies that are always looking for nurses. I only work part-time but could easily work 40 + hours if I chose to. There are two hospitals here and quite a few ltc facilities as well an international heart institute. It's the place to be for nurses and medical staff.

Sorry, I see you are moving from FLA, so yea, it's way different than the east coast, but we like it. Like I said Marcus Daly is in hamilton and they are hiring as well as other places in that area. Hamilton is the largest town that way. Really small is Sula, Conner, Victor, Stevensville, etc.

Well I live in Missoula. There are two hospitals here, St. Pats and community medical center. In hamilton there is Marcus Daly hospital. I don't know where you are moving from, we moved here from a large city in VA. We thought we could commute the 45 miles, hey we did it there. But here it's impossible. It would take you a good 1 - 1 1/2 hours to commute from hamilton. Highway 93 is a 2 lane road with stoplights through every small town along the way from hamilton. (Victor, florence, lolo, stevensville). Plus the weather isn't the best from oct to may. Highway 93 has the leading number of fatal accidents in this state. So, Missoula has only approximately 50 - 75,000 people, a lot of them college students. The statistics for missoula county are misleading because they include lolo, frenchtown, bonner, seeley lake, and other towns. Bonner is nice as well as frenchtown and they are on interstate 90, a real highway and close - 20 min - to missoula. Let me know if you have any other questions.

I am doing excelsior with two friends from nursing school. Right now we are taking a prerequisite for Microbiology. The requirments change Oct. 1 but I think for the better. Instead of 7 4 credit exams there are 8 3 credit exams. If you have your LPN you do not have to take exam 2. There will be also the addition of 3 interactive skills test on the computer and the usual CPNE. I think these changes are for the better. I know some of the concern about excelsior was about the lack of skills information and this will help with that. About the enrollment fee. You do not have to pay that until you take NC3. So if you want to take any prerequisites and then NC1 you can do that BEFORE you enroll. That is what we are doing. I think the first couple of exams will be the hardest just trying to figure out what they want and how to manage your study time. Because of this, you don't want to enroll right away because there is a fee every year you are in the program that you don't finish (I am not sure what it is but I think $300 or so). Also, we are getting our books from the excelsior bookstore and ebay. I think there are quite a few companies that will advertise that they are study program but you still have to pay all of the excelsior fees with that so it ends up being more money. The excelsior stuff is more than enough to get you through. Hope that helps!

I am in an adult situation but definitely need to keep some type of distance. I am in a home for the whole shift and have been warned that this home is full of skewed family dynamics. The worst one being put between the spouses,one of whom is the patient. I feel like you pagan, I do sometimes feel like a babysitter. I am not here to entertain but to monitor health and make sure all equipment is operating properly. I am friendly and caring, I just try not to do anything that is not strictly nursing. I notice that they, the clients, take advantage of one of the cnas by having them to household things and run errands that are not part of the job. I mentioned it to him and he says he knows he's in a bad position but doesn't know how to get out of it because he's started doing these things and now they expect it. He's a great guy and really good cna and I feel bad that they take advantage. I also worry about not keeping up with the skills I learned in school. However, for our family this job is perfect as far as pay and schedule. The hospitals in our area work you to death, give you too many patients and then you get way too burned out. I do have to say that my supervisor is awesome and completely understands all of the ins and outs of home health and is always right there with help and encouragement. She is also a great part of this job.

Is anyone else working in home health right now? I am a relatively new grad - dec. 2006 - that is working my first job in home health. I would just like to know what other experiences lpns are having out there, what type of skills you are using and how you maintain that distance while still caring about someone in their home. I would love to have some input. Thanks.