DaSuperRN

Well, I am not planning on staying with this agency, but I am planning on staying in home health care. I just have a bad feeling in my solar plexus i.e. a gut feeling about this one. Thank goodness I found this part of the nursing forum. I do private duty which means I can be at a home from 4-10hrs or longer depending on the need. I have not been able to do much since I joined this agency because number one there are not many adult clients, and I have not got a good orientation yet. So I need to get together with my Supervisor in person, which she is 2 hours away at the main office. Thanks for all your support!

Well, I knew is was not setup correctly. I have been in nursing over 10 years and I've seen times mostly in LTC where doctors orders would lack either specifics or a diagnoses, but we would get on top of it. Let me ask you this is there a particular person, one single person that goes around from home to home checking up on these things? As I stressed I am new to HH, and I probably should be asking someone in that agency, but I have hit numerous brickwalls. I am just thinking in my mind someone would have to be in charge of overseeing things in these homes. Darcy

Okay, I had posted a question on the forum about med orders in HH, but I erased it during an emotional minute now I am reposting it. For future references: Gees, I hate to be so critical but the MAR med ,and TAR tx orders I saw at a clients were unlike any I've seen before. All the orders were together on one paper carrying over to the back. The times were written as am and pm no specifics, there was one wound care tx, but it has no times, where is the wound and what to use was not included. Plus, there were no diagnoses on any of the orders. I was shocked. Tell me this is not standard protocol in HH, right? I mean orders are supposed to be specific and to the letter. I do not know who transcribe them, nor do I know who obtained them. The physicians orders are all haphazardly in a black note book with, NN and other pertinent information. :Snow: So cold here.....

Well, when I oriented with the nurse those 2 hours I ask what all the things were, there was a tempature control it read 70 yet in the book on the vent paper the nurses were signing off 84, 88 and I question about the 70 reading and wondered if it was because the water was low and ask what was the accepted range. This nurse also was new been there a month, so you tell me. I also question what the 1:5 ratio was on the paper and what did it mean? She did not know??? I understood the off and standby button, and how to drain the tube of water before moving the client. I new how to remove it and put the of devices on like the one to allow her to talk when Vent was off during transfer. It was set a 9. I did not know what that meant. I am the type of person who wants to know what every button is is and alarm etc., and I will not mess with it otherwise. So her sister had to assume responsibility. The trach was really not a problem. Thanks for the tips! I am getting less sensitive day by day on this subject. Today I am very sick with the Flu or something; chills and fever, aches so I will not be posting much. It just came over me probably the high stress hit my immune system hard, sore throat and all.

:Melody: sorry empty link

Hello Thanks so much for your concern. Don't worry I am not taking this assignment. I was supposed to go tomorrow and I told them I would not. I just needed a refresher on trachs, but my main concern was Vent care. Respiratory care is responsible for the vent. I was to assess Respiratory status, which I am a pro at since i worked cardia telemetry, and Med surge for years. I was uncomfortable with all the buttons and alarms. I refused to go until I get training. The ladys sister was there and she did the care not me she is in a medical profession although not a nurse, but trained in vent care. I believe you and I think I am going to quit. I don't like the business tactics with this company. I am scheduled to interview with another on Monday. So I let you know how that one goes. It a shame the stuff some agency try to pull. Sorry, I removed my post it was a silly move. I was offended by a poster. I feel better after reading your note.

She showed me stuff about the Vent the buttons I already talked to the Nurse about it once in orientation, but I still had lots of questions. I basically did everything right because the patient can talk and helped me through it and there wasn't anything except draining the tube from water before I turned the client, and placing it on standby. The trach was also no brainer It is not inner canula and it is not sterile. All it was is dressing change. The followup nurse said, everything was good and I did okay. Alot of insecure feelings came from me. Sorry, I do realize this is new post and you have probably not followed my others. I did not clarify in this one I did a 2 hour orientation, but I still felt uncomfortable being their alone so when I talked with my supervisor she said she have someone there for moral support. I really thought this was support forum you being a premium member and all, but the icon shows that you are laughing. So I wont be adding any more here. Really sucks you can't even get support here.

:angryfire

:Melody:

:Melody:

Hi I am so new to this this, and this agency told me I would only get paid for 2 hours of orientation. I can't stay any longer if not being paid. I learned very little in the 2 hours I was there yesterday I go tomorrow alone for 7 1/2 hours. This vent patient is very stable which is good news, and she can even breathe some off the vent. She is coherent and can walk me through every bit of her care, but I am still worried. I supposed this is ridicilous of me, but I would prefer another more experienced HH nurse to mentor me or a preceptor. This is not LTC and it's certainly not acute medicine. We had a special unit for vent patients at my hospital so our nurses never dealt with it on my unit. We did have 10 telemetry patients, but we were all well trained by the hospital, and had class that lasted a two weeks, with cert test. We read strips and everything. I worked for the government and we were always supplied with good training on anything new. Darcy

:Melody:

:Melody: