mo-mo

I was diagnosed w/ ADD/anxiety while in nursing school and I considered changing majors at that time for that reason. I stuck with it, and I am a pretty good nurse despite and maybe because of my lack of attention span. That fear that you have that you might mess up can be a GOOD thing, as long as it's at a tolerable and fuctional level. Every good nurse does have a certain level of anxiety, or at least a healthy realization that he/she could make a mistake.The truly frightening nurse is the one who believes (s)he is infalliable, or would never admit to making a mistake. We ADD-ers began developing compensatory habits in early childhood to make up for the ADD..We're a little OCD: chronic list-making or clock-watching or chart-checking and rechecking(and, if it's night shift, rechecking again at 0430).These are the habits that can make or break ANY nurse during a hellishly busy shift, and you probably already have it in the bag. I have found that giving myself a routine structure for my shift is essential.There are some nurses who are able to just wing it with little structure(and do great work!), but that doesn't work well w/ADD. The other important thing to remember is to pause for just a moment and double-check your med EVERY TIME before you administer.Routine is crucial and if you work toward establishing one, it will work for you. I recommend counselling and also some independent reading about adults w/ ADD. You'll learn a lot about yourself and how your brain works. At some point you start learning how to forgive yourself for having these 'problems' and realize that you have unique strengths to offer and you are capable of providing excellent and safe and thorough care despite your ADD(or at least thats what happened for me!:redbeathe:yeah::redbeathe:nurse::redbeathe:yeah::redbeathe)

I love the story about the 'Code Brown'!!! Crying shame for sure! My coworker recently got a call from a patient to come check her BP b/c she had gotten in an argument w/ her mother. I once was called by the son of a FORMER pt (like 1+yr since d/c'd) who said his dad had 'passed out' today and yesterday and was intemittenly complaining of chest pain, and could I come visit today:no:(Mother's Day, BTW).I calmly advised to call 911 or go straight to ER and THEN talk to PCP about home health.Now that I think about it,I don't even know how that all played out, but we never got a referral!

I recommend as much documentation in the home as you are comfortable with. My company still uses a paper system (changing to laptops this year, though!) but I think you can still do a lot of documentation in the home...even the narrative.If it is a home where I am comfortable, I just ask, "Is it okay if I sit here for a couple minutes and finish my charting?"And, honestly the majority of clients love the fact that I'm not rushing out of the house.It is more efficient and the charting is more concise if its done right away. Otherwise I document in the car.

Correction:We get $37/day not $25 and we do get time and a half if we go in the field(no minimum that I'm aware of)...Either way, its not exactly bringing home the bacon!!! And union contract negotiations are currently underway.

We were able to avoid a quarantine completely because we sent a blood sample in about 3 or 4 months prior to our move.I literally checked my dog out 1 hr after I got off the plane. We were lucky enough to have a vet who was up on all the state's requirements b/c her parents had just moved to Hawaii w/ their dog! Most of the requirements involve veterinary intervention, so your best bet is to download all the forms and schedule a vet visit to get started on your checklist. Good luck to you and your pup and I hope you have a great time when you get here!:D:D

Does any one else think we should get paid what nurses get paid in hospitals for being on call?($5 or 6/hr and time and a half for visits) I get $25/day and regular pay for visits, which rarely happen.But I have to stay in a certain geographical range, and not drink, and I can't go for a swim (in the ocean)or go anywhere out of cell phone range.Its a huge pain in the @$$ and completely not worth the pay. We rotate every 4 or 5 wks and are OC for a wk at a time.

When I moved out here 3 years ago, it took about 3 months preparation to get my dog to Hawaii.She didn't require quarantine because my vet shipped blood samples ahead of time.(I think the blood was to test for rabies.) But still they have to have a microchip(certain brand), VET ADMINISTERED Frontline, vet clean bill of health, all shots up to date and I don't remember what else, but everything had a strict time sequence. All in all it was a HUGE ordeal and cost a total of @$700 when I tallied up everything involved.Not to mention very traumatizing for my dog. Also, you have to consider the fact that its hot in Hawaii practically all year round. Dogs can get heat stroke from sitting on the tarmac.(Consider how hot it is in the cabin when you sit on a delayed plane for a few minutes...The temperature is much higher and the length of time is WAY longer for the animals in the belly of the plane.)Airlines wont even ship certain breeds of dogs to Hawaii many months out of the year because of this risk. Hate to be a buzzkill but IMO its really not a good idea to bring a dog to the islands on a travel assignment, unless your pup is the size that can ride upfront w/ you. As for my little friend, my husband and I have agreed not to move again until she is in doggie heaven, because her trek out here was really hard on all of us. The main reason I'm so critical regarding this subject is because my husband worked in the cargo dept for an airlines for a few years and saw lots of animals in really bad shape from the heat and stress. Those guys have a whole different perspective on shipping animals. Maybe your doggie could stay with a relative or friend? Or, if you bring doggie, at least plan your trip during the coolest times of the year and of the day!

Possible jobs: drug/supplies rep work for health insurance company medical equipment supplies office nurse/assistant(less pay than a BSN but less stress) medical coder/transcriptionist medical billing I just have to wonder if she had such a bad experience that she is just totally turned off by the entire system.Has she ever talked about what she likes or doesn't like about healthcare or nursing?

I think every one has pretty much covered all the bases! If your hospital is unionized, make sure to contact your rep also. Unions have been very helpful in this type of situation.

Until recently, I worked 32 hrs(paid by the hr)/wk and averaged right around 21-22 visits/wk. I worked 4 days, though.

What a beautiful time to go to Missoula! I haven't lived there for like 10 yrs so don't have any recent info for you, but just wanted to say...Have fun and make the time to get to Glacier and Yellowstone and just the local hikes and drives...Absolutely beautiful!

We have contact iso kits.They each have a 'disposable' cheapo BP cuff and stethascope. We ask the pt to provide a thermometer(since they should have one on hand anyway, to check for fever r/t infection)The first nurse who sees the pt brings in everything else we need including hand sanitizer, gloves, alcohol swabs, wound care supplies, etc and leaves these in a bag in the pts home. I even leave a pen with these things so that all I have to bring in is my nurses assessment form. I put on booties and gown at the door, and I wear gloves the entire time. Pts and families give me funny looks sometimes for going to this extreme, but I explain the nature of these diseases and that it's our policy, and people seem to understand.It also helps the families understand how clean they need to keep their homes (and hands!) to prevent spreading the disease to other family members. I am thankful that my facility provides those kits, an I bet it saves money in the long run. I do not think that swabbing your supplies w/ alcohol will kill these bugs effectively.Bring as few items into pts home as possible.Don't put them back into your bag until they're sanitized (maybe put equipment into a plastic grocery bag when leaving pt home) and I'd at least request 'sani-wipes' to wipe down your equipment immediately after visits.

Aloha Carl, Glad to see someone else from the Big Island! What is MDS anyway?

All of our visits are by medicare guidelines. Even so I can get a good head to toe and VS in 15 to 20 min on stable pt who doesn't care for small talk.That said, I have a pt who never takes less than 75 min: Draw labs, PICC dsg change, portacath needle and dsg change, gtube site assessment, duoderm dsg to coccyx, check PCA and TPN settings...I could shoot the idiot who put a SINGLE LUMEN PICC in this woman!!!

The main thing, most rewarding thing for me is that in this environment, you really have the ability to DO WHAT'S RIGHT FOR THE PATIENT. If that is always your first concern, you'll thrive in home health and you'll love it.