hawkfdc

Its possible there is a moratorium on new home care agencies, meaning the state is not allowing new agencies to be created.

$35 per visit, $80 for SOC typically. If you take salary then around $60000 but be prepared for 30 points per week. Each visit is a point, a SOC (admission) should count for two points. Mileage is a toss up, some agencies pay $5 more per visit with no mileage.

fastaff.com was the agency looking for nurses for Harvey. I have not seen anything for Irma but I know they'll be needed.

How interesting that this conversation is here today. I don't necessarily have teachers sending me kids at the end of the day but they do question my clinical judgement which flips me out. I'm in a middle school and I allow kids to call for whatever ailment they have. I rarely have a kid with a fever but when I do its an all hands on deck affair to get them out of there. Other than that, I don't tell you how to teach-you don't tell me how to nurse.

https://www.flshots.com/ but its not as simple as imputing information. I think you must have credentials.

There comes a time in everyone's life where enough is enough. I reached mine about two and a half months ago and I left direct patient care because I was tired of being force fed CMS regulatory kool aid anymore. I was shanghai-ed at 4am by the HR nurses in my facility for the flu vaccine and I dutifully took it as I was trying to complete my first year of nursing. Five months later I was sick as a dog with the flu. KareyLea covered this, I got the flu because I picked up another strain, simple as that. Since then I have not taken another flu vaccine. I just finished nearly three years in home health going from house to house to house every day and never got the flu and never had the flu vaccine. I did get the occasional cold and I wore a mask to protect my patients and their compromised immune systems. If this truly is tied to CMS mandates re:reimbursement as a previous poster reported (and I have no doubts, just didn't read the article) then y'all enjoy your government ownership. This is not about patient safety, its about money. Ask any home health nurse about 30 day hospital readmissions and you'll hear all you care to about what steps are being taken to keep patients out of the hospital to prevent a readmission. Wake the he** up people.

I'm a home health RN for another week or so (getting the he** out of healthcare). This readmit thing is getting bad. The reality for those of you in bedside nursing and PCP offices is that I can only do so much with a stethoscope and a blood pressure cuff. Most PCPs don't go into the hospital anymore so when I call an MD with an adverse finding at a HH visit, I expect an intervention NOW, not 24 hours from now. And the intervention should not be "send them to the ER I haven't seen this patient in 4 months." For example, 2 weeks ago, visit to Mrs. "Smith", she was feeling kind of weak, took her BP, sitting 110/70, standing BP 68/46. Ok Mrs. Smith, let's call your PCP. Her doctor was a family doctor connected to a hospital system. After I spent 15 minutes on hold waiting to speak to a live person, I spent another 15 minutes telling the operator why I need the MD/NP/PA to call me back. I waiting another 30 minutes or so with the patient, no call back. So I gave her the intervention myself, have a can of chicken noodle soup (all of it), drink 2 tall glasses of water and I'll be back in an hour to check on you. And don't take anymore BP meds (physically took them out of her pill box). Went back in an hour and she had improved but I did not receive a call back from the doctor until the next day. I cannot stop a stage 4 lung cancer patient from developing pneumonia, nor can I head off that case of steroid psychosis r/t steroids at chemotherapy. Here's a news flash, patients are non compliant, especially in their own home. Crappy food, poor living conditions, and limited caregivers make for a difficult environment keeping these people well in the home.

"Well, if you refuse to obtain health insurance, you SHOULD be penalized. How is it your constitutional right to be irresponsible? The greater good of the society overrides individual rights." I don't think so comrade.In the Bill of Rights, Article V of the United States Constitution, no one in this country can be deprived of life, liberty or property without due process of law. And yes, being irresponsible provided YOUR rights and the rights of other are not infringed upon by my irresponsibility is guaranteed by the Constitution. If I choose not to have health insurance this has no impact on you-By being irresponsible I have not infringed upon your life, your liberty or your property.I'm all for the greater good provided it does not interfere with my individual freedom. Is it lost on you that the government just said in this ruling that if you do not buy what they want you to buy, you must pay a tax?

"well, if you refuse to obtain health insurance, you should be penalized. how is it your constitutional right to be irresponsible? the greater good of the society overrides individual rights." i don't think so comrade. in the bill of rights, article v of the united states constitution, no one in this country can be deprived of life, liberty or property without due process of law. and yes, being irresponsible provided your rights and the rights of other are not infringed upon by my irresponsibility is guaranteed by the constitution. if i choose not to have health insurance this has no impact on you-by being irresponsible i have not infringed upon your life, your liberty or your property. i'm all for the greater good provided it does not interfere with my individual freedom. is it lost on you that the government just said in this ruling that if you do not buy what they want you to buy, you must pay a tax?

Throwing my $0.02 in..... Although called the Affordable Care Act it is anything but. Private insurance companies are licking their chops to increase premiums to cover the required preventative care. As of this month, my insurance premiums are more than my mortgage. I fully anticipate another increase of at least 10% in the next few months. I would be (partially as I haven't thought it completely through) in favor of a Medicare type system for everyone. I believe its the only viable solution. You're admitted for a UTI, Medicare will cover your inpatient stay for 5 days, everything including medications are covered. Home health (my particular discipline) if there is a proven need is covered. Medications and other extraneous stuff should be handled like the VA, you need lisinopril BID, here's a 30 day supply, we'll call you in 25 days. You've taken big pharma out of the picture. What I absolutely detest about the ruling is that the Supreme Court said if the guv-ment says you must have insurance or pay a tax/penalty then thats it. Between this and the Kelo ruling, two major tenants of the Constitution were struck down, the right to own property and individual liberty. With this ruling there is nothing the government cannot make you do without penalty and that ladies and gentlemen is scary!

Um yeah, I wouldn't buy a new care in home health. I did somewhere around 38000 miles per year in the last two years in home health. I wouldn't take a new car financial hit (let someone else take the depreciation) of buying a new car knowing that I would be doing that kind of mileage. I've never worried about my car in any particular neighborhood. I just don't think its something to worry about-then again who wants my banged up Jeep with 175000 miles.

Its hard to determine what the hourly rate works out to because like the other posts said, we bring our paperwork home with us-sit in front of the tv and write out nursing notes. But if you are independent enough and want flexibility along with money, home health is the way to go. If you do 30-40 visits per week (just visits, not start of care or resumption of care) its around $1000-$1400 per week pretax. Depending how far you drive, you can get that amount of work done in maybe 6-7 hours a day, but you still have narrative notes to write.

It wasn't the small batteries I was talking about, it was the dead car battery . Oh well issue resolved $140 later-ouch!

And another thing....you have to be prepared for those unexpected things like dead batteries....kinda like what just happened to me.

I made the transition to home health nearly a year ago and am so glad I did. Enchantment basically summed it all up. If you are organized, like to drive and can not let things bother you too much then you can do home health. Some have said salary is the way to go, others have said per visit. I do pay per visit, righ now my census is low and I just looked this morning and my paycheck was pathetic ($900 for 2 weeks worth of work) but I was home by noon every day. Last summer when I was doing 40 visits per week those two week paychecks were nice ($2500 once, most all over $2100). Its up and its down and as long as you can adjust your spending accordingly, it will work. Now I've not seen this said yet, maybe it was said but not very emphatically, so if you tae nothing else from this home health thread, understand this. IF YOU CANNOT TOLERATE ANY OF THE HOUSES FROM THE SHOW HOARDERS THEN YOU WILL HAVE A HARD TIME IN HOME HEALTH. Yes, there are some nasty a$$ people out there and there will be instances where you will have to make the clinical/social decision to contact DCF. I have had my share of cockroaches, piles of trash, and unsafe living conditions but as my supervisor said one day there are people who choose to live like this and there's nothing you can do about it. They're rare, but they do exist outside of TV. Have to go now, have to see my 5 and get home by 2:00.....:)

The bright side of night shift-the marathon of a 12 hour shift is a pleasant jog most of the time, instead of the 6 hour morning sprint then the 5 hour afternoon sprint broekn up only by the 30 minute break to scarf down lunch. I worked my night shifts at a hospital that served the full dining room menu from 1 am to 3 am.

So I have a VA patient that I've been seeing since July 30, non healing sacral and hip wound. Admission weight was 94 lbs. After months of antibiotic theray which would make the patient sicker and nauseated, I have managed to get his weight to 107.8 lbs. Some might think that I'm a pitiful home health nurse, but I view it as an accomplishment. Its a Christmas miracle, and I believe I saw a little twinkle in his eye today. Merry Christmas to all.

I have been doing home health now for 6 months and I love it. YEs, when I had 18 patients the case management felt overwhelming but I have a good support system, and my learning curve has been long as far as Medicare regulations go but the one thing I know is that the harder I work, the more I get paid. Unlike in the hospital when the harder I work-hey thats just great, I kept them alive 'til 645. Its a matter of figuring out how to work smarter, not just harder. And yes I am one of those with a problem with authority and constant oversight. Thats what drew me to Home Health.

I finally got on the road about 11 am, done by 6 pm. Depending on what I have to do, I'm usually done by 3 each day.

Wow, what a day yesterday. I typically try to pull most of my visits to M, T, W, Th and have an easy day on Friday with just a few visits. But my husband and daughter both ended up with the flu on Thursday so I stayed closer to home and moved my visits to Friday. I had already scheduled an appointment for Friday morning so after that I had 9 visits and then a Start. ANd in amongst all that was a staff meeting that I conference called into about staffing for the holidays. So I finished my my 9 visits and went to my Start of Care and found the patients rigid, arms drawn up, mouth clenched. He was already severely handicapped so I wasn't real sure if this was his baseline. Deep breath in and here we go-could not get a blood pressure, tachycardic, tachypnec, diaphoretic. Dad says he gave him PO Haldol, check the drug book and there in red what do I find-Neuroleptic Malignant Syndrome. Surely you jest, check the symptoms, um yeah, spot on match. Called EMS, shipped off the the ED. If that was the right undiagnosised call, chalk one up for the field nurses! I'm going to swing by the ED shortly to see what happened to him.

Ok, gotta jump in here..... Don't take it personally. You have to look at it from the side of the nurse on the floor. The job is a "hit the floor at 7 am and run like mad for at least the first 6 hours" and you really don't see a breather until about 2:00 in the afternoon. WIth 6 patients, all needing meds, all needing assessments, the occassional dressing change and new orders to tend too, sometimes having a student tagging along is just that "one more thing" that adds to the whole stress. I've always tried to treat my students well and teach along the way, but the life on the floor is pretty damn stressful in the morning. Hence why I left floor nursing....

Tasteful clothing, as long as the shorts are not too short and the tank top isn't 4 sizes too small, its ok. But its also cold in the classroom.

For starters, take a deep breath and relax....you're not going to spend the next 16 months reading everything. There's just not enough hours in the day. FOr success on the tests (besides dosage calc) use the CD's out of the text books and study the NCLEX questions. MOst questions for most test are drawn out of a question bank for the NCLEX. Good luck, be on time, don't **** off an instructor, wear appropriate clothes-both in school and out of school, don't text in class and you'll be fine.

I discussed with my company owner the other day about going full time, but I think I'm going to stay PRN. I pull a full schedule but as PRN I can say no at any time.

Ok, I'm not a real nurse. Since I'm not a real nurse I won't be able to go out today and draw labs and change the dressings on the stage IV sacral wound, insert a Foley catheter and change another stage IV sacral wound, change the dressing on my diabetic patient with foot wounds, change out the IV bag for my q12 hour vanco drip, draw PT/INR labs, or teach my patient the correct foods to eat so your food will digest instead of dump with your s/p esophogectomy. SInce I'm not a real nurse, maybe the student can come take care of that for me since she knows it all....