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  1. DallasRN

    Gaining experience/knowledge in HH

    I greatly empathize with you. I've been a RN longer than most of you have been alive. My primary experience in years gone by was in some high level and complex ICU/trauma units, ER's with a short stint on Med-Surg (those are some hard working people!!). Personally, I think I'm a darned good nurse. However, working in those areas I never had to deal with wound vacs. I'm not well-versed in wound assessments/treatments. Those are things I'm having to learn now and part of what I like about home health - the new challenges. As for the family member saying you don't know enough. True. You are not a walking encyclopedia of nursing knowledge and good luck to him on finding that person. We nurses tend to try to set ourselves up as "specialists" of sorts when in reality most of us are "generalists" and especially in the HH arena. Jack of all trades, as you said. And you know what, 99.9% of the time that is the perfect thing for HH. We are in the home for a very short period of time. We can't address and/or undo years of bad habits, bad health. We can only do our best for the 45 minutes a week we are there. And yes, just like in the hospital or SNF, you will occasionally "miss" something in the flurry of activity. Your're fine. Hang in there and know that you will always do your best.
  2. DallasRN

    Home Health Interview!?

    Excellent questions from BofM's!! Wish I had thought of asking for help with questions a year ago.
  3. DallasRN

    This MD culture

    It does sound to me, based on your assessments, a physician call was indeed warranted. I agree with others that the nurse caring for the patient is the one to make the call. She/he will have answers the supervisor or charge nurse won't necessarily know. That said, even as an experienced nurse in the ICU, I always consulted with another nurse prior to making a call in the middle of the night or even on a weekend. (Unless, of course, it was an obvious emergency situation). Sometimes just running things by someone else can help and if nothing else, that other person might even give suggestions on what to report to physician. Now for the fun thing......years back I recall one of the meanest, ugliest, nasty docs I have encountered in my 36+ years of nursing. Other nurses would quake in their shoes if they had to call him. Day or night. You would report something - major or not - and he would just hang up on you. No comment. Zip. Nothing. I used to "volunteer" to call him. Each time he hung up, I'd call him back..."sorry, doctor XXX, we got disconnected before I could take your order". And I'd do it over and over until I got a response. With the Wuzzie grin.
  4. DallasRN

    The Future Nurse Bully- Is it You?

    Although this article is geared towards the nursing student or newer nurse, it is timely for me. I'm an older nurse - in actual years AND in nursing years (1982 grad). For the past year or so, I've been trying to break into the home health field. My background was critical care and ER so this is new to me. An assessment is not. Frankly, I know I don't have the stamina for todays hospital environment so I'm happy to pass the torch. Part-time home health fits me perfectly. However, I've run into some of the nastiest, ugly, self-serving nurses than at any other time in my long career. Not once have I even attempted to come across as a know-it-all. I don't know it all. This is a new arena for me. All I really know is how to assess. I'm having to learn wound care, the OASIS, communication notes in Kinnser, time management skills. So many things!! And sadly, many (not all) "seasoned" HH nurses have chosen to be negative and demeaning. Bullies. And most HH nurses are older. That makes it even sadder. We should have learned, by now, to nurture and support our peers. This type of behavior is a sad commentary on our profession - regardless of the specialty, the age of the nurse, the duration of his/her involvement in the profession.
  5. DallasRN

    Cigarette Smoke in the Home

    I don't know that Vicks, etc. would help. The smoke odor (or whatever it is) gets into my nasal passages and that's it. I'm done for. It's gotten so I feel it almost immediately. I'm good with pets (I'm a definite animal person) unless I'm doing wound care or the pet presents a trip/fall risk to patient. Just that blasted cigarette smoke. I'm thinking of trying a mask. I really hate to refuse a patient for this reason and not to mention that puts others in a bad position - having to ask if there are smokers in the home. Interesting the things we run in to in home care, isn't it?
  6. DallasRN

    Cigarette Smoke in the Home

    Rolling down the windows isn't much of an option here today. I think the wind chill was in the 20's. Chilly, chilly! But seriously, I have started carrying some of that Febreeze fabric spray with me but fact is, the smoke is in my nasal passages and nothing gets rid of it. As I mentioned, I did smoke years back and I've always said I was born smoking...everyone in my family did. I remember having colds frequently and also having those colds turn into chest colds in a flash. Just seems odd that now I'd get so sick so quickly just from the exposure. I know of a couple of nurses that refuse patients in homes with animals due to allergies. I hate to think I may have to end up refusing patients in homes with smokers but based on the way I'm feeling now, it may be my only option.
  7. DallasRN

    Cigarette Smoke in the Home

    I think I may have developed an allergy to cigarette smoke. I smoked for years but quit years ago. Now, it seems, I simply cannot tolerate even a little bit of cigarette smoke. Each and every time I have to go into a home where a smoker resides, I end up with a sinus infection. Thus far, not enough to require antibiotics, but enough to make me feel miserable for a few days. And it seems to be getting worse. Anyone else experience this and if so, what did you do? I'm feeling seriously bad! Thanks for any suggestions.
  8. DallasRN

    I Must Be Missing Something

    Thanks all, and yes, I've now decided you do have to "bounce around" a bit to find a good fit. Nothing is ever perfect but somethings are worse than others. I'm now with my 3rd agency. Thought the second would be fantastic. It wasn't. Thus far, the 3rd seems to be at least trying to do some training with me and they're extremely busy so I don't think I'll be without referrals. It really is hard to find respect in nursing. Maybe it's different in the hospital although it wasn't several years back when I was a hospital nurse. How many of you can recall when nursing was simple? Schoolnurse73, I would never name an employer I have made negative comments about. My experience isn't necessarily the experience of others. Not to even mention the potential legal issues.
  9. DallasRN

    job forcing app on personal phone

    Something came up yesterday, myjasmine, that made me think of your post and questions. I asked my manager where they kept the hand sanitizer in the supply room and was told they don't supply it. Hmmmm - previous employer did. I expressed surprise that they don't supply it and was told, "You can buy it at the Dollar Store". Yep. I can. But it's just another example of an employer not furnishing the supplies we need. I can go through a bottle of that stuff in a busy week. So another $52/year out of my budget. My phone, my tablet and computer, my pens/papers/markers/clips/rolling bag. My fax and copy machine (for receiving referrals, etc.). My electricity. My b/p cuff/stethoscope/thermometer/pulse ox. And the list goes on. But a tracking app on my phone? And requiring me to upgrade my phone for THEIR app? Nope.
  10. DallasRN

    job forcing app on personal phone

    I'll be interested in reading the comments of the more experienced home health nurses. I have an issue with being required to use my personal phone and IPad although I haven't been required to download any apps. Personally I would have major issues with that. And being required to upgrade your phone at your expense? Seems a bit much to me. The other issue, as I see it, is that we nurses continue to allow these companies and facilities to take advantage of us.
  11. DallasRN

    Are We Too PC?

    Well, a couple of things...first and again, using deliberately hurtful words has nothing to do with being PC. It is simply being mean. Second, you will NEVER ensure everyone has the same "common sense and sensitivity chip" you describe or wish for. We all come from different backgrounds, have different sensitivities, grew up in different cultures (whether that culture was a national or local culture or simply our family culture). We are not clones. Robots. Things that may bother you might have no effect on me. As for your Japanese friend, I have to wonder why she wouldn't speak up for herself - agency or not? And did you speak up for her to your co-workers? To me, this PC stuff is exactly what the original poster and others have mentioned...taking one simple thing that has been around for years totally out of context and making an issue over it. I bet if we could take a national vote we would find a very small percentage believing the ...Cold Outside song politically incorrect.
  12. DallasRN

    Are We Too PC?

    Lil Nel, I think it's an entirely different situation when people use derogatory terms to intentionally insult, degrade and demean others of any race, religion, sex, etc., etc. There's nothing PC or otherwise about using those types of terms. It's mean, ugly and meant to inflict harm and should never be tolerated by any of us. I don't think we can even draw a comparison to using those types of words to the current "movements" to eliminate songs from our "playlist". Where's the foul in wishing someone a Merry Christmas? I have friends that will occasionally wish me a Happy Hanukkah. I'm not Jewish but I certainly appreciate the thought...the sentiment. We've become far too sensitive, IMO.
  13. DallasRN

    Are We Too PC?

    Well, djh123, what about Rudolph the Red Nosed Reindeer? After all, those other reindeers were bullying poor ol' Rudolph so perhaps we should insist that song most of us grew up singing should be banned. Makes perfectly good sense to me.
  14. DallasRN

    Are We Too PC?

    "Do you think before you speak? " PC has gone way too far, IMO. As a result, I find myself NOT speaking or being as friendly as in days gone by. It's just easier to smile and say nothing rather than try to figure out if what I might say or the look on my face or the way my tone is interpreted might be offensive. Even at the grocery or out walking my dog...I just tend to keep to myself now-a-days. As a society, we are being bullied by a few *noise-makers*...they threaten boycotts, demonstrate. There is no longer room in our society for saying "I'm sorry." If you made a comment 10-20-30 years ago that was considered OK during those days, you are forever held accountable for that comment. I truly feel sorry for those that will be living in this world in the next 50 years. It's almost as if the current society is trying to make us into clones.
  15. DallasRN

    What Do You Carry In Your Bag?

    It's probably a silly question for most of you, but for those of us new to the field, it's information we need. I have the typical supplies given to me by the agency - dressing supplies, wound care supplies, gloves, etc. But what else do you find you need frequently or even just occasionally when you're out and about? For example, someone told me to always carry extra batteries for the SAO2 monitor...something I would have never thought of until I was in someones home with dead batteries. Thanks for any and all suggestions.