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  1. DallasRN

    I Must Be Missing Something

    After MANY years of all different types of nursing (and a successful career IMHO), I decided to try HH nursing in my "golden" years. First, I read here extensively - pros and cons. I read all sorts of things online. I thought I would really enjoy it on a part time basis. Spent several hundred dollars getting set-up (new printer, new Chromebook, updated phone, added wifi to apt, bags, b/p monitor, thermometer - all that stuff you need in the field). I even hired a dog walker to the tune of $20 bucks a day so I didn't have to worry about him. I was serious about this job. Wanted it to be mutually successful. When interviewed by 4 people I was 100% upfront - no experience but excellent assessment skills and generally a quick learner. Well, the DON hates me! Within 2 weeks She said to me, and I quote, "I didn't want to hire you but ______ said she would train you". I blew that off by saying "I think you'll be happy you did in 6 months". Two weeks later, she said it again. I didn't blow it off. Along with other comments I went to the administrator who just happens to be her son. Interesting. Nonetheless, all was better for a few days. Then...I can't please her. I document too much. I don't document enough. I should be able to take a full load. I can't take a full oad - I don't have enough experience. I can't win. Time...I work all day seeing the "dump on new person patients" (expected), leaving home at 6:30, getting home at 5:30, then spend my days off doing paperwork and the unbelievable payroll paperwork. I'm exhausted!! I'm only supposed to work 3 days a week but constantly get messages...can you take w/e call, can you go draw blood, cath a pt. Can you see ____'s pts? She's overloaded. Can you see ____'s w/e insulin pts? On and on. And just FYI.. I'm an oldie Goldie but I'm not "old". I do yoga, run/walk with my 70 lb dog 3-4 days a week, no meds except thyroid. So my exhaustion stems from this job and the job is now leading to depression. And I don't like that. So after this long lead-up I'm asking...am I missing something? Is it me or just this particular agency? What do you live about HH nursing? Will it get better or should I give up with this particular DON/agency owner? And another FYI... I've only been there SEVEN weeks. Many TIA,s for any guidance.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. DallasRN

    Nervous About Nursing School and Working Full Time

    I agree with much of the other information provided and have just one thought to ad. I had just read another Nurse Beth response in which asking for help was mentioned. Well, as you pursue your education - and working, school, family responsibilities will be difficult, no doubt - ask for help. From friends, neighbors, relatives, the kids if old enough... We nurses are frequently bad about asking for help. Child care, grocery shopping, running a few errands, help with household chores...instead of a Christmas gift, ask for a week of freezer meals, etc. We adults sometimes need a village, too.
  8. DallasRN

    I Must Be Missing Something

    Hi TristleRN and thanks for your comments. Just to update this thread, I now have a new and seemingly great job with a company that knows my limitations in home health but willing to train. The difference in the overall attitude of other nursing and clerical staff and managers is like a night/day difference. Everyone seems very goal oriented, want to do the best job possible...but they seem to truly enjoy their work and their patients. They laugh and smile a lot, they seem to like and respect each other. Just a great group. It took me longer to get this job than I had anticipated. However, I held out for a company I thought would treat me with dignity and respect. The salary is a bit less than I would prefer (aren't we all worth a bunch more than we're paid?!? :) ) but I learned long ago, and especially with the other company...money ain't everything!! I did post a new thread ' MY NEW JOB - just to kind of update everyone that encouraged me.
  9. DallasRN

    My New Job!!

    Some of you may remember my posts back in May/June about the absolutely horrible job I had with a local agency...my first HH position. After many years of a rather decent nursing career, that job was demoralizing. I was worried I wouldn't be able to get another job with my lack of experience combined with only about 3 1/2 months at that agency. Generally a bad situation. Some of you were so encouraging and I thank you! Now for the good news. Back in early August I FINALLY got a decent interview and knew from the minute I walked in the doors it was a place I wanted to work. Warm, welcoming, inviting. The clinical manager was encouraging and well aware of my lack of experience but willing to train me. (And I think she'll be tough in a warm way - which is good). It's a major player in the DFW area. Large area, many branches. It took weeks to get the background stuff done. The pay wasn't as high as I had made at the awful place but I had learned that lesson. Money isn't everything and a few dollars isn't the end of the world. In the interim, I was offered another job - smaller agency, higher pay. I took a gamble and held out for the good place. Need I tell you I started a couple of weeks ago? WooHoo!! I've ridden with several nurses that have been there for 5-7 years and LOVE their job. I've been to a case conference with staff from all over the DFW area and sure enough...they've all had that same vibe...warm, welcoming, love their jobs, happy, eager to share their knowledge with me. I've found my home in nursing. My goal is to be the best HHN for this company I can possibly be. That means I'll likely be coming here and asking questions frequently. I'm just as happy as can be with the way things have turned out. I'm only working PRN (my choice) but will probably be able to work almost as much as I want. I had told the manager I am perfectly willing to take call, work holidays/weekends, etc. once trained. I'm single with no kids so it really isn't a big deal for me. Anyway, all is great!
  10. This is an older post so I'm sure your decision has been made. My only comment is to be very careful in terms of judging an agency strictly from the monetary standpoint. I'm certainly not assuming you were doing that, but after my experience, I'll always toss that thought out there for consideration. I was a highly experienced nurse but green as could be in home health. Was offered and accepted a job with a small agency offering me great pay. Ended up being the worst job of my 36 years in nursing. I have a friend still working there and she tells me in the 5 months I've been gone they've hired numerous RN's and LVN's who end up staying just a short time. Sad. Now I'm going to post something about my wonderful new (lower paying) job! :)
  11. This article was perfectly timed for me. I'm starting a new HH job Tuesday with what I believe is going to be a fantastic agency and I want to be the best I can be for my new manager and company. I feel I was really lucky to be hired since I only have about 4 months experience in home health although many, many, many years of nursing experience. The other agency I was with for those few months was beyond horrible. Anything I can learn is helpful. Knowing a QA nurse might contact me and why is particularly helpful and timely because as a new employee as well as a relatively new HH nurse it's likely I would feel I had done something wrong. Many thanks!
  12. I fully agree and taking it a step further, why not allow shift-sharing or splitting into two 6 hour shifts? For the sake of continuity, that might not be best in some situations, but in others it would work fine. Day surgery where the patients are in and out anyway. OR. Pre-admission areas. Some long-term areas where patients get to know their nurses - they would likely support having 2 nurses they know during a 12-14 hour period. In addition to older nurses feeling to tired to work 12-14 hours, there are other reasons. Some are limited in terms of $$'s they can earn (based on their retirement/receiving SS benefits). Some live a distance from a hospital so an hour drive each way coupled with long shifts... Another advantage to those of us that are older...we no longer have kids so working weekends and some holidays just isn't a big deal.
  13. Thank you so much, doda677, for mentioning that picture. I looked at it and thought the same thing. That person looks like an old, haggard, shrew and definitely not a person I would want to work with or take care of me if I was a patient. I'm definitely an "older" nurse and while I no longer work in the clinical setting, I have many friends who do and frankly, they are some of the happiest, smiling, secure and confident nurses I know. They've lived through the years of uncertainty with themselves and their profession. They've spent time in management and decided having "a life" is more beneficial to their personal goals at this stage of their lives. They've gained the respect of their peers and the doctors they work with. They are the bedside leaders in their clinical environments. When the day arrives that I'm the patient lying in that bed, I hope it is an older, experienced, organized nurse assigned to me...someone who can truly assess and pick up on subtle signs that only experience can provide...not a nurse running around helter-skelter, feeling overwhelmed by what is only the days events. How many of us remember those "really old" hospital nurse grads who could handle just about anything thrown at them from day one?
  14. DallasRN

    59 and No Longer Safe

    I am so sorry to hear your story. I don't have any advice beyond Nurse Beth's excellent advice but thought I would let you know I can certainly empathize. Age discrimination is alive and well. I'm a few years older than you but like you, years and years of varied experience. Several weeks back after interviewing for a job I knew would never be a good fit, I sent the Executive Director a very nice e-mail thanking him for his time but stating I felt he would be able to find someone better qualified for the position. In the meantime, I have a friend working in that facility but he did not know we were friends. He was overheard saying, "I would never hire anyone as old as her". Demoralizing. After you get your health checked out, do consider telephonic nursing. I did that several years back and thoroughly enjoyed it. I really think you can sometimes make a greater impact on a person's life and health over the phone than you can in the hurried hospital environment. Best of luck!!
  15. And what's even sadder is that those that have sought treatment, been treated, and continue to receive treatment (whether in the form of medication/counseling, etc.) are likely to be better staff members and caregivers than those that are not acknowledging their need for treatment, attempting self-treatment, or simply living in a state of denial regarding their need for treatment. Very frankly, in my opinion, it is almost impossible to escape the need for some sort of treatment for depression and anxiety in this day and age. Many of us are isolated due to computers/social media. The daily news is anxiety provoking. Families live far apart. I congratulate anyone who has taken the initiative to seek the self-care they need. We self-care by having our hair and nails done, maybe a little Botox here and there, gym workouts. We take care of the outside and nobody questions it. So why not take care of the inside?
  16. DallasRN

    Patient abandonment?

    Perhaps others can address this better but I would be very concerned that an employer was accusing me of patient abandonment. That is a very serious charge and could affect future employment. If indeed they believe you abandoned your patients, they should have reported to your State Board. Did they? I'm thinking I would consider contacting an employment attorney and have him/her look into this situation. It's one thing to be terminated for cause - too many call-ins, insubordination, etc., but abandonment??? Good luck!
  17. DallasRN

    I Desperately Want Out

    Absolutely!! I would question the motives of a BF who would want me to spend half of my waking hours in a job that wasn't making me happy or fulfilling.
  18. DallasRN

    I Desperately Want Out

    Not much left to say after so many excellent replies but I do want to reinforce one comment. Someone mentioned working nights might be an issue (if you are). For me, nights were absolutely horrible!! At the time, I didn't realize it was the shift but I became terribly depressed, hated nursing and everything about it. Resented having to work weekends, holidays. Of course, at the time, I also resented breathing, food...you name it. I was gaining weight but hardly eating. Exhausted all the time. Felt like I was in a fog. As soon as I quit that job and took a day shift, my attitude changed a 1000%. I'm just one of those whose circadian cycle will never adjust. Just something to think about.
  19. DallasRN

    When You Can't Take a Day Off-Even When You're Off

    Kind of along these lines, a friend and I were talking last night...we're both applying for the same management position. Discussed how great it would be to be able to job share. Could share call responsibility. Could cover when one was sick or on vacation. She's an excellent admin type - reports and such - while I'm better at the "people" stuff (staff, visitors, marketing types of things). We make a great "whole". Job sharing would allow you to really get away while having confidence things would be handled in your absence. Would probably increase longevity in many positions, too. Less burn-out.
  20. DallasRN

    Is it a waste of my talent to go into Home Health?

    You know, it's all in the way you look at it. I did acute care for many, many years...SICU, MICU, CICU, ER. I did a stint in Med-Surg after many years in the critical care areas (and that kicked my fanny for sure!). I did case management. Except for L&D and Peds, I've done most of it. And then I went into home health. That initial foray didn't turn out too well for me due to the agency I worked for. Still, in the short time I was there, I learned so much. Different things, to be sure, but learning all the same. Home health is not the cakewalk some of us (me?) had assumed it to be. However, for me, it was the type of nursing I had been searching for for the last many years. Time to actually LISTEN to and HEAR my patients. True family interaction. Tons of teaching with generally receptive patients and families. I found most doctors to be receptive to and supportive of nurses in the field. Not once did I call a doctor that did not call me back in a reasonable time and if urgent, would immediately take my call. You will lose some skills and true, you won't be as marketable in the acute care arena after a couple of years. But the upside IMHO is that healthcare is shifting more towards home care. The faster you can get a patient out of the (bacteria riddled) hospital, the safer that patient will be and the better outcomes you will get ***with skilled home health nurse*** involvement. For me, I love it and I'm now searching for a decent agency that will take me with only 3 months experience. If a decent agency is offering you the opportunity with no experience, I would seriously consider making the transition. Whatever you decide, best of luck in your career.
  21. DallasRN

    I Must Be Missing Something

    April5293, I think you are absolutely correct. This was a no-win situation for me from the get-go but at least I had the opportunity to discover a new-to-me area of nursing that I found out I really enjoyed and I learned tons of new stuff. Not meaning to sound at all cocky, but after 36 years of nursing, there isn't too much I don't know about nursing per se' - assessments, labs, hospital nursing, etc. But HHN was totally new. Having the opportunity to learn a new area (and even struggle a bit in the learning - especially the OASIS stuff) felt invigorating to me. I was loving that part of it. I've taken a few weeks off and done things I wanted and needed to to (I've chalk painted everything sitting still!! ), I'm now beginning to look for a new per diem/per visit/part time position. I don't mind working weekends/holidays so I might be a bit more marketable than I think. Fingers crossed!!
  22. DallasRN

    New Grad Loses Job at 3 Months

    It just makes my blood boil when I read posts like yours. Being a new grad is difficult enough without having to deal with being terminated just a few weeks into your new job. When I graduated (back in the dark ages) I was fortunate to be accepted into one of the nations premier critical care internships. My hand was held for the first 6-7 months of my career. I turned out to be an excellent critical care nurse but frankly, I don't think I would still be in the profession without those than mentored me those first few months. That said... I'm not sure I would recommend you go into a CCU position right away unless you are 100% assured you will have a fantastic preceptor. The last thing you need right now is even the slightest hint of failure in your new position. But that's just my opinion... Regardless of where you end up, I want you to think about doing something each and every day. Get a designated notebook. After you've gone home and relaxed a bit, spend a few minutes going back over your day. In your notebook, write down what you learned that day. Maybe jot down your assessment of your most critical patient. What did the various cardiac parameters tell you? Was there anything you missed during the busy day that you can think of now? Any meds you were not familiar with? Any physician orders you questioned or did not understand the basis for? Write out any points of confusion or unanswered questions. If you are unable to find the answers on the internet, make a separate notebook of questions you want to address with your preceptor. If your preceptor doesn't schedule specific times to meet each week, you can request time to go over things. Don't be put off. It's too easy to get caught up in the busyness of the day - for both preceptor and new nurse - so don't let this get overlooked. It's way too important. Bottom line...be your own best preceptor! You can do this!
  23. DallasRN

    Data Collection Nurse: What's Up With That?

    I don't think this type of work would be for me. However, I have a LVN friend that is about as specific and detail oriented as they come. Seems like that is what would be needed in this type of review. She has about 20 years experience in skilled nursing units and several years in home health including being a clinical coordinator. Is there any possibility of LVN's working in this area? Maybe reviewing files for nursing homes, etc.?
  24. DallasRN

    How To Sell Myself...

    without much experience? How can I convince someone to hire me and especially when I doubt I'll get much of a reference from the other place I've been working. If you're interested, my previous thread will give you lots of info: https://allnurses.com/home-health-nursing/i-must-be-1154122.html So here I sit with 3.5 months of experience. Truthfully, I still need some training, but not a huge amount. I'm great with the SNV's and documenting that info. I've never done an admission Oasis, but I've done a couple of Recerts, a single ROC, a single Discharge and did them quite well, if I do say so myself. (Don't tell anyone but it took me HOURS to do them :) but I'm learning!). My strong points: 1. Extremely good with the SNV's including the documentation. 2. Familiar with Kinnser. 3. Excellent assessment skills (many years in ICU/ER help that) but a bit weak on wound care as it's done in the Home Health arena. 4. HUGE amount of enthusiasm for the job. I absolutely love being out and about, having the time to really "listen" to and teach my patients rather than the hit-and-miss stuff one is forced to do in the hospital. 5. Perfectly happy doing visits and leaving the other stuff (admissions, etc) to the more skilled nurses. 6. Available to work weekends/holidays but I only want to work PRN or part time - 3 days a week. I don't care what days. 7. I've reviewed many hours of youtube videos on HHN. 8. I've developed excellent relationships with the facility staff, DON's, and doctors I've been involved with these past few months. 9. I now know the amount of work involved - documenting, placing/receiving calls, etc. (didn't know all that going into this). 10. Fantastic venipuncture skills (my claim to fame after years in ER ) . My weak points: 1. I've never done an admission Oasis and would require assistance with that.. 2. Slow (but thorough) on the other things - recerts, discharge, etc. 3. Still need some training but mainly a resource person to answer questions as they come up. 4. A bit weak on wound care as noted above. 5. No experience with LVAD's, Mediports One thing I've done is print off copies of all recerts, ROC, discharge reports I've done. I've blacked out the names and all identifying info with the intent of having those things to demonstrate my work. Good or bad idea? Anyway, this is my predicament. Any and all advice will be greatly appreciated.
  25. DallasRN

    New to Home Health and Confused

    You are not alone in your frustration with the so-called orientation. I'm a nurse with 36 years experience behind me. I absolutely know what I'm doing in terms of assessment, etc. However, I did not/do not know home health. My orientation consisted of following a nurse around, doing all the vital signs, taking off shoes to assess edema, listening to breath sounds...all this done on patients (about 95%) that I honestly did not understand why they were being seen. One patient had a "wound" on the coccyx that I would have called a boo-boo but I carefully applied a band-aid once a week, week after week, while she documented wound care. From someone with about as much home health experience as you, I would say first and foremost, follow your own "gut" about things, i.e., the elevated b/p. If you walked out of that home without notifying a doctor and that patient stroked or had a MI, the law really wouldn't care you were "in training" with your acute care background. Your name tag says RN. It does not say GN. A couple of times, I had to really push issues to get things done. You will, too. Read everything you can find to read on HHN. Online and books. Does your agency have a library type of thing? Look at youtube videos. There are some good ones. You will start coming across other HHN as you're making visits or sitting in McDonalds documenting between patients. You'll find they might be willing to share helpful tips. There are some nurses on here that provide invaluable info. They've been in the trenches for a long time. Pay attention to what they say. We made it through nursing school. We made it through all sorts of acute care nursing. Think of the multitudes of things we've learned along the way. This is just something else we can and will learn. (To bad you aren't near me. We could form our own "training" group of two and nail this job!)