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I<3H2O

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  1. WWHHOOOAAAA, *I* said to tell the supervisor that her last day is the 26th. I never condoned quitting by turning in her stuff on the 26th. The only reason they are saying she can't quit until the 31st is because she isn't quitting, she is going PRN. She obviously doesn't want to do that so she should just tell her supervisor she is done. I agree it would be very unprofessional to quit in the manner she asked about. You read way more into what I actually typed out. Please don't put words into my mouth.
  2. Tell her you changed your mind and you don't want to go PRN. Your last day is the 26th. Be done with that toxic environment.
  3. I see Eversana has jobs posted around my state. Wondering if anyone has any input on them? Sadly, overall they seem to have a lot of negative reviews. However, we all know that most people who leave reviews do not do it for praise.
  4. Would you be responsible for all SOCs and ROCs on Saturday and Sunday? If this is part of the job then you won't be working from home. You will likely be out seeing patients all weekend. Ask about how many nurses are on call in addition to you triaging. Ask for an average of how many calls came in on the weekend for the last 8 weeks and how many resulted in the triage nurse going out.
  5. Awesome! Thanks for the suggestions! 😊
  6. Does anyone know from personal experience of cargo scrub pants that have pockets on both legs? I don't live near a scrub store so I have to buy online. What brands? Styles?
  7. My thoughts have always been "pregnancy is not a disability." If my employee came to me with this, I would be irritated.
  8. Jeepluv, I think we work for the same company! í ½í¸”
  9. Why do you have to tell them?
  10. I'm just about at my wits end. I cannot keep staff. Everyone is stressed about the continuously updated list of "you must have this on every chart" that they are ready to give up. Our OASIS reviewers/coders make so many changes to the 485/OASIS that the nurses and therapists have actually stated "why do we even take time to do the assessment because the coders change everything." Our company was was recently sold to another huge company and if it doesn't get remarkably better soon, I have to leave. They want these 485s to have 10+ safety measures (who has heard of diabetic precautions, incontinent precautions, etc), 4-8 functional limitations (urinary incont as a limitation? Cmon the let a few drops loose when they sneeze!). They make recommendations to add the route to oxygen. How are they going to take it...rectally? Specific dates for goals to be met? What a joke! You damn well better document a FSBS and diabetic foot check on every diabetic pt, every single visit OR ELSE! No matter that the pt denies being diabetic or the fact that 4 medical records say not diabetic but ONE does. There is so much that MUST be done but you better get X visits done per day and don't have OT. Two hours for a SOC? Sometimes it takes 40minutes to complete an accurate medication reconciliation. :/ are you all all seeing this type of stuff?
  11. I work for a large corporation and they are forever changing what is "required" in our documentation. When I started several years ago, orders were written kind of vague such as wound care: "cleanse with saline, cover and wrap". Now it has to be written, "skilled nurse to perform wound care to left calf using clean technique by removing old dressing, cleanse wound with wound cleanser, pat dry using gauze, apply medihoney 2mm thick, cover with non adherent dressing covered with abd pad and secure with tape." We can no longer write "may accept orders from consulting providers" now we have to write may accept orders from Dr. Larry Smith, Dr. Michael Gray, and Dr. Susan English. We have to write out a lengthy description of how the patient is homebound: limited range of motion of left knee, pain 7/10 with ambulation, risk of infection due to surgical wound, is only able to ambulate 10 feet and then must rest for 3-5 minutes due to SHOB before ambulating any more. Diabetic foot checks must be documented on every single visit. Blood sugars must be documented on every single visit or we must document every single visit that the doctor has advised the patient that they do not need to check their FSBS. Every intervention must have a goal date. Cannot check a pulse ox without an order to do so. Cannot write an aide care plan that has ANYTHING PRN because the aide is not skilled enough to decide. Cannot write that the patient may have a shower or a tub bath b/c the aide is not skilled enough to decide. (hello, can the PATIENT not decide?) Do this and more in less time, less time, less time and don't you dare forget anything.
  12. I had a discussion about this topic with one my coworkers. I'm sorry but I do not care how badly someone needs care, if I cannot use a proper bag technique due to filth and bugs then I'm not starting the patient. I do not think we, as home health nurses, should have to "take just what you need" and worry about what bug fell into our pocket b/c homes are infested.
  13. LUPA is low utilization payment adjustment
  14. Is 25 visits the minimum or the maximum? That should be your first question. Secondly, I would simply approach the scheduler and ask about how assignments are made. My previous scheduler didn't know the lay of the land well at all and would schedule us to run all over 3 counties and then we would revisit all three the next day and meet up with a different nurse in 2 different towns. LOL Deciding if you can say no or not needs to be a decision you make based on the determination of if the 25 visits are the minimum or the maximum.
  15. KelRN215, I think you may have missed my point. :) Maybe I was not clear. However, if you have someone who takes a BP med and they know the purpose, action, and side effects of that med, the likelihood of them returning to the hospital due to a medication error is slim. However, if you have a pt. who takes 10 meds, 3 of which are brand new and they need teaching, I would think you would see that patient a little more frequently. If the patient has several medications including high risk medications, the likelihood of a readmission due to improper med admin is a lot higher. That is what I meant by considering the meds in to the picture. Occasionally, you will find a pt. who knows more than you know about every single medication they take. Those are rare.

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