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I<3H2O

I<3H2O ASN, RN

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I<3H2O's Latest Activity

  1. I<3H2O

    HH weekend triage nurse

    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.
  2. Anyone here also the Privacy Officer? New position and I've been told I'm the Privacy Officer. The P.O. before the one I replaced was sending out the Privacy practices annually to every resident/guardian and I've found 15 years of signed "I received the Privacy Practices" papers for 130+ residents. The P.O. I replaced was only in the position for 11 months before moving up and she didn't know this was something that was being done. So, do any of you in LTC get this signed annually? I cannot find ANY regulation that says this is necessary.
  3. I<3H2O

    Cargo pants suggestions

    Awesome! Thanks for the suggestions! 😊
  4. I<3H2O

    Cargo pants suggestions

    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?
  5. I<3H2O

    Pregnancy & Home Health Nursing

    My thoughts have always been "pregnancy is not a disability." If my employee came to me with this, I would be irritated.
  6. I<3H2O

    Doctors refusing to sign FTF and Plan of Care

    My problem with this situation is I've now been seeing your patient for a week, a month, 2 months without signed orders. What happens in the event there is a lawsuit?
  7. I<3H2O

    Overworked Home health RN

    Jeepluv, I think we work for the same company! í ½í¸”
  8. I emailed OasisAnswers about buying the binder they give during class and they said I could only buy them at the class and if someone I knew was going they could buy me one. The problem is that the nearest class in 2017 is 6+ hours from me. I don't know anyone attending a class.
  9. I<3H2O

    OASIS question

    I think you're confused about OASIS submissions. Your agency may require an OASIS to be done on every patient but not every OASIS is submitted. What I am confused about is why would someone admit with a non Medicare payor if Medicare is primary? I've never ran into this situation, I guess.
  10. I<3H2O

    Labwork orders

    Skilled nurse to draw XYZ during week of Feb 7, 2017. (?)
  11. I<3H2O

    Telling employer you're pregnant

    Why do you have to tell them?
  12. 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?
  13. 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.
  14. 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.
  15. I<3H2O

    What bag/attire/organization???

    I find that on this group, there are a lot of home health nurses that are more like private duty nurses and they are in one home all day long. The type of home health nursing I do is going from home to home to see patients all day. I wear scrubs every day as do they rest of the nurses there. Our bags have to have certain things like a "clean" and "dirty" section. This is a requirement. I had a really nice bag from Hopkins medical that I had my name embroidered on and paid $40-50 for. It is a really nice bag however, I have found a better alternative. I customized a fishing stool for my work bag. We have regulations about where our bag can be placed in the home. I take a folding fishing stool that has a bag under the seat and a strap to carry it. In the bag under the seat, I put my "dirty" stuff (thermometer, pulse oximeter, bp cuff, and stethoscope). I have customized it so that I have a place to store my gloves, my hand sanitizer, and my alcohol swabs to clean my equipment.
  16. I<3H2O

    Question about home health

    I agree with the PPs. I think my med surg experience has helped me TREMENDOUSLY in HH nursing and I cannot imagine going to any other specialty before Med Surg!
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