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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.

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.

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.

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.

Awesome! Thanks for the 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?

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

Jeepluv, I think we work for the same company! í ½í¸”

Why do you have to tell them?

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?

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.

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.

LUPA is low utilization payment adjustment

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.

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.

Someone who is likely to return to the hospital (CHF, pneumonia, etc) within 30 days should be seen as frequently as your company will agree. Probably at least 3x week for the first week and twice for the 2-3rd weeks. Those who are just started b/c they went to ER too many times for constipation, you could probably see a couple times the first week and then weekly and ultimately every other week. This all should be based on dx, number of medications they take, how familiar they are with the dx and medications, and how many disciplines you have in the home.

To me, proper bag technique is: Your bag has separate compartments for clean and dirty. You have something to use for a barrier when you are in a home (plastic bag, wax paper, scale liner, newspaper) Put down your barrier (on a hard surface preferably but DEFINITELY not on the floor), place your bag on it. Clean your hands. Get out all of your equipment that you need. Then clean all of your equipment before putting it back into your bag. Do not get ANYTHING out of your bag without cleaning your hands first. If you step away from your bag and realize you forgot your stethoscope, you must clean your hands before getting it.

The patient must be given information on their rights and responsibilities, how to get a hold of the state and your accrediting agency, notice of privacy practices, etc. Please review Medicare Conditions of participation for home health. They are found online. :)

In my state, an LPN can do meds through a picc.

I do not believe that agencies are reimbursed specifically for mileage. If they don't pay mileage, then they probably have to pay drive time and it is probably cheaper to pay mileage?

I would chart: PICC line in LUE. Purple lumen with blood return, flushed with 10ml normal saline using push/pause method. Vancomycin 1gm/250ml infused via purple lumen at rate of 250ml/hr per pump. Purple lumen flushed with 10ml normal saline followed by 5ml of heparin 10u/ml using push/pause method. PICC site is without edema or erythema. Pt. reports no adverse reactions to medication. I would teach about care of site, do not get wet, watch for signs of infiltration (if they are self infusing), side effects of medication.

yeah, tell her what she can wear. Just like a good controlling man should do. :rollseyes: The OP seems like a troll.

I think asking someone to complete an OASIS,especially a SOC OASIS in the home is a RIDICULOUS expectation! There are no many things that I have to look up the item intent on (even after completing OASIS for years). The company I work for expects all visits except OASIS visits to be completed in the home.

Words of wisdom that were given to me: When you are interviewing someone for a position, ask them what they want to be paid. They should know their worth. A person who settles for whatever you give them will soon look for a new job that pays them more." So, I would go in asking for what *I* felt I was worth. If you will "settle" for $70k, ask for $72k or $75k...all they can tell you is no.

Thank you all for your input. Being new to management and not exactly "knowing your role" does pose some difficult situations.