dusky1228

Good luck!

I’ve been in Home Health for over 20 years, after many years working in the hospital. This has most definitely not been my experience. We schedule our own patients once they are assigned to us, so they are flexible within the time range as long as you see them as many times as you’re supposed to. If you were part time, you would be paid regardless-but as a per visit nurse, you may be the last one in your agency who is given patients. That may not change. Why not look around for another Home Health position?

i was in this position (had a picc line), and at that time, i had no difficulty letting selected people know-and i was fine with it at that time, with that group of staff, including managers. if i had to do it now though, i would not feel comfortable letting anyone know. maybe i would let some trusted co-worker know, but that's it. circumstances are different now. managers are different now. i agree with the posters who say it may be viewed (whether reasonable or not!) as a liability. you do not want anyone being able to imply that any difficulty you may have in your rotations are due to any medical condition you have, when it may have nothing to do with that at all. if you can meet the requirments of school and clinicals, and your doctor is fine with it, then you have no need to let anyone know. good luck, whatever you decide.

These would also be the ones who insist on bringing their feverish, coughing child to visit a relative's severely premature baby in NICU--and lie about being the brother or sister of the baby just because they "just can't wait to see the baby"! :angryfire

like some others have said, silk thermals are great for wearing under scrubs. they are thin, soft, warm and come in great colors. i got several of different colors to complement my scrubs. i found mine in the jockey store. :paw:

Yes, Yes, Yes! That's my days too!

I also agree with what so many others are saying: your sister needs to come first! I think on some level you realize that. I might also point out how damaging it would be for your 11 year old sister to be living in a home where it is SO obvious that one of the people living in the house *really* doesn't want her there. If I were her, I'd be hurt, insulted, and very uncomfortable in what was supposed to be my home too. That's no way to live for anyone, let alone a child. He sounds rather selfish, and you don't at all. Consider moving on with your life. If you choose to stay involved with him, fine, but living with him may not be in all of your best interests. Good luck!

Changing *anything* may be enough to help you feel better about your life and career. You may be suffering from burnout. Try changing shifts, units, or specialties. If you can't do it where you are, try looking for something in a different location. Maybe try home care or doctor's office, or school nursing or correctional nursing. You could even try agency. Good luck to you!

I think Vito is making the point that if there is 60 billion available (and I'm not so sure it really is!), why not spend it here, in the US, for any one of the myriad of serious diseases or other problems that need resolution? It's sort of like supporting a family that you don't even know, but neglecting your own family. I think our responsibility shuld be here first, THEN elsewhere if needed, and can be afforded.

I work in an agency that has the same "amenities" yours does (computerized charting, etc). Our productivity is expected to be 6-7/day, though mine is 5-6 because I cover an entire large county instead of the 1-2 towns that most of my colleagues do. I would think I died and went to heaven if my productivity was 2-3! And we don't have even half of the backup assistance/support from the office staff that you describe! I would be SO grateful for that, as I know my co-workers would be also. Keep doing what you are doing. If any of your staff leaves, they will soon find out just how good they have it. :wink2:

the amount of notice may not be law in each state, but may be governed by facility policy. for each of the many positions i have had to give notice for, the amount of notice required by facility policy was equal to the amount of vacation one was allowed for that year. that being said......i also feel like 2 weeks should be sufficient.

Seems like if you quit after just *one* bad work experience, then there are a multitude of other nursing opportunities! Try something else, different hospital, different venue, different type of nursing. If you enjoyed the nursing care, but just were overwhelmed with the overload and poor morale (who wouldn't be?) then go somewhere else and try. Since you love journalism, if you had a bad job experience, wouldn't you have tried another job somewhere else? Give nursing the same chance-you may just have to find the "right fit", and that "fit" is different for everyone. Good luck!

You are welcome. Best of luck!

Depends on your specialty area actually. Mine is MCH, NICU babies, so NGT are used for feedings much of the time. And often are changed *way* more frequently than "weeks".

I'm not sure if this is what you are looking for, but a Corpak Corflow nasogastric tube is a long-term use nasogastric tube that is rated to stay in for 30 days at a time, and a regular nasogastric tube is a short-term use, being inserted with each feeding or at least changed every 24 hours at most. The Corpak *is* a nasogastric tube, but is the brand name of a *type* of nasogastric tube that is intended for remaining in for 30 days at a time. Hope that helps!:paw:

I have one of these, and I love it! I wish it had been available when I was in nursing school. Someone asked if it looked like a pen, or if you can tell it is a recorder. I have used it in it's recording capacity, and you'd have to look closely to see the "Rec" button. It looks like a chubby pen. It works as a pen too, so you can write without the record function too. It has come in *very* handy for me. It has a number of uses, and I am very glad that I got it.

Simple answer: Say "No, I'm sorry. I have plans. Maybe next time." Unless your job requires you to work these extra shifts, it is up to you. Because you are new, it seems like everyone is taking advantage of a new person who hasn't burnt out yet. It's nice that you help, and you can continue to do that, but do it when you choose, and maybe the favor can be returned. Good luck!

Not only instructors, but managers too. Your post came at a great time. I have been at my current job for 18 years without any issues or problems, and now just 6 weeks ago, there is a new manager, and I have had to have 3 meetings and countless reprimands over *nothing*. I cringe when I hear the phone if it's that manager. It has me on edge constantly. While your post won't make this problem go away, it made me feel better to have it confirmed that the problem is not me. If I have had over 20 managers in my career, and never had any problems, and *now* I do, then it obviously is not me. Thank you.

well, it's pretty much the same concept as training them to go outside. i used a regular cat litter box and soft litter. the type is just personal choice. now he is using a dog litter box-it has a slight cut out in the side so he doesn't have to hop over the side. when he was a puppy (he's 5 now), i would just put him in the box every hour or 2, immediately after eating, before bedtime, or whenever he looked like he was sniffing for a place. when he would "go", i made a fuss or gave him a tiny treat. if he had an accident (rarely happened), and i caught him at it, i would just pick him up and put him in the box to finish his business. he trained in one weekend-and he's a chihuahua, and they are notorious for being tougher to housetrain. he is the second chihuahua i have trained to the litterbox. the other was my first chihuahua. they were both males. my current one just has to have a pad along the back wall of the litter box so he can do his little "leg lift" safely. it's so great to do-no worries about discomfort or accidents, or taking him out when the weather is really bad. i even trained a 13 year old dog to the litter box-just exactly this same way.:paw:

i have a very small dog-a 5 lb chihuahua. i have some long hours, and usually i take him to "doggy day care"-i bring him to a friend's house until i come home. but there are days that i can't do that. i make sure he has plenty of fresh water, and some dry kibble. he uses a litter box, so i don't have to worry about his being uncomfortable. when he was younger and i had to leave him, and i had roommates that had a puppy also, i bought a puppy playyard and set that up in the living room. inside the small playyard (which was adjustable-i made it about 5 ft x 3 ft) i set up his soft crate with blankets and toys. this way he was restricted and protected when i could not be there, and could go curl up inside a doubly-protected hiding place to sleep. when i get home, i always spend a little while cuddling him and playing with him. see if you can work out dogwalking or doggy day care at least sometimes, just to break up the long day for him-if not, just spend lots of time with him when you are home. good luck!:paw:

Thank you for your quick response GilaRN. I can't say that I am offended at all, I understand her point. What I objected to was her *way* of telling me. It was presented in such as way that *no* manager should do. It was actually me that suggested going to the clinic or to one of my community contacts where FHR is done routinely so that whatever skills checklist is needed can be performed. Obviously all the details can't be presented here, but I can tell you that I was being told "We have never done this at the Agency", when I have been at the agency for 18 years, and have done them since day 1 there, *with* evaluation and being signed off on a skills list. But since it is so long ago, that skills list is no longer there, so I was trying to find something that is still documented somewhere that would cover the new requirement. We all understand that when new managers come in that there are changes (remember, I have been there through 13 or more manager changes) but it seems wiser to let us know that some new policies or procedures are going to be instituted, rather than just saying "We have never done this at this agency" when I know we have, and they have *not* been there to know it. I have previously had outside contracts arranged between my agency and another agency to do specialized care for extremely high risk pregnant women, and have completed a skills list for those agencies as well in cooperation with my agency. As for providing my own doppler, I did that at the time because when the one that was provided went belly-up, I asked for a replacement and kept getting told "it's on order", but it never got done, so I bought my own-medical grade doppler. I did the same thing when my infant scale died. Maybe I shouldn't have to, but I did because the agency was primarily an adult agency and my MCH program (I was hired for it, and deevloped it over the years there) sometimes got left out when it came to ordering supplies that were unfamiliar to them. Thanks for your input-I really appreciate it.

Hello all! I hope you all have a Happy Easter or Passover. To try to make a very long story much shorter, I need to give those of you who don't know me a little background. I have been an RN for almost 30 years (since 1980). My specialty since the beginning has always been OB, though I did my fair share of med-surg and multiple other specialties as a float nurse or agency nurse since the beginning because I wanted to get and keep experience in other areas. I worked in a Level III regional perinatal center for over 15 years. In that time frame, I was charge nurse on the high risk antepartum unit, and we did inpatient and outpatient NST's in our NST room. I hold my Inpatient Obstetrics Certification from NCC (it was AWHONN when I was first certified) in 1989, and have maintained it since. I currently work in home care, and have done so since 1991. My caseload is maternal-child health, which may include high-risk pregnant women. However, I now have a new manager (again), and problems have arisen not only for me, but my coworkers as well. :angryfire I have just been told that I can no longer do fetal heart rates by Doppler for our patients (even with a doctor's order) because she "can't verify" my "competency" in it. She also told me that the agency never provided an agency Doppler. I pointed out that I *DO* have an agency-assigned Doppler, but that it malfunctioned several years ago, so I bought my own from a medical supplier because the agency never ordered a new one for me. I also pointed out that it would be a liability if we accept high risk pregnant patients and then did not do fetal heart assessment, because we would not be fully assessing a pregnant patient if we didn't. I consider that part of vital signs. Does anyone have documentation about whether a certification in Inpatient Obstetrics should be sufficient documentation of competency with fetal heart assessment? It seems that it may, because the eligibility requirements include fetal heart monitoring and assessment. Also, would there be liability in NOT doing a fetal heart assessment in these high risk pregnant women? Are fetal heart tones considered a "vital sign"? Any written documentation would be appreciated. Anything would be of help. In the meantime, my next "requirement" is being told I need to go to the local clinic to have someone supervise me in checking a fetal heart by Doppler, which just seems comical to me because I have been a nurse in the specialty for almost 30 years, and I can do it in my sleep, but if that it what is required to satisfy someone's "rule, then so be it. Thank you all!

this is such good advice! i think we often forget that this is a public forum, and as such, is usable for almost any purpose. be careful.

Today was one of those awful days, dealing with an absolutely impossible person. But I only ever wished that *she* never became a nurse! Not me. I always am glad I became a nurse-I just wish some other people never became a nurse.

we use pda's, and if i have to document in between visits, i just write in a communication note for that patient. when we used paper charts, we had a short communication sheet form that we used for in-between-visit documentation.