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melsman1904 has 6 years experience and specializes in Home Health.

melsman1904's Latest Activity

  1. melsman1904

    how many points

    30/ week SOC = 2.75 pts Recert = 1.75 Roc = 2.25 Oasis D/C = 1 Routine SN visit = 1 pt
  2. melsman1904

    ICU Male Nurses - Scrub Question

    I second Aviators. I'm in home health and give my scrubs a thorough beating sliding in and out of a car all day. They are some of the most comfortable scrubs I've ever owned. Also, you can customize them to practically any configuration you could want. They are more expensive than a lot of other brands, but well worth the extra dough.
  3. melsman1904

    Wound care opinions (apologize for length!)

    If the drainage is r/t edema, you would need to control the edema. What is causing the edema? Venous insufficiency? Do you have a current ABI? From what I read, my next step would be to discuss with the Wound MD the possibility of utilizing something along the lines of the Coban 2 layer wraps if this is venous insufficiency. If Wound MD agrees to order, you need to get an ABI so you can select the proper pressure. Further reading that you may find informative: 3M Coban 2 Layer Compression Therapy: Intelligent Compression Dynamics to Suit Different Patient Needs Cobanâ„¢ - Wound Care: *: Critical & Chronic Care : 3M United States
  4. melsman1904

    Nurse Retention ideas

    Most others have mentioned it already... The #1 reason we all work: MONEY. I challenge anyone who disagrees with that to do any of our jobs for free while maintaining the (sometimes) unreasonably high standards required of us for 12 hours. Don't hold us to "Professional" standards and then treat us like blue collar workers. And before anyone gets offended, let me make it clear that there is nothing wrong with being a blue collar worker. My state BON recognizes me as a professional and holds me to higher standards than those expected of blue collar workers. So, pick one and stick with it. Don't expect us to martyr ourselves just because a patient has needs. News flash- every patient has needs. Allow proper staffing so that those needs can be met and we can take adequate breaks. And proper staffing should not be limited to just nursing. Other members of the team (Aides, Lab, Xray, etc) should be staffed adequately as well. Quit telling us that YOU can't fill these open positions, give raises, replace equipment because money is tight and then break ground on some new building project. If you can't staff what you already have, why the hell would you build additional space?
  5. melsman1904

    How does you agency handle on call responsibilities?

    Thanks for the responses. Very interesting to see the differences from agency to agency.
  6. Just out of curiosity, how does your agency handle on call responsibilities? 1. How many on-call shifts do you have each week? 2. How often are you required to handle weekend on call duty? 3. What hours are considered on-call/afterhours? 4. What's the pay structure like? 5. What area of the country are you in? I'll throw my answers out there: 1. We usually have 1 primary and 1 back-up on call shift each week with the exception of the week following our weekend. Usually, we only have a back-up shift after working the weekend. 2. Right now we have 2 weekends in a 6 week period. One weekend is spent as the primary on-call and one as back-up 3. M-Th 17:00-08:00 Weekend is 1700 on Fri - 0800 on Mon 4. $20/ weeknight shift and $40/ weekend shift. Any visits made on call are paid at normal visit pay depending on type of visit. 5. Central Alabama
  7. melsman1904

    Quality between Littmann models that big of a difference?

    During nursing school, I had the Lightweight II S.E. and it worked ok. In fact, I used it for probably a year or so after graduating. I had the opportunity to use a Cardiology S.T.C for a while and the difference was night and day to me. I got a Master Cardiology for Christmas this year and I find that the acoustics on it are about the same as the STC. I will say that the STC feels like a freakin anvil hanging off your neck. The chestpiece will do some serious damage to desks, bedrails, etc. if you drop it. Heavy!
  8. melsman1904

    What kind of holiday bonus do you get?

    I get to be the primary on call nurse for ~200 home health pts. Oh, and since Tuesday is my normal call night, I get to be primary on call for New Years Day as well. I must've been extra good this year for Santa to bring that shining nugget of coal right there!
  9. melsman1904

    holiday pay this year-what??

    What is this holiday pay you speak of??? For us, it's just another Sunday. No weekend diff either. I'm not complaining though. I could be asking "What is this job thing you speak of?"
  10. melsman1904

    Night shift work

    It could be considered a stepping stone. I hired in to a hospital on nights and was able to score a day shift position after some time because I was already an employee. One distinct benefit is that you may know about an open position before it is posted for the general public to see.
  11. melsman1904

    male nurses with beards

    Like mofomeat and Bortaz, I got the short end of the stick on facial hair. I can grow in a decent goatee, but the rest just grows in thin ans splotchy. Lately, I've been wearing the goatee as Mrs. Melsman seems to enjoy it.
  12. melsman1904

    on call/ low census status

    I see this situation a lot at my current facility. Some take PTO, some take unpaid leave. I really don't know what others do, but I usually volunteer to pick up a shift later in the pay period if needed. Also, I budget accordingly so that I can absorb the impact of missing a shift. While it's not ideal, I have dealt with much worse.
  13. melsman1904

    Customer Service? Maybe on your home planet.

    Please understand that I'm not asserting that unprofessional behavior is acceptable, no matter the circumstances. Now, let's look at this a little more in depth. We've all heard about patient rights and responsibilities, right? Well, a lot of attention is paid to pt. rights. But what about those responsibilities? Here are some that I found HERE. Maintaining Healthy Habits Being Respectful to Providers Being Honest With Providers Complying with Treatment Plans Making Decisions Responsibly Meeting Financial Obligations Avoiding Putting Others at Risk From the examples I gave in my previous post, most of these responsibilities are not being taken care of by the pt. If we were talking about a bank and not a healthcare facility, the story would be much different. Let's take a look at a few of these. -- Healthy habits-- Bounce a few checks and see how accommodating a bank will be with rudeness. -- Respect toward employees-- Drop a few F bombs when your bank returns a check and see how far that gets you. -- Honesty -- Give false information involving a banking transaction and you might just get hooked up on fraud charges -- Comply with tx plan-- Miss a few mortgage payments and you may be living in your car...until it is repossessed because you chose not to pay the note on it as well. --Responsible decisions-- See Healthy habits --Financial Obligations -- See Tx plan -- Avoid putting others at risk-- Threaten a teller with bodily harm if she doesn't do exactly what you want and see if you still have an account with that bank tomorrow.
  14. melsman1904

    Customer Service? Maybe on your home planet.

    I've only been a nurse for a little over 2 years, so my experiences are somewhat limited. However, most (in the neighborhood of 95%) of the rude pt behavior I've experienced has been over things out of my control. Examples are giving pain meds early and allowing food items not on the prescribed diet. The other 5% have been a mixed bag of things. A lot of folks don't want to do PT after ortho sx and that can get heated. Explaining the benefits of ambulation over bedrest falls on deaf ears for some of those pts. More to the point, healthcare and customer service seem to be much like oil and water. They just don't work well together. In healthcare, the customer is not always right. In fact, much of what we do daily as part of our jobs is exactly opposite of what the "customer" views as best practice. For instance, non-compliant diabetics may see a candy bar as appropriate and so they insist that they should receive such foods. We all know, though, that will only hinder a positive outcome. Also, to compare healthcare to any other occupation where dealing with the public is a central component is illogical. What other industry would provide services regardless of a "customer's" ability to pay and still tolerate rude behavior?
  15. melsman1904

    Overtime, how much?

    I rarely see OT on my unit. Usually, I get called in on an off day and then get canceled later in the week. It's not ideal, but it will do for now. It really makes it difficult to plan things on my off days. I guess, working with a great group of people makes it tolerable, though.
  16. melsman1904

    Anyone ever have a famous person as a patient?

    I've taken care of a professional athlete's mother. He was there with Mom all day and was a pretty nice guy. If anything, he struck me as a little naive. He walked all over the unit barefoot. I told him that it wasn't such a great idea to walk around barefoot, but he shrugged it off. Oh well, job security, right?