KSU-SN

Not sure about entry level now-when I was hired for med/Surg almost 10 years ago I started at $24/hr cost of living in NE Ohio is much lower than in California but still $28 per visit sounds quite low to me

So I have recently been hired at a home health agency PRN. I currently work at another agency hourly and make $30/hr. This new agency pays per visit and their rate is $28/visit no matter if it’s an assessment visit or routine visit. I have no idea what the average rate is but that seems really low! I make about $240/day at my hourly home health job. I would have to see 8-9 patients a day in this new pay per visit job to make that. And they are telling us that each visit HAS to be at least 40 mins or the agency doesn’t get reimbursed correctly?! There’s no way I can see 8-9 patients with each visit being 40 mins or more...along with the driving that would be like a 12 hour day. FYI I am a RN and am in Ohio. Am I being cheated?

If someone other than you is changing your documentation that is wrong...if they are suggesting that you downgrade some of your answers due to what can the patient safely do then that is one thing but if your supervisor is taking it upon him/her self to change Your answers then that is not right. My agency sends us an email once they audit our OASIS and makes suggestions but never changes anything for us

I was told the question is asking not what the pt can do or is currently doing but what is SAFE. It's all about safety

The agency I work for just started having us do medication reconciliation every 2 weeks and after every doctor appt. we have always done it at every SOC, ROC, and recert. They say if we do not do it every 2 weeks and after doctor appts and document it on the care plan we will be written up. Just wondering what other agencies are doing about medication reconciliation? Is this common to do so often? I feel like I'm constantly having to do this and the patients are getting fed up with having to pull out all their meds and us go over them so often.

I would never get my documentation done if I didn't chart in my patients' homes! I can't imagine seeing 5-6 patients every day and then at the end of the day have all that charting to do

Medicaid patients aren't required to be homebound correct?

I am new to home health, just started 2 1/2 months ago and just last week started doing Start of Cares. I am still on "orientation" if you can call it that because since my second week on the job I have been on my own. Basically I shadowed a nurse for 4 days and then they put me out on my own. I feel like I have no idea what I'm doing...I know the nursing part of it as I worked on a busy med/surg unit for years but home health nursing is SO different. Anyways, I was doing a start of care a few days ago where about halfway through all of the OASIS interview I had to call 911 and send the man to the hospital. I had done vitals and assessment and everything. I had not gotten the consent for care and treatment signed as I usually do that towards the end when I have gotten a better feel for the patient and how often we should be seeing them, etc because on our consent we also have to fill out our visit frequency and they are signing that they agree to that also. When I went back into the office and they found out I had not gotten the consent signed before doing vitals everyone was upset and really disappointed in me. The nurse educator stated "I told you to always do that first." Well, funny thing is, she went out with me to complete my first Start of Care with me and guess what....we did the consent for care and treatment towards the end. I did not call her out on it though, I just apologized and said I wouldnt let it happen again. I shadowed 4 nurses and every one of them did the consent last....I truly did not think you had to have a consent to even touch the patient, I thought the consent was for the patient to sign to agree to continue being seen by our homecare company and agreeing to any further orders and to the frequency of visits that we had agreed upon. So my question is....is it really important to have the consent signed before even touching the patient? Could you actually get sued for taking vitals and doing an assessment before getting a consent signed?

Hi I just verbally accepted a position as a RN Case Manager for visiting nurse services here in Ohio through a large hospital in the Akron area. When the woman from human resources told me the hourly wage I was stunned. She said it would be $25.50 per hour. They do also reimburse you $0.41 per mile. I make more than that now as a floor nurse at a hospital that I was told pays less than this Akron hospital. I was thinking I would be paid more in the $28/hr range. I dislike the thought of getting less per hour and working more days per week. I work 3 days per week now and this new job is Monday-Friday. I was talking to my husband and he wasn't happy, he says I should talk to them about the wage and see if I can negotiate for a better hourly wage. Does $25.50 per hour sound about right for an RN Case Manager with home health and is that wage possibly negotiable?

Our post-ops are not transferred by a nurse they are transferred by a transporter....and we do not get any kind of report. They come up with a trifold filled out with the meds they were given, what their incision site looked like, IV site, and a written nurse's note if there were any problems. And at shift change it is very common to see a train of 2-3 post ops rolling down the hall at the same time.

I work on a surgical care unit and we most definitely have to have an order for an ice pack. Many of our surgeons specifically do not want their patients to have ice packs to their incisions and we had a patient once who came in with a red and swollen leg and she was given an ice pack without a Dr. order. She developed gangrene and the surgeon was very upset and said that it directly contributed to her development of gangrene.

If someone called me in the middle of the night or whenever and told me my mom or dad coded, NOTHING could hold me back from going immediately to their side.

My grandma was pretty recently diagnosed with ALS....she is 83 years old and until about a year ago she ran on the treadmill every night, played basketball with us, mowed 2 acres of grass by herself most of the time...this diagnosis has taken her very hard and it's so sad seeing her deteriorate. She is gradually losing her strength especially in her hands, having a lot of difficulty swallowing. I don't think you ever really understand what it's like until you see a loved one go through it or especially until you go through it yourself. I love my grandma dearly but I can't help but wish she would die from another cause (something quick and less heartbreaking) before she becomes a prisoner in her own body.

Influenza B was the strain going around in my section of the country and a few doctors at work said that people who got the flu shot were still getting the flu because it did not cover Influenza B, only Influenza A.

At the hospital where I work, our management doesnt have our back at all and its very frustrating. A couple of weeks ago we had a female patient who had cancer, was in her 50's, but was still alert and oriented. Her husband, who none of us had ever seen before, came to the nurse's station demanding to know the results of her labs. Our charge nurse asked him if he had the HIPAA password. He IMMEDIATELY tore his hat off and slammed it down on the nurse's station and said "I am her husband!! I dont need a d*mn password!" Our charge nurse gets up and says "Lets go down to the room and we will discuss it with your wife also." He comes around the nurse's station ranting and raving IN THE NURSE'S FACE that shes going to have a problem if she doesnt tell him what he wants to know NOW. She said "I'm sorry but due to confidentiality laws I can't give you that information unless it is ok'd by your wife." He was like "ok you're really gonna have a problem now!" By then someone had called our nursing supervisor (why they didnt just call security I will never know..) Our supervisor came out and just told the charge nurse to tell him whatever he wants to know. So she did. Its like REALLY?!? And he was allowed to stay.