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LTC & Private Duty Pediatrics
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SirJohnny has 8 years experience and specializes in LTC & Private Duty Pediatrics.

SirJohnny's Latest Activity

  1. SirJohnny

    Aveanna Takeover of Maxim

    It's soon going to be just two major players in Pediatric Private Duty: Bayada and Aveanna. They will bill the state $50/hour for the kid, and you'll get $20. Welcome to America.
  2. SirJohnny

    Refusing a case in home care

    Screw the agency manager. He is looking out for his own interests (e.g., gets paid commission for the sale). Remember, this is a business, not some feel good charity work. By feeling sad or getting angry, the manager was playing to your feelings as a young, caring female. Gotta grow some callouses and let it roll off. There are other cases out there. They know that. Agency is greedy, they will find you more cases. It's a win some, lose some game for the agency. They know that.
  3. SirJohnny

    Pediatric Private Duty Cases

    I have a regular four night a week account, and then float the other two or three nights. Sometimes, I will grab an evening shift on an easy kid. I do not like to chase kids around, so don't work day shift. Usually good for 50 to 60 hours a week. Gotta work overtime if you expect to make any $$, as rates are super low ($25/hour with no benefits and no shift differentials / weekend differentials).
  4. SirJohnny

    How NOT to suck at turning a Pt, esp. w/ trach/vent??

    Keep practicing. It's hard at first, but you will get good at it after a few weeks. If patient is obese (> 300 lbs), screw it and tell agency you need a CNA in there with you. Leave if agency refuses. They are the ones making all the money, not you.
  5. SirJohnny

    3 States Won't License Excelsior's ADN Grads

    There was a nurse, he goes by the name "Nick the Nurse" and used to run a blog. Anyhow, he received his ASN from Excelsior. Applied to California. They turned him down. He appealed their initial ruling. They told him to get his BSN. He went to that online Western Governor's University for his BSN (which he managed to get in a few weeks ... as this school gives credit for "life experiences."). California accepted his BSN and granted him a license. This would be around the 2010 timeframe. ---- I am wrapping up by PMHNP/DNP at the University of Pittsburgh. Did my ASN through Excelsior, and BSN through Univ of Pgh. Am thinking there might be a legal loop hole or legal case to get a California NP license (which I know requires an RN license). I believe Nick the Nurse, used several legal arguments in presenting his case. He published his argument, but has since taken it down. If anyone has a copy, can you please post. Thanks!!!!
  6. Update: Oct-2017 -- Here is a link to webpage that explains in terms for us dummies. Nephrotic Syndrome vs Glomerulonephritis NCLEX Review ============= To differentiate between the two -- Here is what I use: ... "itis equals infection which produces lots of blood." Hope this helps.
  7. SirJohnny

    Graduation Vacation?!

    Yellowstone is completely awesome in August. If you can swing it, hit the park the day after Labor Day. Weather is still nice, most of the park facilities are still open for another week or two, wildlife is moving around (getting ready for winter), and most of the tourists have cleared out. If you are into fly-fishing, this is when you want to go. Hardly anyone will be fishing, and all the streams (where you are allowed to fish) will be open. Did you know the Yellowstone River inside the park does not open to fishing until July 15th (to allow the native cutthroat trout to spawn in peace). I was there Labor Day weekend 2002, and spent 2 hours walking/hiking the 5 miles back into the 1st meadow on Slough Creek. This is a world famous location for fly-fishing. Couldn't believe that I had the entire meadow to myself (unheard of). Caught and released around 30 cutthroat trout that day. Had to wait for a moose to get out of the way (was standing on the trail) on the way back to the car. Ended up driving over to Cooke City that evening. Found an old hotel/restaurant/bar, around 10 at night. No one else there, so I ended up eating a spaghetti dinner and talking with the waitress (actually helped her clean up/vaccuum the place). She gave me the phone number of a hotel to crash out at that night (only $25/cash). Ended up spending the night, until about 3 in the morning, talking about fly-fishing with the hotel owner. We actually tied about a dozen or so flies that night while trading fishing stories. The next morning, I headed back to Denver, Colorado (where I was living at the time). Actually, ended up using the experience as the basis for my undergraduate nursing school admission thesis (it's somewhere here on allnurses.com ... can find by doing a search). Anyhow, it's something to think about. ------ I graduate (hopefully) in Dec 2018 from Univ of Pgh - DNP/PMHNP program. I am actually planning on driving down to Disney World about 10 minutes post graduation. Not sure if I will go to the parks or just lie around in the hotel for an entire week. I'm already 3 years into the program am so utterly ready to get it over with. Whatever you do ... have lots of fun. :)
  8. SirJohnny

    PA scope of practice for LPN. Iv pushes?

    All: Apparently Pennsylvania changed their scope of practice for LPNs, who are now allowed to administer, initiate, and stop parenteral nutrition (TPN). I am not sure when the law changed in Pennsylvania, but here is a link to the BON website. Please scroll down to Item 12 on the bottom of the page. Again, this discussion pertains to PENNSYLVANIA LPN's only. 049 Pa. Code § 21.145. Functions of the LPN. =============== (g) An LPN who has met the education and training requirements of § 21.145b (relating to IV therapy curriculum requirements) may perform the following IV therapy functions, except as limited under § 21.145a and only under supervision as required under subsection (f): (1) Adjustment of the flow rate on IV infusions. (2) Observation and reporting of subjective and objective signs of adverse reactions to any IV administration and initiation of appropriate interventions. (3) Administration of IV fluids and medications. (4) Observation of the IV insertion site and performance of insertion site care. (5) Performance of maintenance. Maintenance includes dressing changes, IV tubing changes, and saline or heparin flushes. (6) Discontinuance of a medication or fluid infusion, including infusion devices. (7) Conversion of a continuous infusion to an intermittent infusion. (8) Insertion or removal of a peripheral short catheter. (9) Maintenance, monitoring and discontinuance of blood, blood components and plasma volume expanders. (10) Administration of solutions to maintain patency of an IV access device via direct push or bolus route. (11) Maintenance and discontinuance of IV medications and fluids given via a patient-controlled administration system. (12) Administration, maintenance and discontinuance of parenteral nutrition and fat emulsion solutions. (13) Collection of blood specimens from an IV access device. ==========
  9. SirJohnny

    Agency in Dallas area, pay, quality

    Rule #1: Nothing stops the med pass. You just keep going until you get done. Rule #2: I never look for patients. If I can't find the patient, then I flag that section of the MAR, and will come back to it sometime. Lots of times, I will find the missing resident(s) in the TV room or in the Dining room. But I am not going to be running from the hallway to the TV or Dining room for each patient. Rule #3: Learn who your diabetic patients are. Hit those folks first (or at least make sure you see them within an hour of either side of the ordered med time). The other LTC meds, if late, won't kill anyone. Ruke #4: Snack off the med cart. Most LTC facilities have fig newtons or oreos for their residents. It's ok to grab a package or two to snack on while doing the med pass. Your first couple of times in a new facility will take the entire shift, and you won't even have time for any form of a break. Hope this helps.
  10. SirJohnny

    Sleeping Nurse = No Agency?

    Whenever I start a new case, I make sure the parents are ok with me hitting the books/laptop at night. If not, then let me know, and I will find another assignment. I work PDN as the night float, and also go to NP school. Thus, I hit the books while the kid sleeps. Fortunately, nearly all of my cases are stable, and I can get a good 6+ hours of studying in on an overnight 8 hour shift.
  11. SirJohnny

    Capstone - what do you think?

    Hi there: Your capstone project may have to reflect on patient improvement outcomes versus nurse improvement outcomes. Depends on your institution, so be sure to verify before really digging in too far with your project. Also, be sure to secure your committee members early on. I know at my university (DNP/PMHNP), we can develop protocols that improve nursing efficiency, but the overall goal has to be improved patient measures (e.g., satisfaction, outcomes, lower costs, etc.). A completed project that does not show significant patient improvement at the end of data collection and statistical analysis, is still a valid project. I am in the middle of my DNP capstone project ... and it takes forever to get approvals from the capstone committee, and the IRB. My population is demented nursing home residents, and I am in the process of writing inquiry letters (as well as knocking on a few DON doors) to see if I can generate any interest. As mentioned earlier, the process takes forever. Good luck!!!!
  12. SirJohnny

    Tips for Psych NP student

    Jules: Thanks for the info.
  13. SirJohnny

    On call pay

    Thanks for the info.
  14. SirJohnny

    On call pay

    Jules: If you happen to get called, do you get extra pay above the $300 to $500? Just curious. Thanks in advance.
  15. SirJohnny

    Assigned to a filthy home?

    By law, your agency must supply personal protective equipment at no charge to you. This means gloves, masks, soap or alcohol based hand cleaner. If not, then contact OSHA and file a complaint. Regarding a messy home. I have 3 or 4 cases that are messy to the point there are roaches, flies, and other bugs in the house. The bugs stay on their side, the kid and me stay on the other. I have (on more than one occasion), ripped everything out of the kid's side of the room, and cleaned (using micro-wipes) the entire area and re-built/stocked the area. I then make it clear to the parent(s) that this area is to remain clean. I also leave a note for the other nurses to keep the area clean. Unfortunately, I bounce between 15 different clients (some I don't see for a month or two, as I am the night float). So areas that I have cleaned in the past tend to fall in disrepair again. At least I tried. In private duty nursing you have two choices: (1) Either fix/clean the area, keep your mouth shut and keep your job. (2) Ignore the problem, and keep the job. (3) Call CPS or report to your agency, and lose your job (or at a minimum, the account). Johnny
  16. SirJohnny

    Want to get a DNP but need help with a research project

    All: What is the Effect of Using Clorox Wipes versus Lotion Infused Baby Wipes during Perianal Care in Reducing Urinary Tract Infections? How Many Licks Does it Take to Reach the Center of a Tootsie Roll Pop? Hope this helps.