starcandy

I am new to home care and the agency that I work for is a disorganized mess. I got very little orientation. I was just thrown out there after 4 days. My problems are I do not understand "home bound" per medicare rules. There are some patients that I have that I will not consider home bound. I feel pressured to accept everyone. I will discharge a patient and a week or two receive another referral for the same patient. I am finding out tidbits of information that should have been received in orientation. Which is very frustrating. How many patients should a case manager have? I am responsible for SOC and revisits the first week or so, then the LPNS continue visits. Is it common to have a scheduler or you schedule your own visits??

I just started last week in home health. I did my first SOC with preceptor last friday. Monday, I was given 10 more start of cares , with the addition of 14 new patients that need recerts, discharges and regular visits. I am new to oasis-c and overwhelmed. My manager says I should progress and be able to do 5 SOC a day.

How many are can you complete in one day?? How many for one week?? I am new and feeling very overwhelmed. It takes me 2 hours just to finish the interview

I think case studies are a good idea. Drawing electrolytes and CBC with diff would be a good start too.

I was a LPN since 1986 and worked the first year in a nursing home. After that, I started to work agency private duty and nursing homes part time for a while. I had four small children at the time and decided to be a stay at home mom for 6-7 yrs. I returned to nursing in 2001 working midnights in a LTC. I bought a Clinical Procedures manual and a drug book for Amazon.com and went from there. I learned a lot, but I felt I needed more to have a more thorough clinical picture of my patient. Because of the lack of retraining for LPNS in my area, I decided that is was best for me to pursue my RN. I think working in LTC is a good idea and I am sure you will do fine.

I am a 2004 grad of HFCC, Congrats to all:yeah::yeah:

I would have done the same as you and tried to get more IV access. No, I did not catch the contraindication, but we learn something everyday. :chuckle

I understand you needed more IV access for your patient, but why was the Dr. upset??

Kati2005, I hear HFH has great orientation program also. Did you feel they did a good job with orientation to SICU?

I know they still use contract nurses at the DMC. I would like to do agency nursing for a change of scenery also.

I will keep my regular job and use the agency for supplemental income only. I know nurses who contract with agencies and have full benefits. This is a good way to go because the nurses will contract with a hospital for a certain number of days and the hospital has to use them or they are cancelled with pay. A con is that you will not be able to get the continuing education that a regular job will offer you such BLS ACLS or telemetry classes.

There is an agency Critical Resource Inc. that pays 42.00 /hr. They are located in Brighton but you can fax all your info to them. I am thinking of going per diem with them to make extra money. I am in the process of looking for other agencies also.

I have never been able to get a handle on "Nursing Time Management" I have searched books that specifically address this subject and have not found one yet , or I have very generic information . To be brutally honest after 3 yrs of being a Rn, I am still overwhelmed at times. If I can begin a shift where everyone is fine and I can finish assessments , vitals signs and charting in a timely matter it would be great. Most days this does not happen.

I agree with you. :lol2:They don't pay me enough for this job:lol2:

This is what I did I gave the morphine and pt was sedated resps decreased from 30's to low 20's. It was ordered q 1 hr prn. I know the goal is to maintain comfort but I did not want to be the one to speed up her impending death. I assume terminal weaning wwill be discussed very soon.