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kwagner_51

kwagner_51

Geriatrics, Pediatrics, Home Health
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kwagner_51 specializes in Geriatrics, Pediatrics, Home Health.

I'm Married and have 4 children ages 16, girl, 12, 10, 7 boys

kwagner_51's Latest Activity

  1. kwagner_51

    Director of Nursing Home Health Agency! HELP!

    I came on here looking for advice. I didn't ask to be judged and left wanting in other nurses eyes. 1.) I have met the OWNER and he is very comfortable with me taking the position as DON 2.) He is willing to TEACH me and so is the Administrator. I have met the nurses in the field and they are very well versed on OASIS. 3.) I wanted information on what to study so that I would have a leg up when I take over. 4.) The requirements for the DON position are: At least 2 yrs experience as an RN, one of which must be in HH. Willingness to LEARN and take some of the pressure off the Adm. I have been an RN for almost 3 yrs and have worked in HH for over a yr. 5.) I will also keep my other job and will be working 7 days a week caring for pts and working as DON. 6.) I asked for help, so I can provide the best care I am able to. Instead I have been told that I have no business taking this position. I didn't ask if I was qualified for the job, I already KNOW i am. I wanted to share in my good news about the position. Instead, I have been told that the employees will hate me and that I should quit before I even start. :argue:
  2. kwagner_51

    Director of Nursing Home Health Agency! HELP!

    Hi nurseby07, I have been in HH for over a yr. I also did home visits with children r/t Head Start for a year. so I have over 2 yrs collective experience. I don't have experience with OASIS but as far as being in compliance with Fed rules I had to get an entire program within Federal requirements within 6 weeks. It was so far behind and had papers missing when I took over. The program passed with no problems or errors.
  3. I took a p/t DON job in HH. Does anyone have any suggestions about what I will be doing? I will start on Oct 13,2008 Some of the things I was told at my interview were: OASIS Hiring P & P Supervised Visits State regs Really need some input from Nurses who have been there and done that. Thanks!!
  4. kwagner_51

    Are 15 Minute Visits Possible?

    I have one pt that is stable. I go in give his meds, give his eye gtts and take his BP. I am there about 15 min. I wouldn't be there that long but I have to wait 10 min between eye gtts. Hope this is helpful!
  5. kwagner_51

    Tobramycin

    I had to give this to my 19 y/o pt yesterday in his nebulizer. I checked the box and the orders. Orderes were 2ml per neb. The box is labeled for injection!! This guy can't talk and has no way to tell us if he has ringing in the ears, etc. I need to know if this is common? Can the injectable solution be given in a neb treatment? I looked it up in my davis guide but am still confused. FYI he does NOT have CF he does have pneumonia LLL. Thanks!!
  6. kwagner_51

    OB clinical...long lament

    Hi there, I also didn't get to see a birth. However, I was able to shadow and did get to see a vaginal birth and a c-section. I cried like a baby on both. The shadowing report didn't count toward my grade because the rotation was over, but it was worth it to me to see it!! See if you can shadow. Good luck!!
  7. kwagner_51

    Loved my first week as a private duty nurse!

    :redbeathe I told my dh and kids that HH et private duty are the BEST kept secrets in nursing!! I have been doing private duty for almost a year now. I LOVE it and am not looking for anythin else!!
  8. kwagner_51

    Nursing Concerns/Advice

    He can't talk and may have the reasoning ability of a 3 y/o. I found this site and copied the picture and info for her, but I can't make her order it. I wish I had the $$$ to buy it. http://www.acidrefluxpillow.com/PTPDesign/toddler.html He stands about 3'9" and his legs are crossed most of the time. He weights about 70 lbs. He can't walk but can scoot on his butt.
  9. kwagner_51

    Nursing Concerns/Advice

    I am working HH and desperately need some advice. I care for a 19 y/o male pt. He has a G-Tube and a Trache. He is not on a vent and is mobile. I care for 2 other pts with g-tubes. Neither of them has the problems the 1st pt has. He is constantly getting pneumonia. Here is the problem: I was caring for one pt and was thinking about the 19 y/o. Comparing the similarities, ie G-Tube, resp fail, etc. It hit me like a ton of bricks. I almost puked when I realized why he was getting pneumonia constantly. Since Dec. he has had pneumonia no less than 6x. He spent a week at Riley Hospital. He came off the atb last week and this week Monday he had a fever. Tuesday he was dx with pneumonia again!!! When I took over the case in Dec. the nurse before me had him lay down to give his bolus feedings. I was concerned about that given that he has a G-tube. I had him sit up to feed him. He has 1000 ml of feeding running at noc while he is sleeping. I have put him to bed and hooked the feeding up to the pump and his g-tube and let it run. Here is the problem: HE IS NOT ELEVATED!! He sleeps on his side and has an almost flat pilow under his head. I immediately called his Mom and explained that he needed to be elevated at least 30 degrees while he was eating. She took my concerns to his dr. and the dr pretty much laughed and said good luck trying to keep him elevated!!! :angryfire I took my concerns to my boss and asked if I needed to write an incident report. She looked at me like I was crazy and said the family had been doing this for years. Therefore, I wasn't responsible for the pneumonia. :angryfire I don't feel like I am being a good advocate. Do I need to talk to the dr? I honestly believe that if we could get him elevated he wouldn't get pneumonia as often. Please give me advice. Am I rght to be concerned? Am I wrong for not writing up a report? Thanks!!
  10. kwagner_51

    private duty nursing??

    I have been in private duty nursing for almost a year now. I ABSOLUTELY love it!! I am losing one pt due to family [ hers] issues. The POA is bi-polar and refuses to medicate self. She watches us with a camera in the room and tells us how to do our job. [Literally, instructed me on how to give a fleet's enema. You know, left lateral position etc :angryfire :angryfire ] I care for two young males. One is 19 and has trisomy 9 the other is 14 and has trisomy 8. I have very little spare time for reading etc. The 19 y/o will sleep and he likes basketball. When I work nocs I put him to bed. The 14 y/o likes pro wrestling. His fave is "Undertaker". I am supposed to do all the moves that his rivals do. Of course I don't do anything dangerous. We have so much fun. Last Sunday we walked outside and I introduced him to trees. Unknown to me, he is afraid of trees. we will work to overcome that fear. I actually got him to touch the trees and to stand under them so he could see how tall they are. As far as losing skills, I think that I have gained skills. The 19 y/o has a new HHN that has two machines. One is the regular HHN machine. The other one hooks into the first machine and delivers 10 lbs of pressure to force the medication into his lungs. It attaches straight to his trache. He also has something called a percussion vest that he wears while he is getting the neb tx. It precusses his lungs to help prevent pneumonia. I don't think I will be leaving any time soon!! :heartbeat :heartbeat :redbeathe
  11. kwagner_51

    Is it ever okay to quit a nursing job without notice?

    My first nursing job was at our local hospital. I was hired in July. Learned alot but was in a managers meeting in Sept with a laundry list of 'crimes' against me. Stupid things like, Doesn't know how to assess for a subdural bleed. [i had just graduated] Uniforms are not ironed, isn't able to take pts on her own yet.[i hadn't passed boards yet and hadn't been through their nurse training either]. Said that "When I am a nurse I won't have to answer call lights". [seeing as how I had never worked anywhere in the medical field before, answering call lights relieved the boredom.] And my all time favorite reason: DRUMROLL: I BRAGGED About passing NCLEX!!! I was telling everyone that I had passed and that I was now a nurse. I was happy! I was fired after 89 days and 6 days after passing NCLEX!I was never trained at the hospital to be a nurse. It has been over 2 yrs and I still can't get hired back. I finally decided that I DON"T want to work for them. I walked out after my last shift a year ago. I was the only RN in the building,. I had 2 LPN's, 2 QMA's and 3 CNA's working. I had to cover the QMA's and had a death on my unit that night. Even though I quit w/o notice, they still called and asked me to come in.
  12. kwagner_51

    Clonidine prescribed for pt

    Trisomy 9 is an extemely rare chromosone disorder. He is not verbal but can "talk" For example, his bottom is raw from severe diarrhea. I put Riley's Butt Cream on it today and he squirmed all over the floor. I know that it hurt him. As far as being in pain, I don't think he is. Can you list some of the the off label uses fopr clonidide? Thanks!!
  13. kwagner_51

    Clonidine prescribed for pt

    That's ok. I just remembered something. This is a new order but he is also taking predinsone [N. O.] and he started to scratch nurses and Mom and pull their hair. They were giving him 4 tsp QD Mom told them no more because he was shaking so bad and was extremely aggetated. They cut it back to 2 tsp QD and we are slowly weaning him off of the prednisone. Here are his discharge diagnosies: tracheitis Influenza B Severe Actelectis yeast infection Does this info help any? Thanks!
  14. kwagner_51

    Clonidine prescribed for pt

    Hi, Y'all, I need some serious advice. My pt is 19 y/o and weights about 70#. He has Trisomy 9 very rare. Anyway he came home today from the hospital and has an order for clonidine 0.1 mg 3 x a day as needed. I didn't know what that med was and didn't have my med book with me. I don't have his baseline B/P so I don't know if he is hypertensive. I read that even 0.1mg is considered toxic in children under 12 y/o. I know that he is 19 but I don't know what they base the age on. Is it weight or organ growth? I need to know ASAP> If it is dangerous for him to take it, I will call his mom and tell her so. Thanks and eagerly waiting for wise answers.
  15. kwagner_51

    Advice needed r/t job

    Hi y'all, I have a question and would like your help sorting it out. Here is the situation: I work in home health, doing shift work. Pt 1 is constantly getting sick with pneumonia and strep throat. He is very hand fixated and has scratched/clawed my hands, to the point that I have bled. [it is not done on purpose.] Pt 2 has severely diminished lung capacity and has requested that if I am sick to please not come to her house. I was with pt 1 two weeks ago when he got sick again. Monday and Tuesday of this week I was sick. I was running a fever and felt like I had a URI. I no longer have a fever but do have a deep cough. I was asked if I wanted to work with pt 2 this Friday for 8 hrs and then work pt 1 for 4 hrs. I was going to do it. I need the $$$ due to the fact that I didn't work my 12 hr on Tuesday. While I was at pt 1's house last noc, I realized that I couldn't work at pt 2's house d/t the possiblity that 1. I have a cough and think it might be r/t the fever and 2. I might carry something from pt 1 to pt 2 or vice versa. I called my boss and tried to explain it to her, but she said I couldn't let that stop me. After all, nurses care for sick people in hospitals going from one to another. I do NOT think it is the same thing. For one, pt 2 is in her home environment and has asked me not to come in sick. PERIOD!! My boss pointed out that she has 24 hr care and that any one of the care givers could make her sick. I understand that point. However, if a pt requests that we not come in sick, shouldn't we listen?? What are the chances of me carrying pt 1's illness's to pt 2? Please give me some advice!! Am I being stupid? Thanks!!
  16. kwagner_51

    Help!!!

    When I took NCLEX, I didn't take a review course. I used Saunders book et CD and Mosby's online tests for the NCLEX. I passed the first time. A friend of mine took the review class and failed NCLEX the first time she took it. Another friend failed 2 xs. He got ALL 265 questions every time. He passed on the 3rd attempt. Good luck!!
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