GYPSY1349

amen to that!!!:heartbeat:up:

for "travel nursing" your experience needs to be within that year (in any specialty in a hospital setting):heartbeat..however, there are traveling home health jobs in quite a few areas, and it is huge in california.

[color=sienna]i have a garmin street pilot that i got two years ago...it's wonderful, and has never gotten me lost...which is more than i can say for my sense of direction!

ok now...take a deep breath!!! congrats on making a great decision...you'll be amazed at how much you already know having worked as an lpn. many of us also had families and obligations that appeared overwhelming while going through school. and there are a lot of us who also were lpn's when we decided to take the plunge and become rn's. if nursing is the profession you love, whatever it takes to get where you want to be will lbe worth it! when things get tough, repeat after me...."this too shall pass!!" blessings to you, you can do it! :redbeathe

That only works if you are not the one in PAIN. Remember...Pain is subjective. It is not our job to decide who or who is not a "drug seeker." Our job is to DO our job, with compassion and professionalism. :redbeathe

Absolutely! I LOVE nursing, and always have since my first day in nursing school, some decades ago...But once I got out of the "hospital rat race" and went into Home Health, I finally felt as if I'd found home. For all the reasons you mention, and many more, I'll never leave Home Health. :redbeathe

The only Palm software I use is the Davis Drug Guide...use it all the time. And, yes, I do use a GPS..as I'm "directionally challenged!" LOL... I have a Garmin Street Pilot, which I love. It does not have to be permanently mounted, so I can take it off, pop it into my glove compartment when I'm in a less than upscale neighborhood. I sure wasted a lot of time trying to read maps before I got it...and will never be without one again!:redbeathe

Actually, there are HH nurses that just do visits...to different patients most of the time, without doing Case Management. Some agencies have specific Case Managers for a certain group of patients, some by zip codes, some by specialties (i.e. Cardiac, IV..etc) So, for most, there is a difference, not only in the work required, but in the pay.:heartbeat

[color=sienna]hey candida...come on back to the travel work any time...the water is great! hugs, jesse:redbeathe

you have an interesting, though skewed perception of travel nursing...and maybe it comes from being in management, although i'm sure you haven't always been a manager. were it not for travel nurses, many hospitals in this country would be forced to shut down. one of the reasons so many thousands have chosen to travel, is precisely, because they were tired of the exact attitude you express in your post. i have been a travel nurse for over a decade, and have traveled from one end of this country to this other. prior to becoming a traveler, i worked in a hospital setting as a loyal, tried and true employee...i worked my way up to a position as director of clinical services, in charge of all licensed personnel in the facility. not only did my hospital use travelers, we treated them so well, that the same ones are still returning year after year after all this time. it takes a very special type of individual to make it in this field, and it goes beyond what is taught in nursing school. the saddest thing for me, after a lifetime of commitment to my profession, is that we are still in the dark ages, when it comes to supporting each other. your post proves this unequivocally.

[color=darkslategray]traveling as a nurse can be an awesome experience, or a failure...it really depends on your attitude. yes, there are high paying positions, particularly in california, and if your housing and insurance are free, your mileage reimbursement fair, and your hours are guaranteed, then you can make a very nice living. however, that being said, you have to approach each job with the right attitude. you must be willing to really be of help to the facility and flexible in what you are willing to do. you must also be firm in declining to float to areas where you are not trained or feel comfortable with the level of care required. ...and then there's the attitude of knowing how to negotiate your contracts, so that both you and the agency make a decent return for your efforts. yes, there are less than "happy" assignments, but then there are also a zillion opportunities for learning and seeing this beautiful country of ours with fresh eyes, and finding out just what we're made of. i've traveled for many years now, from one end of the country to the other. successful travelers never stop learning from each other, and sharing our expertise. each assignment can be an adventure or a failure. i truly believe it is all up to you, and how much time and effort you are willing to invest in searching for that "good fit" in an assignment and location, then going in with eyes wide open, and an attitude of "bring it on!" happy travels!:heartbeat

unfortunately, for some agencies, even some considered "reputable," the $$$ is the bottom line, and stuff like this happens, way too often, in my humble opinion. however, fortunately, there are reputable companies that allow their case managers to decide if a patient is appropriate, either for an admission, or for discharge. we all make our choices, to speak up or stay quiet, and for very different reasons. it's a matter of what you can live with, i suppose. but i'd rather take the high road, whatever the cost. :redpinkhe

if there is no skilled nursing need, then the nursing assisance cannot stay, as aides must be supervised by an rn every two weeks per medicare regs. the patient's blood pressure is controlled by her meds, and you cannot change the sciatica and back pain, except to provide teaching on her pain meds, repositioning, etc. which i'm sure has already been done many times. probably pt has also worked with her...nothing left to do...she needs to be discharged. :redpinkhe

too funny! i'm a vna nurse myself, in northern california, and often go to homes that literally do not have a place for me to sit...i've got the getting down and back up off the floor routine down pat! where there's a will, there is a way..sometimes we just have to be creative!

ambiguity is part and parcel of being human...sometimes we just have to make ourselves get out of the rut. remember that bad situations are always a possibility, wherever you travel. the only choices we have are what we make for ourselves, especially in how we let others treat us, and how we respond to situations. everything that happens, we allow to happen. with that in mind, resume your career when you're ready and make better choices. hawaii is a wonderful place, and i'm sure the change of scenery will do wonders for your mental health...just remember..you are in charge of how you feel and respond to the nonsense we deal with every day, and not just at work, and like you said...this too shall pass! (it's my personal mantra, as my loved ones will tell you!) blessings and prayers for your quick recovery!:typing

take your time to recover...and when you're ready, take the plunge! if you've thought about it for years, and have a little courage, traveling could just be the one decision to revitalize your life and the love of your career. one very good thing about being a traveler, is that if you don't like the place, you only have 13 weeks to put up with it! good luck, hang in there..."occupational stress" is more common than you might think...and we've all been there with you before!:redpinkhe

as a long term traveler, i'll be glad to help in any way i can. do you have some specific questions or concerns? :redpinkhe

Did you mean this for the person who originally posted?

i have a very close friend, and know of several others, who have been doing this for years. however, they do not work for travel agencies. what they have done is signed on to work the prn pool at various hospitals, and the rates vary from $60.00 to $70.00 per hr, depending on the specialty. some have secured their own apartments, some stay at "extended stay" type hotel/motels and some have gotten an apartment that they share with one or two others nurses who do the same kind of perdiem work. as others mentioned, they are responsible for their own health insurance, and travel expenses, living expenses, etc. but given the rates, it offers them the opportunity to return home for several weeks each months, and so far it seems to have worked out to their benefit. my best friend is in her third year of working this way, and loves it. hope this helps.

patty, it sounds like you just haven't found your "niche" yet...be gentle and kind to yourself...you really haven't been a nurse for so long that you could feel completely comfortable in any setting. i know that changing areas seems like it might make things better, and sometimes it does, however, keep in mind that the er requires being able to manage a wide variety of patients and conditions, and often very quickly, as in life and death situations. if you truly feel you are ready for a change, go for it...but as the saying goes, don't jump from the frying pan into the fire! god bless and good luck with whatever decision you make. sometimes we just have to take a leap of faith, and go for it...other times, it's best to really consider our skills and our needs for a little while, so that we can make the very best decisions for ourselves. :heartbeat:heartbeat

congratulations on taking the step out of the hospital setting and into home health...i hope it will be as rewarding as it has been for me. in home health, you will have the experience of being in the patient's home, and truly, without rushing, be in a position to fully evaluate their needs and concerns. the opportunity to actually spend the time teaching the patient to improve or learn to cope with their health status can be priceless. you will learn to prioritize and assess in a way often not possible in the busy hospital setting. yes, you will be on your own, and that is scary at first...so stay calm and focused. you only have that one patient at a time, and you have all the time, in fact, often weeks and weeks to get your desired outcome. make a good plan of care, or follow the plan started by the admitting nurse...adjust it as you go along to meet the patient's needs, and you will do fine! as for case management, get comfortable with your one on one visits first..figure out what works for you and your patients before you take that leap. with individual visits, you are only responsible for that one patient, at that specific visit. in case management, you will be responsible for the outcomes of a group of patients, regardless of whether you have seen them recently or not...so in a sense, you will also be monitoring what all the other nurses do during their visits, through chart reviews, getting report from them, following up, etc..it's a much larger concept, and you'll want to be completely comfortable in your skills before you tackle it...but the good news is that it is doable. take your time, enjoy the experience...it's not for everyone, but with the right attitude and the commitment to provide the very best care you can, one patient at a time, you will do just fine! good luck and blessings to you!:icon_hug:

could you be a little more specific? thanks.

Hi to you Sis! Glad to see you here again! xoxoxooJess:w00t:

there are a couple of issues going on here. first, if this is a medicare patient, medicare requires (legally) that there be a "willing and able caregiver" available to help coordinate and manage the patient's plan of care. have you tried contacting this patient's mother or other relative? additionally, you and your agency are not obligated to continue care on a non-compliant patient. to do so, places your license and your agency's accreditation in jeopardy. your first line of defense is to speak with your clinical nurse manager about the issues of lack of caregiver, and the patient's non-compliance, risks he faces, etc. concurrently, you should contact the patient's physician immediately, and make sure you speak to the doctor's assistant (nurse), not the receptionist, and clearly outline the problems you are encountering, which place the patient at risk. there are, unfortunately, many agencies that will accept any patient, and keep them on the books endlessly, while no real nursing skill is being performed. there has to be documented nursing skills for each visit, other than routine vital signs, for legal medicare or private insurance reimbursement. i would address these issues with your nurse manager as well. in my opinion, having worked home health as a case manager for many years, this patient is ready for discharge, as he is non-compliant with the plan of treatment.

I've done quite a few assignments with Cross Country, among others, and have not had any issues with them. My pay has always been correct and on time, my housing excellent, and the choice of locations large enough for me to go just about anywhere.