lashuna1028

The agency I work for delivers medications for a 2 week supply so pt will get exactly enough for 2 weeks. If he is running out early than I would inquire why. If he is saying he needs to take more to relieve pain then the pain medication regimen needs to be changed immediately. Get with hospice doctor and come up with a medication that will work for him. Dont assume, dont get yourself mixed into the patients personal affairs. Just stick to the nursing.

In LTC facilities you have to follow policies and procedure for that facility. If the facility requires an order for their residents to smoke than you have to follow their policy. Hospice or not. It is different with home hospice patients. If a patient is on hospice you are supposed to report any change of condition to Hospice so the hospice case manager can come and assess. IE no urine output your whole shift should have been reported to Hospice nurse.

No, its your choice to work on call as a case manager UNLESS you agreed to it when you were first hired. You can simply tell them you can't. They would have to hire a PRN nurse.

This is my first home health job. Well I was actually hired to be their Hospice case manager but they have me helping with home health patients since hospice census is low. And I really dont mind BUT I was not formally trained to do home health and was told nursing is nursing.. While that is true the philosophy of home health is different and also the documentation. So I ask because it seems as though most of their patients do not have a need of skilled nursing that I can identify. Some of their patients have been on service for at least 2 episodes or more yet the SOC or 485 have not been completed so I would go in blind of what patient needs. Seems like they have a lot of Abnormality of gait, DM II, type patients where the visit seems redundant and pointless to me. So I dont know, I dont like it. I dont feel like I've made a change with HH patients. I feel like Im missing something mentally with the whole concept and trying to figure it out on my own.. I only have one direct patient care wound care patient so far that requires a wound vac.. Another problem is, someone else in the office does all the assigning for the patients and they switch nurses around all the time for the same patient every week. I dont like that. As a hospice nurse, I am used to being with a patient from beginning to end.

Honest answers pls. On average how long do you spend in each home? Im not talking about when there is a need like wound care or something serious going on that need your direct care. Im talking about the visits where it seems like all you do is check their vital signs and fill their med case for the week and after thinking and finding something to "educate" on ??

What are some other ways I can write Pt or PCG understands teaching besides "understanding verbalized/voiced"?

I found a job! Started working 2 weeks ago at a skilled nursing facility! I am leaving this comment because I remember feeling like I was the only RN in Texas with my issue and no one was able to guide me. If anyone is in a similar situation please feel free to PM me. I will say this, when I started making finding a job my full time job, getting up and dressed like I was going on interview, calling places in area first before going there to see if they were hiring and filling out applications.. it didnt take long at all to find this job... ANYONE in a situation like mine online applications WILL NOT WORK, you have to go out and show your face. Don't mention anything about stips to HR or anyone else but the Director of NUrsing (the person that will be signing your stip papers) which is usually the one interviewing you. Be upfront and direct (the hardest part) before you even start the interview. Something like " Before we proceed, I need to be upfront and tell you that I have stipulations for x amount of time with board of nursing for x" and ask if he/she would be willing to work with you. Sell yourself, be genuine about your mistakes, and show your passion for nursing. Please PM if any questions

Getting frustrated now, Texas Board gave my license but with stipulations for 1 year due to criminal background. Not to get much into details of my charges but they both deal with domestic violence from being in an abusive relationship. 2009- Deferred adjudication for disorderly conduct and 2011- Deferred adjudication for assault to family member. There's nothing else on my background except for these two. These charges are listed publicly on my license for the one year, but I have to be working as a nurse before the 1 year starts. I CANT FIND A JOB, I have been applying any and every where. I recently updated my resume to include getting my ACLS certification and also I am starting UTA's RN- BSN program this year. I need help, how can I move forward with my nursing career if no one will hire me because of my background?? Where are some types of facilities that may hire me??? Any advice or suggestions are greatly appreciated

Yes it did help, so I will apply anyway even though it says "unrestricted license" and just explain if they ask. Thanks

ok, i know this may sound like a dumb question but i just want to make sure if the terms are the same. i have stipulations due to a criminal charge of assault to family member and the stipulations are to provide direct patient care in nursing home, hospital or any clinical setting, work at least 64 hours per month and work where there is at least another rn on facility grounds. i can still perform all rn duties within the scope of a rn so would this be considered a "restricted" license? on some job qualifications it states [color=#454442]full unrestricted licensure required so does that mean anyone with any type of stipulation is excluded?

Ok, thanks for the advice, now I just need to come up with a speech to present the information without being too detailed about it

I know its quite odd to do such because I am trying to sell myself on a cover letter but I was advised to just be upfront and disclose it which also gives the opportunity to sell regardless of the blemish. My background and the stipulations placed is due to the domestic violence relationship I was in. Does anyone else think this is a good idea? At least I'll know if I am interviewed after disclosing it wont be that I didn't get the job because of it, or else I wouldn't have gotten the interview anyway. They're going to find out anyway and it's so much easier for me to write about it then to talk about it in an interview. Any other advice or suggestions will be greatly appreciated.

True and again with that being said does it also tell you if that medication is expired or contaminated? That pill could be 2 years old or even coated with cyanide or lead poison. Isnt the quality of the drug also important? If these are not legalities then maybe its ethics. I work with Alzheimer's patients so I am even more of a patient advocate... maybe I am being a little over protective??

Well being able to identify the drug is not the only point here, even if I could identify the pill (which most of them I can) that still doesnt validate its expiration date or contamination, especially with capsules which can be opened. I like to be able to open my pills out of the package or bottle it came in. Thats just like giving a prefilled syringe to someone with a written label another nurse put on it for you. If I didnt draw it up out of the bottle it came from, I'm not giving it. Its not that Im so suspicious of foul play but this should be standard nursing care. And Im not saying its not okay to use your home meds because I know people are on a fixed income and etc but whats not okay is to just hand me some lose pills in a sandwich bag or cassette and say give this to my father at this time. For those that want to use their home medicines they should be required to have them still in the prescription bottle or OTC bottle

Ok, for the nurses working in long term care and assisted living facilities you may have run across this issue. We have a respite client admitted from home that will be staying with us for a few days. I have orders from MD in the chart for his meds but the family brings all of his meds already prefilled in those home cassettees (you know the ones with the days of the week on them) UNLABELED. No prescription pill bottles or even OTC bottles for that matter...just these cassettes...And whats even more surprising is the director of nursing here, RN BSN knows about this and these pills were actually written on the MAR for us to give. The morning nurse has been giving them and has been signing them out on the MAR but I am the only one that seems to have a problem with this. I am NOT giving these pills to this man and I am going to sign them as NOT given! I dont know what they are and even if I could identify some of the pills I still dont know if they are contaminated or expired! I need input from other nurses regarding this. I would like backup on my decision and even where I could find where it talks about this somewhere in Nursing Practice Act as a resource. Thanks