S.N. Visit

If the client has been discharged due to being in the hospital or away on vacation and we pick them back up to readmit during a cert period, then we use the new SOC date because it's a completely new episode, but we don't change our SOC for routine recert's. Instead we use a "Follow Up/ Resumption of Care date" as the date we actually assess our patient for recertification (within 48hrs of order)then our SOC remains unchanged. I imagine you are now using the SOC date as day order is received, so tracking those pesky important dates are easier to be within compliance for CMS but it confuses me to why you'd use a new SOC date if you are doing that on all recerts. Hope that made sense and answered your question.

I can only speak from my experience. I hire LPN's & brand new RN's to perform less critical types of cases, for example: simple wound dressing changes, Foley Cath's, or to set up routine medications. I leave the complex cases & management to experienced R.N's.

Care Scout, is my favorite other Insurance company. Paperwork is a breeze in compared to Senior Bridge.

I just bought into a Home Health Care Franchise as non skilled at this time. All in all, I think you are looking to start with about $125,000 to get started through the first year. The banks, and SBA are being very tight at this time with lending, as there is no collateral in a home health agency. Just lots of blue sky.

I have severe allergies as well and take 3 rx strength antihistamines daily (optical, nasal and by mouth). Benadryl and other OTC antihistamines are useless to my reactions, so I understand completely about having to take a ton of antihistamines. I am sympathetic to you, however it was your first day, I would have went to work unless I was going into anaphylaxis or mentally impaired from the antihistamines. To answer your question, I'd go to the supervisor but keep in mind that if she or he has never experienced a severe allergic reaction, he/she may also belittle your decision to call in sick. I'd bring a note from my allergist. Best of luck with your new job!

I'm on a new path too, sort of.. My current employer (HHA) is shutting the doors this friday. I'm going to give it a go and start my own. Best of luck to you!

Too much to post here and not enough time to list my reasons I feel they hated me. I agree the above examples weren't the best to use. Maybe they didn't "Hate Me", instead they really disliked me intensely. I had nearly 2years experience with them to know. Those two quotes were actually the nicest things they ever said to me.

:lol2: This makes me chuckle!!

I cannot deal with vomit either! It grosses me out to no end. Luckily to date, I have not had to clean it up in my short nursing career. I started as an RN in inpatient psych (all patients physically stable) and now I am a Case Manager, RN in Home Health . I spend minimal time with the patients compared to the LPN's and CNA/HHA's. My point is, maybe you should stay in nursing but find a different area to work in.

RN's in Iowa most definately pull PICC lines. Additional training comes into place when an RN "places" a PICC line according to policies of workplace/BON.

Maybe she became an LPN?

Oh Yes, I had two med surg clinical instructors absolutely hate me. To this day, I still don't know why. I sucked it up, did everything they asked and passed. Biting my tongue during the last face to face evaluation with the two who hated me was the hardest thing to get through. I was told by one "I feel that I failed you from becoming a good nurse & you are narrow minded." My second CI told me that "if I go into mental health after graduation instead of Med surg, I would be throwing away everything I learned and I wasted 2 yrs of her time. " They made my clinical days hell, but i survived. I am however thankful that the majority of my instructors did like me. My point is you are not alone. Hang in there. Do what you have to do to be a survivor.

I also work home health, so I will reschedule as well.

Nurse, mother and 7th & 8th grade certified Cheer-leading coach.:anpom: It really depends on the day which occupation I prefer. The pay & my mental sanity is so much better being a nurse.

Studies have shown that artificial nails, as well as chipped nail polish, possess a greater amount of gram negative bacteria and pathogens than natural nails. The grooves and rough areas create a perfect space for bacteria to reside.

I'm not sure what to think about this...I'd rather have a publicly advertised site to check out a physician, surgeon, or dentist rather than a nurse. * Note my sarcasm* Since everyone is now encouraged to check out nurses, how about adding on to the site to check out a police officer, teacher, real estate agent, clergy, child care provider, plumber, cosmetologist , architect, bus driver and a pilot too?

In addition to the heavy transfers, I think the OP is also meaning she hasn't been orientated to the CNA's usual routine. Such as the CNA's will know where the shower heads are kept, but the nurse may not if they don't use them often. Maybe the CNA gets the fridge temps, but the nurse may not know what time or where the chart is kept. Maybe their computer charting is different. Maybe the CNA's know where to put laundry after hours, but the nurse does not. Maybe all the CNA's know to check the blood glucose machine q night at midnight, but the nurse might not. It would be easy for the CNA to remember to change batteries on the Hoyer lift, but the nurse might not. I have been in that situation as an RN working covering a CNA. When you don't do something often it would certainly be nice to be trained or at least have a list of what needs to be done.

I do! Case Manager in HHC...Love my Hours & schedule flexibility, type of work, co workers and patients.

I'm only on my 3rd class, but so far so good. I take 1 class every 8 weeks. Yes, they accept Federal funding. They only offer the FNP program or MSN-Nurse education program right now, so if you want to go into mental health NP you will have to get certified later et elsewhere . I think Allen college in Waterloo Iowa has online RN-Mental Health Nurse practitioner. I think after the year 2015 (at least in Iowa), you have to earn a doctorate to become NP. I'd keep checking around until you find the school that fits your needs and affordability. It took me 6 months of searching until I decided on Graceland (In state tuition).. Good luck finding your program. :)

I'm an ADN nurse . There is a need for Mental Health but lack of providers in my area so it is a consideration.

I did a quick google search and came across this site : Psychiatric / Mental Health Nurse Practitioner / CNS Program Directory Looks like there are several programs . Btw, I am doing RN-MSN (FNP) through Graceland College in Lamoni Iowa, all online except a 4 day mandatory seminar next spring.

I've seen a lot of Sonata given .

I found nursing school to be very challenging because I had other responsibilities and conflicts going on like raising 3 young kids, building a new house, and work. I think it all depends on where you are at in life and where you go to school if it's challenging or not. I was in an ADN program. We had 6-12 page APA disease process papers, NANDA care plan diagrams and a list of our patients meds (dosage, usage, side effects, interactions, classifications) listed on index cards that had to be hand written out before each clinical. Many of nights I was up until 0200-0300hrs.. It was challenging to keep up on house work, study for tests, shop, run kids around, prepare dinners, lunches, take the dog for a walk, pay bills, work, live life and get the clinical work done on time. There were not enough hours in the day for a 8hr a night sleep or leisure time with my family. Fast forward to today, My RN-MSN program is much less time consuming and far less stressful ( maybe due to my kids being more independent, my house is built and no clinical or redundant papers at this moment. ) I agree that everyone does have their strong points, however if you have a lot going on in your life, nursing school can be challenging. Best of luck to the OP in your endeavors!

I was taught in nursing school, after removing the EMLA cream, to use Povidone-Iodine first in a circular motion from inner to outer using 3 circles, then use alcohol prep to remove the Iodine in same manner. Recently I went to a con-ed class, and they told us to first use alcohol & scrub back and forth , zig zag and criss cross over the port. Then use the Povidone- Iodine in the same criss cross zig zag motion not removing the Iodine before inserting Huber needle. This has me wondering, how everyone else is doing their port access when chlorhexidine or chloraprep is not included in the kit?

These are the kinds of questions you will have on the NCLEX. Don't over analyze..Try a Saunders book...