jbudrick

Hello Raine: Pay per visit can be beneficial as long as your patients keep their appointments and the visits go quickly, without excessive driving. When you get the patient who is not home for the visit or has time consuming needs, you lose. At the agency where I work full-time RNs are salaried and have a productivity requirement and full benefits. If productivity is under the nurse can use PTO or in some cases administrative time. If their productivity is over, they get paid per point. Per diem nurses ask for start of cares or the number of visits and risk not making money. We usually have lots of work and "fall-out" visits are quickly replaced. Rarely the per diem goes home empty handed. Best wishes, Budcoupon

At my agency, full and part time nurses receive the same pay rate including orientation. Per diem nurses receive a daily flat rate for orientation and are paid per visit. A lower orientation rate of pay sounds fishy to me....

Hello AI RN, Why Choose Home Care Nursing? The first year in home care can be challenging—just like any nursing specialty, there's a steep learning curve. But with time, you'll gain confidence, speed, and mastery in your role. And the rewards are well worth it. Here are some of the key benefits of being a home care nurse: Focused Care: You care for one patient and family at a time, allowing you to give your full attention without the distractions and conflicting priorities common in other settings. Autonomy and Control: You have the ability to structure your day and spend the time you feel is appropriate with each patient—within clinical guidelines. This flexibility empowers you to deliver truly personalized care. Community-Based Practice: Instead of being confined to a hospital or facility, you work in the community, often in patients' homes. This setting offers a more personal and holistic view of your patients' lives. Efficiency and Routine: With experience, tasks like documentation and infection control become second nature. Even the OASIS assessment—yes, all 179 questions—will feel manageable and familiar. Flexible Scheduling: You can often arrange your visits around personal appointments and activities. As long as your work is completed, your time is your own to manage. Meaningful Impact: Home care gives you the chance to make a real difference. While not every situation is ideal, the moments when you truly help a patient or family are deeply fulfilling. Best regards, Jbudrick

I am over 65 working as a Clinical Nurse Manager and Educator in home care. I see other mature nurses working in Performance Improvement. We even have some mature nurses in the field seeing patients.

The interesting thing about reducing the isolation time where I work has been that nurses are often still too sick to come into work.

Hello Artsmom, It is interesting to ask what the patient expects from the home care nurse. Oftentimes, it is not a service that our agency provides. Some patients judge a nurse by what is done for the patient in a concrete, physical way. Some patients don't see the value in education and assessment. They don't want to hear about things they can do for themselves to improve their health. They want you to do it for them. Home care is not for everyone. Don't let a few unrealistic patients ruin your day. Keep up the good work. jbudrick

Twenty years ago I got my first job as an RN being a Case Manager in home care. After many years of nursing in different specialties and college degrees, I find myself back at the home care agency where I got my start. I am promoted to Clinical Manager/Educator. It is amazing to experience the evolution of my career.

I actually almost had to quit nursing school because I had to leave the house for clinicals at 6:30 a.m. The day care didn’t open until 7:00 a.m. I hired a girl working at the day care to come to my home and take my child to day care on clinical days. It worked out well. I had some impressive job offers. We decided we didn’t want live-in care. My first job as a floor nurse didn’t work out. They wanted me to work double shifts. I couldn’t do it due to child care. Somehow I made it through the day care years. I stayed home when my child was sick. Fortunately, it wasn’t often. Home care worked for me. I really wonder about the nursing profession as a whole. What other job expects every employee to be available 24/7? I know nurses who can only work weekends. Employers want them to be available to work full-time days for two weeks of orientation first. How do you arrange day care for that unless you have family? Some really creative ideas are needed to find an answer that works for each nurse. Best wishes as you begin your career. Diana

I am in Connecticut. Consider home care with a Medicare agency. You could be a case manager. My husband traveled when I was a new nurse, and day care was not available for hospital shifts. I got a job with a home care agency new graduate program. Twenty years later, I am precepting a new grad. My chance to pay it forward. Best wishes for your new career. jbudrick

I am certified by the Certification Board for Infection Prevention and Epidemiology. I am certified in Infection Control (CIC). As I am preparing for recertification, I have come across a CDC Train continuing education course for long term care infection prevention it is on line, 19.5 ceus and is free. I have completed Module 1 and it is a terrific course so far. You do get a certificate whether or not you choose to get the ceus.

Please keep in mind that when you are in a patient home there are no other medical professionals around to assist and collaborate with. Of course, even when others are around, it doesnt mean they will help you. Basic assessment skills, driving and map skills, patience and acceptance of choices that patients make are essential. You will spend lots of time calling doctors and RNs with reports and documenting. You will work in the uncontrolled environment of a patient's home. It is imperative that newly licensed nurses in home care receive a thorough training program. In my area LPNs usualy work in doctor offices, LTC or home care. All areas of nursing have good and bad aspects. The trick is finding what works for your personality, temperment, and family obligations. Best wishes as you start your career.

I work as a Wound, Ostomy, Continence nuse in home care. I find that many patients erroneously believe gloves have some kind of magical property that prevents germs. Many don't even wash their hands before or after wound, IV, or ostomy care because they believe gloves alone are enough. I use these opportunities to provide education about gloves not replacing hand hygiene. In fact, hand hygiene is superior to only glove use when providing self care. Patients see medical professionals always wearing gloves during procedures. As nurses we need to remember that patients don't necessarily know about infection control. It is an important nursing function to provide basic infection control teaching to every patient - most importantly, hand hygiene.

The knowledge you will gain from the educational program is valuable, even if you already have a wound care job. You will also make connections during classes, clinicals, and the WOCN society that will help you with your career. I am glad I did it and I plan to renew my certification. I attended Emory. Most of it was online and one week in person in Atlanta. I work for a major health system and was able to complete my clinical hours within my organization. I did have the option of clinical hours through Emory. I would definitely do the Emory program if I had a chance to do it over again.

Another problem with pets is that some pet owners don't vaccinate their pets. Imagine getting bit by a cute little dog that hasn't had its rabies vaccination. I know a couple of clinicians that has happened to. The agency I work for requires all pets to be put away for visits.

Professional Class is about the business side of WOCN practice. It covers models of Wound Specialty Practice and independent entrepreneurial opportunities. Bridge week is very beneficial for the WOCN. Students attend after completing their online modules, and get hands on lab practice and clinical experience that is very helpful for WOCN practice. You also have the opportunity to meet the instructors and your classmates from all over the country. You do get some clinical credit for attending. If you can't complete your clinical in your area, Emory will help you get clinical placement in Atlanta or nearby, but it is costly. I was fortunate that my employer has a contract to provide clinical experience with Emory and has several WOCNs on staff. I successfully completed all requirements in February, 2017. Best of luck in your pursuit of a WOCN credential. Diana

Hello Nurse Bulldog: Your question about Lymphedema Specialist has come up at the home care agency I work for. Keep in mind that my experience may not be typical of your agency or area of the country. Usually OTs are employed at Lymphedema Clinics. The problem is that if the patient has a wound, they want nursing to do the wound care. Patient's have difficulty getting to the lymphedema clinic, getting wound care done by the visiting nurse, and removing wraps that are applied at the clinic. Most of the wound nurses in my agency are not interested in doing Lymphedema in the home for several reasons. The home environment of many lymphedema patients makes the thought of spending a long visit unpleasant due to potentially unsanitary conditions. How and where will the patient be positioned while wraps are being applied? Who will perform showering and hygiene for the patient? Unfortunately, the biggest barrier to Lymphedema in my agency is patient nonadherence to the program even under the best of circumstances. Hope this offers some insight into this new angle to home care nursing. Best wishes. Jbudrick

Hello Box of Rain, I understand your situation and how you feel. I have experienced something similar. Not all people have the personality and/or temprament to work the floor. Some nuses lives do not allow for the flexibility to work the floor. You have tried three jobs and havent been able to make it work. You can have a successful career in nursing by trying a job that matches your strengths. Home care, doctor office, school nursing, OR training programs, research, are all areas to look at. Say to employers: I now have hospital and floor nursing experience and realize my strengths and where I can best provide patient care and be successfull. You can make a good career once you understand that not every nurse is suited to working the floor in an inpatient setting. I hope you realize that all people have strengths and weaknesses. You should not have to take drugs and change your personality for a job. Best wishes, Jbudrick

A mirror to see wounds when the patient can't position for examination, a head lamp, flashlight, a spray bottle with hydrogen peroxide/water for accidental carpet stains (like blood), extra pens/sharpies, EMT scissors, shoe covers.

is the Mark 5 bag heavier? I can imagine hanging it on a doorknob.... Jbudrick

Listening to a lecture on tape takes as long as the class did. The best and most efficient use of my study time was to listen intently to the lecture and take notes. I reviewed my notes after the lecture and before tests. Hope this helps. Good luck. Diana

I completed the WOCN Emory program in January. Bridge week was in February. Emory provided study materials specifically to study for the certification exam. Bridge week helped me prepare for the exam also. I strongly recommend the Emory program. I followed the instructions and passed all three exams on the first try. I took one exam per week, just as Emory recommended. Good luck in your journey to certification. Have a good day. Jbudrick, CWOCN

Another option is Montgomery straps. If you really need to change the dressing three times daily, this is low cost way to to keep the dressing in place and reduce skin damage. Best wishes. Diana

Hello Big Mike: One thing to consider before signing up for an $80,000 nursing program: How are your grades? Nursing courses are usually much more difficult than the prerequisite courses. If your grades are holding you back from being accepted at a less expensive college, you might want to reconsider nursing altogether. I think most nurses would agree that being accepted into a program is the easiest part of getting a nursing degree. In any event, best of luck in your pursuit of an RN. Diana

Please keep in mind that the depression may follow you into the next job. It sounds like you are having a hard time building a life in your new town. Definitely discuss the depression with your doctor. Also, follow the basic nursing advice of eat right, get plenty of exercise and rest. Spend time outside of work socializing with other people, like take a class or participate in a sport. Hope things look up for your soon. Diana

Sacred Heart University, Fairfield, CT