ame222

Does anyone have an actual schedule with labs depending on what medication they take?

FYI: This is for long term care nursing:

From ame222: Can anyone share their schedules / forms for recommended labs for medication monitoring and how often they are being done. What forms / tracking procedure do you use to assure these are being completed. Who orders your initial labs and who follows up on further labs to be ordered? How do you audit your ordered labs on new admissions--then the follow-up labs. Any forms you could share? Does anyone have a form they could share on lab tracking: When labs are drawn, verifying all results are recieved. What procedures do you use to assure all lab slips are made? What procedures do you use to assure routine drraws are being ordered and done? I am open to any suggestions and would like any forms you are willing to share. Thankyou for your help.:)

Can anyone share their schedules / forms for recommended labs for medication monitoring and how often they are being done. What forms / tracking procedure do you use to assure these are being completed. Who orders your initial labs and who follows up on further labs to be ordered? How do you audit your ordered labs on new admissions--then the follow-up labs. Any forms you could share? Does anyone have a form they could share on lab tracking: When labs are drawn, verifying all results are recieved. What procedures do you use to assure all lab slips are made? What procedures do you use to assure routine drraws are being ordered and done? I am open to any suggestions and would like any forms you are willing to share. Thankyou for your help.:)

Can anyone share their schedules / forms for recommended labs for medication monitoring and how often they are being done. What forms / tracking procedure do you use to assure these are being completed. Who orders your initial labs and who follows up on further labs to be ordered? How do you audit your ordered labs on new admissions--then the follow-up labs. Any forms you could share? Does anyone have a form they could share on lab tracking: When labs are drawn, verifying all results are recieved. What procedures do you use to assure all lab slips are made? What procedures do you use to assure routine drraws are being ordered and done? I am open to any suggestions and would like any forms you are willing to share. Thankyou for your help.:)

F:283 Dischage Summaries: Recapitulation of the residents stay, Final Summary of Status. Does anyone have any advice to share with me on the correct way these are to be done? How do you coordinate with medical records? Are these to be done after the entire chart is closed, or immediately after the resident is discharged. Does anyone have a form they could share with me? Thankyou to anyone who can offer assistance on this. :redbeathe

Dear Cape Cod Mermaid: Can you (or anyone else) point out some specific web sites, books and any other resources I would be able to study and learn from to bring out the best possible expertise? I am very organized, can stay focused and multi task at the same time. I have found out there is specific training provided but I also want to learn on my own time as well. Any information, resources and or good ideas or encouragement anyone might have is appreciated. Thankyou to anyone who responds.

I have been filling in as Interim DON for several months. I was asked to do it, it's not something I necessarily would have wanted, however in many ways it's made me a better person, much stronger and I realize I am able to cope with much more than I ever gave myself credit for. They weren't able to hire one as soon as they thought and several lined up rescinded their offer. I have been offered (almost pressured) to take the DON position by upper management, Administration. I have been an ER, Acute care nurse for many years, in Long Term for a little more than 5 years. I do not feel I have the knowledge required for this position and the more I realize the seriousness of the responsibility, I don't think I would be the fit they are looking for. I am very strong Clinically and am very organized,. I feel challenged in multi-tasking and have a great relationship with the entire staff at the facility. Eventhough many think I should and could do it, I feel my knowledge is inadequate to do the job justice. I think the person in that position should already know what is required and any corporation wouldn't accept the excuse "I didn't know, I didn't do that on purpose, I'm still learning." I am currently a VERY BUSY Clinical Care Coordinator, plus taking on many extra jobs as the Interim DON, which makes my days very long. Many days I'm working 10-12 hours before I finish up. Where many commend me that I am doing a great job, I still feel I lack knowledge that is mandatory in that position. The thought of accepting the position, then failing at it (like I have watched many before me do) would be totally devastating to me. Can anyone enlighten and advise me on this. I would like to hear of your past and present experiences with this position and what type of person you think it takes to REALLY succeed at it. I would like to hear the advice and suggestions anyone might have on this. Thankyou.

Thanks for responding. I can really say "DITTO" to feeling much the same as you. The job offered me in Home Health sounded like a real "dream job". It didn't turn out that way. I, too, got very tired of the "politics" and "competition" there. They offered me something to start that I believe they couldn't ever provide me. I was assured there were NO politics there (by the DON who is also part owner of the company) before I started, but then I guess it's however YOU classify politics and who makes them! There are politics everywhere, and I believe there is no "perfect job anywhere". I never got the amount ($ or # of visits) they promised me, then when questioned, was given "excuses" as if I didn't understand what I was told, when I felt it was made VERY clear. I also liked the work...alot, but after weighing the pros/cons I decided to take the new job offered me, which is exciting to me. The Home Care company was pvt. owned, and many of their policies just didn't seem very honest, but then I wasn't the one running the place and if you work for them, you have to go by their "rules", right or wrong. Where I'll also miss the independence, I won't miss the "politics". The benefits of working in LTC don't even touch the surface of what I was offered (not given) in Home Care. Once I made the decision to accept the new job, I didn't feel bad leaving the company, however telling the clients was difficult. I based my decision on economy, which made it easier. Good luck to you.

.....Just curious. Why did you choose to leave Home Health. I will be doing the same. I'm leaving Home Health, have accepted a job as Clinical Coortinator/Unit Manager in a LTC Rehab Center, which I previously worked at for several years. I'm excited about going back to this new position. How is your job going? Good luck to you.

The HH Agency is "thinking" about providing a cell phone for business use only. How does someone "estimate" the # of minutes needed? What are other Agencies doing in this area? Various cell phone companies provide different plans. Just curious as to how others handle this and what other Agencies are providing for employees.

Our agency does not provied cell phones, nor do they reimburse us for business time spent on our own cell phones. I don't think this is fair to be expected to pay for our own plan (family plan) with specific minutes which of course are used up making calls, recieving calls and messages when we are in "no service" areas...which often resultes in overage minutes which are paid at top rate. I have mentioned the possibility of either reimbursing me a specific fee monthly or providing me with a phone for business use only. They haven't moved on this yet. Any suggestions on a different approach? How do others deal with this issue? This ends up being extra money out of our family budget... and causes problems.

My first admission alone took me 2.5 hrs in the home and another 3 hrs. finishing up at home. We get paid a flat rate, no difference for admissions. I have to agree, practice really helps. The OASIS is so foreign at first, but again, practice helps. I can do an admission in much less time now. Perserverance pays off.

In reference to the following note, this might help. I purchased the book called "Wound Care Essentials" by Sharon Baranoski and Elizabeth Ayello. It is a great reference book and has helped me alot.

What kind of information are you looking for?

I don't live in MA, but live in a rural area. Our agency is small and our case load varies. I see anywhere from 5-9 clients a day. We don't get paid by the hour, but the case, which is $30.00/case, plus $.35/mile. This also pretty much evens out to what I'd make at a facility, maybe a little less. The difference is well made up even with the lack of politics and back biting which is rampant in any facility I've worked at in my many yrs. of nursing. Our benefits aren't top notch either, but again, I figure it evens out for the same reasons. Eventhough I miss the direct contact with c0-workers, I've gotten used to that. I dislike all the paperwork, which is NOT computerized, but instead ALL handwritten. I've been able to tweak some of that and try to finish the bulk of it in the home, which is much better than spending 4-5 hrs. finishing it up at home, which used to be the case. Alot of it, I find is tweaked by trial and error. At any rate, HH nursing to me is a much better fit than facilities (hospitals AND nursing homes). I still wonder what "they" mean when they say that HH is nursings best kept secret. What does that REALLY mean. I've asked it in the forum before, but no ones really come out and told me and I hear that used quite a bit. I really get alot of good advice from this forum and I do appreciate it.

Management went out of town for a "Seminar" for over a week. Needed someone to take call...I was delegated, but wanted to be reimbursed. They are all salary, so...I'm getting 10.00 weeknight from 5pm-8am and 30.00 weekend day. I was wondering what the "going rate" was out there. We get $.35/mile, $30.00/visit. Some days a visit might be 50 miles away (in our rural areas) as most are. Average daily miles can be as much as 130miles. Just curious as to what the rest of you are getting. Irregardless this is so much better than hospital and nursing home work...half the hassle and so much less politics.

It takes a little bit of time, but I try to call the clients the eve. before to give them a general idea when I'll be there the next day. Since I live in a rural area and do a bit of driving each day, I'd rather do this than to get there and not have them home. Sure this is frustrating for you. I don't think we'd probably get paid anything if they weren't home. We'd probably be told to go back and try them later that same day. The only time I've had a problem is when a lady was put in the hospital and didn't tell the agency. I didn't get paid anything for the visit.

I also live in a rural area where jobs are somewhat scarce. Yes, I do believe it is possible for a new Grad to suceed in Home Care, however, this also depends on what clinical experience you had in nsg. school and what type of orientation you will be provided when you start. To be very honest though, I would believe getting some clinical experience in different areas, learning how to make astute clinical decisions, Physician/nurse interractions, etc. would make it easier for you. I was a nurse for over 30 years, did a multitude of different things from ER, Trauma to Geriatrics and Oncology...all of which I enjoyed. And...even still, Home Care took alot of learning, it's a "different type of nursing" than in a controlled setting. It requires alot of organization, assessing, teaching and ALOT of paperwork, much of it done at home and alot of driving (in a rural area, also). This was a big adjustment for me, I still ask alot of questions, and I've seen alot (environmental and domestically) and I'm persuaded that there are some people who couldn't and wouldn't do what we do out here. It takes alot or determination to catch on and really feel like you're doing a good enough job. I've heard that Home Health Care is Nursings best kept secret. I've always wondered just what "they" meant by that. Can someone let me know...really, I'm curious. And to you scubadoo, best wishes in your endeavors. This forum is a big help and provides alot of support.

For all you HH Nurses out there, I need some advice. Part of our job is to assess and instruct. Aside of the general assessment and the main problem which is skin ulcers and wound care, it isn't possible to ignore the surroundings either. When assessing the environment and it is known that there are "bugs" infesting the area (such as fleas from animals and cock-roaches), also animal excrement on the floor, old food sitting out, and general filth... just WHAT is our responsibility, and what would your approach be to get the client to understand how this can/does affect their health. Infection control is such an issue as is the general environment. This is a rural area, much poverty and lack of education and simplicity. It's so hard to go to these places time and again, instructing them on the same, yet feeling like I'm not making any difference. How can I re-approach this? I'm a professional and take my job seriously, but this is really discouraging sometimes. How can I reach this client? Thanks to all of you for your advice and suggestions.

We get paid nothing for a no-show appointment OR for delivering specimans (other than mileage) either.

I agree with what you said. "They" say that "Home Healthcare is Nursings best kept secret". Eventhough I'm not exactly sure that "They" mean by that (anyone can let me know for sure), I do like the autonomy and feeling REALLY appreciated. It took me awhile to feel like I was actually organized, which requires me to do alot of paperwork and preparation at home. This can be time consuming, but still is SO much better than working in a hospital or LTC nursing which I did for 30+ years before choosing to do HHC. I did (and still do) ask many questions, but if you have a boss like mine, they don't ever mind taking time to explain how it's done in HHC, which IS often different than other places. The teamwork is different, often working independently, however this is SO much better than the arguing and complaining done in other types of Nursing. Keep up the good work and this forum really DOES serve a purpose and provides good support for both the experienced and non-experienced.

WOW, both responses sound great to me. Our HC pays 30.00/visit, regardless if is a new admit, acquity (high tech), admission (OASIS), etc. The mileage is .35/mile, no pay from your home to first visit and no pay from last visit, home. The only difference is a weekend visit that they pay the entire mileage. We see an avg. of 5-7 cases a day and get paid per case. I have never accepted a job solely based on pay, I have to like what I do, however including mileage, this still averages out to close to the same I got paid working in a hospital or LTC setting and with the autonomy, respect and the environment, it is well worth it for me. Sometimes it's not always about money, either. There's got to be a bit about self satisfaction and just helping others in need as well. Different people have different outlooks on what Nursing is all about, I guess.

How do I PM you? I'm not sure what that means. Thankyou.

Does anyone out there have any advice on this? I would appreciate it. Thanks.