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Tampa121

Tampa121

ICU/CCU, Home Health, Case Management
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Tampa121 has 35 years experience and specializes in ICU/CCU, Home Health, Case Management.

"Spreading cheer and saving lives, one day at a time is what I love to do!"

Tampa121's Latest Activity

  1. Tampa121

    Relocation to MA/fingerprinting

    Hi all, I am a FL RN living in Tampa, FL and returning to MA, to live near my family. I have maintained my renewals for MA RN License. MY question-I am due for fingerprinting in August 2015. I am moving the end of this month. I called MA Board and left message, no callback. Do I go ahead and get fingerprinted here? I am not sure if MA requires fingerprinting and which type. Can I request through sheriff office my own? Any help will be appreciated. I resigned from my HH position last month to get ready to move, I should have gotten them done before resigning. TY
  2. Tampa121

    Do you miss face to face?

    I have read articles, stating welcome to the new nursing practice. Insurance driven, of course. We have DOCS in the BOX and now Tele Nurses. Yes, you can do a lot of T/T by phone. My moto: When in doubt...send them out!! TO ER if in crisis!
  3. Tampa121

    Leaving Home Health Nursing

    I didn't renew my ACLS this year, and now am kicking myself in the butt!
  4. Tampa121

    Visiting nurse job offer salary?

    Get the money you feel you need up front, IMO. With MCR cuts who knows where the salaries are going to be in a year!
  5. Well said and extremely truthful! I just left a FT position with a HC company after 6 wks. I was miserable. call pay every 3rd wkend 30.00 a day and no extra pay for wkend visits. And, always Sat. I had 2-3 SOC,ROC's d/t hospital dcing Friday after 4pm, plus covered 3 counties. During the week, I put an average of 125 miles daily! No mileage for traveling to first vs which is normal during week, BUT wkends, when office is closed!!! Not good for me if 1st pt is 65 miles away. No cell phone, I have to use my cell. I call my pts to schedule vs, that's all. I have a company tablet to take wd pix and start note in home. with 3 SOC's somedays, I spend all day Sat, completing OASIS's, visit notes. So much computer time-I have head drop!!Micro-managed-big time. Not paid to case manage, call MD's, POA, our office to give DON report, other clinicians involved in pt care. Mid 50k salary- underpaid in my mind.MY pts were PICC pts with 1-2 IV meds, Vanco, Cefepime. Lab wk workly and all MDs wanted troughs done on Monday, then if a PT/INR or BS out of range, then extended visit. I did T/T cg's to administer the IV meds and they did well. So, my advice to all nurses starting HC, discuss company expectations, caseload, non visit case management time and your expectations, your training needed to make transition in to HC. Yes, Gentiva pays well, but how well is relative to FT Case management. Please, do not entertain the idea of a 40hr work week!! It will be many more hours. I know many RNs who are leaving HC and LPN's who tell me they would never do it if they had their RN. I went back to Per diem, so I can decide my workload and have a life! I love HC per diem, not FT in Florida. Good Luck!! Stay safe driving if you take the position. I would start Per diem, and test the waters!.
  6. Tampa121

    About texting..

    You always provide a wealth of information! I applaud you! TY
  7. Tampa121

    What would you have done?

    I would most definitely called 911, because she could arrest in family car if they drove her. This way here, she has paramedics to provide CPR if needed. Yes, we cannot force pts to go by ambulance-but you can call 911 for them to evaluate her and they will tell her she needs to go by ambulance. If she says no-they have her sign refused against medical advice and you have a witness for your decision to send her and her refusal. Same thing happened to me a month ago, I called 911 and did not ask pt. permission to do so, paramedics arrived. Pt. refused to go to ER, he signed doc stating he was refusing to go to ER and I was covered. He was dizzy, too, low BP, hx of CA, etc. I documented what happened-called my agency and left pt. at home. I called his MD, told him what happened (documented that call). I told him to call 911 if dizziness continued and documented that, too.Patient ended up OK.
  8. Tampa121

    Case Conference

    Thank you, Libby!
  9. Thank you, Karen, this list is great. I will be taking some of these courses and pass along to my peers.
  10. Tampa121

    Case Conference

    What is the MCR Reg for Case Conference? We document in our note who we spoke with and why. Our DON wants us to IDS Case Conference, but she is not sure how often is one required. She thinks it is weekly. I am not sure, I thought it was monthly. TY
  11. Tampa121

    Accessing central lines/IV starts

    I agree-always ask for an in person in-service from a trained nurse, NOT YOUTUBE!! Go over it several times, ask questions. I am an RN and have been to IV in-services from pharmacies and IV companies like Coram, including hands on in services in acute care. Then, do co-visits with a trained nurse, and when you are comfortable, only then accept a case you have been properly trained in. You always should have access and a copy of the Plan of Care (485). The first time or even a few times-you are within your rights to ask for an experienced nurse to go with you for co visit. It's the pt's life and your license!!
  12. Tampa121

    Pt's home infested with bed bugs, fleas, etc..

    Hi-yes, I did call MD-and he said he was going to call ER. I documented properly in EMR, including who and when each person was notified, including patient and her brother, who were in agreement with the plan to send her to hospital and that she probably will go to SNF. She might have stayed at hospital for IV antis, not sure.
  13. Tampa121

    Pt's home infested with bed bugs, fleas, etc..

    Yes, you can refuse to see patient if you are per diem. Seeing that the DON placed pt. on hold-is she attempting to problem solve the case. I agree a SW needs to go in, the MD needs to be called and yes-this pt. is an elder at risk d/t open wounds with insects in wound. Your agency should report this patient. Are there family members? I say he should go back to hospital and then to SNF-for wound care and state will possibly fumigate his house. I had a pt. whose home was infested, she had PICC line and bugs were crawling all over IV equipment, etc. I called MD, told him what was happening (I saw her two times), he said send her back to ER, so they can send her to SNF. I hope this helps!
  14. Tampa121

    Point system for FT

    TY-yes, I agree. Small company in Tampa,FL. One DON, me, and an LPN. Since starting I have squeeked by to get 30, but on my weekend on call, I have seen pts both days, ROC's and SOC's. Plus, no health insurance. plus, I earn below 60k, which my former DON said was very low, like by 6k.
  15. Tampa121

    Point system for FT

    I am FT salaried HH RN. BUT, Administrator and DON told me after I had been working there 2 weeks if I don't make 30 points q week, I have to see scheduled pts. on weekends. Have you heard of this? I already am on call every other wkend, with no pay, so conceivably I could be working every weekend! TY
  16. Tampa121

    Half pay for RN BID Insulin visits daily

    TY NRSKarenRN, Yes, DON told me MCR only gives a lump sum for diagnosis. So, that is why they pay I/2 for both visits-total 35.00 day. She is complicated, confused, lives alone. Her son lives 5 minutes from her and refuses to give insulin.He was taught by the previous nurse and has given it to her when he has taken her out in the evening. DON says if her visits are complicated, like low BS, document it, submit it to her for approval. She has a Novopen. She can't be taught, half the time she does not know if it's am or pm. She is unsafe living alone, but manages. He has friends who come in and give her a shower and take her out for lunch. Sometimes, they would keep her out and I would have to track them down by cell phone or just wait! So, I told them I could not continue to take care of her. They didn't like it but gave her to a FT LPN. I am per diem, so I do know I can refuse a case, only if they could find a replacement for me. I was never told half pay when she was assigned to me. I felt bad about it, but I can't work for low wage, when I could be doing a regular visit for 35.00. I am ready to retire, feeling burned out after 40 years! TY again for your concern.