bubblesbanks

I am sorry to hear this happened to you. Unfortunately, I strongly still believe most of society doesn't accept or realize mental illness can be just as debilitating as a physical illness/condition. Light & love to you.

I am that nurse who has a chronic condition that one day will just get worse. I have to go out of state monthly for doctor's appointments, and have been blessed to find a job where the companies' management works with me on all this. Since my illness my work views have changed. If I am not valued by a company because of my condition then that company isn't worth my time. No job, or the management is worth the stress of losing/worsening my health. At the end of the day I am the only one who is going to look out for me.

When I return to work I will see if I can get you the regulation & post it for you.

From what I know all disciplines must be present with the IDG meeting. It is up to the company if all disciplines stay present through the meeting, or rotate in/out per caseload. Many times we all stayed in the meeting due to other nurses covering for the primary RNCM, or on-call seeing the patient. With patient's who get ancillary service from what I know the regulations state that the RNCM is the one who initiates other services (Chaplin). If the patient declines Chaplin services or other services then "No, the Chaplin does not have to be present." The nurse will need to be sure to document that services were offered, and declined by patient. This will cover you when a survey is done. If ancillary services are requested (MSW, Chaplin) then that discipline has 5 days to do their assessment, and can be discussed at the next IDG meeting. With my past hospice job, my experience was if MD was unable to make it to IDG we would either have the back-up medical director attend, conference all the medical director, or the manager would get with the MD prior to the IDG to discuss cases. Hope that helps.

Be ready for larger case loads then hands on nursing, and be very patient with dealing with contractual agreements/arrangements with the government. Some people really enjoy this type of work. I did not care for it much. I was very happy when I was able to get back to hands on nursing. I wish you the best of luck.

I just had this happen to me, and am also wondering how normal is this? I was called out due to the foley not draining. I irrigated the catheter, and immediately noticed that urine was coming out of her urethra/lady partsl area. I then deflated the balloon, and re positioned it. Pt. had not complaints of pain/discomfort. After all that, I went to change her bed liners (since she had been leaking), and upon cleaning her find the catheter tip with balloon inflated sticking out. Wonder if it is a possibility the catheter tip went through the urethra. I was under the impression urologist usually surgically close the urethat area when doing a supra-pubic catheter. Anyone have input on this?

A nurse's way of bringing in the New Year.

Mommy_2_2, The HHC nurse you spoke with was only trying to warn you, but she did you a dis-service by not filling you in with the complete story. I am not a new nurse, but am a year into HHC nursing. It is a whole different ballgame! I came from a big hospice company who paid me salary, and I had great benefits. I went to HHC because I thought it would be the most similar to hospice in the flexibility of hours. You do get flexibility, but most times you feel to stressed to take it. I recently went PRN with HHC, and am now looking for a better job. Things I do not like about HHC: you get paid per visit, which means your pay is based on how much you get out there, and do. It's like a dog eat, dog world. You are not compensated for all the time you do spend doing the paperwork side of it, and there is a lot of it. Now, the positive side to it maybe you will work for a bigger company then I do, and get better pay, or more benefits. I work for a small company, have no benefits, and only get paid for 1 hr. of office time per day to do what the boss calls "case management". Mind you, this is not to do my notes, but to do "case management". I am paid the 1 hr. to see my pt., and do my note. It is a rough field to work in is what I have concluded, but I wish you the best. You might find you love it. For me, I have developed a different opinion. Just keep you eye and ears open. You never know what you will find. Good luck!

I was in your shoes when I took on a hospice job too. 8 years later, I haven't looked back. There are apprehension only because it is new. I found I had a knack for hospice, and loved the interaction with the pts. and families. If you are out in the field you will not have as many skills you will be applying as you would in the hospital setting, however there will be other skills you will learn such as how to think on your toes being out in the field, and working with the resources you have. You will also learn a little about doing social work helping the families through these difficult times, and helping them to find resources to make it through. All in all I found it very rewarding. It is emotional stressful at times, so you have to give yourself the allowance to "just take a break". The hospice company I worked for had great benefits. Lots of time off. I learned it was for good reason. You do need it, because you work hard at your job. I hope you will find you love it as much as I found I did. Good luck!

Thanks everyone for your replies. I think I have figured it out. You have to love HHC. As paradiseboundRN states. I have always had good paying jobs, so the rat race of HHC is new to me. Being in New Mexico makes it a little rougher I believe also. Sounds like Jeweles26 has the best set-up. I might need to go in, & talk to my boss about pay. It really stinks to work 8 hrs., and only get paid for 5 because I olny had 5 pts. to see that day.

I am reaching out to the allnurses community to try to figure out wages for HHC pay? I recently started in HHC, and am really confused/frustrated with how I get paid for the work I do. It seems the work out ways the pay. So, I am looking for clarification or verification that this is really how HHC works. I get an hourly wage for regular home visits, and re-certifications. Two hours of pay for an admission, and 1.5 hrs. of pay for a resumption. I either really suck at this job, or the pay for the work is not equivalent. I do a lot of charting from home for free, because my company will only pay 1 hr. of office time per day for what they call "case management". The company states I should be able to finish my charting in the hour visit I have with my client (2 hrs. of admission, 1.5 hrs. for resumption). That hour is also suppose to include your drive time to the pt's home, assessment, calling dr's if needed, and charting. Our charting is done on computers, and it is often a struggle to even get the darn things started up, and connected to the web, so that we can chart on our web based charting system. Is this how HHC works?

ava'smomRN, I am two years late, but congrats on your big achievement! What a challenge! Pretentious, hog wash! You know how hard you worked for that BSN, and in my opinion you should be darn proud of it. I am sad to see that most our current peers seem to be either burnt out, or just plain miserable with themselves. Lighten up people! Can't you wish a fellow peer well in her achievements? I sign BSN RN after my name, and darn right I am going to flaunt it! I was the one who worked by butt off for it, and had to pay for it. You should feel entitled to own the title you worked for. Do well ava'smomRN with the higher education you have received.