lioneliz

Funny thing happened today...I was just wrapping up a visit (pt assessment caregive teaching wound care & dressing for a patient with a tunneling abdominal wound) when she told me that her husband couldn't understand why the HH staff always checked her bp and temp. She seemed rather amused by her husbands lack of knowledge about what we do and proudly said "I told him you all are sort of like nurses only you're not in a or hospital." Now it was my turn to be amused. I let her ramble on for a moment and the said you are right we are nurses that work outside of a hospital. I'm sure that little bit of information was like water running off of a ducks back.

Hey these are great stories! It is nice to know someone out there understands and has been through some of the same situations, (and some I hope I never experience. Keep em coming.

This was not really a typical event in a typical day in HH, but I just had to vent a little. A man came by the office the other day and asked about hiring someone to help bathe his mother. He told me his brother and he had been assisting mom to bathe because she couldn't do it by herself since she had recently had a stroke and had just come home from the hospital. I thought hey this lady sounds like she needs a home health eval and proceeded to discribe what services we offer. But, the man quickly held up his hands and said we don't need home health services we already have that through *****HH agency. They are sending out a PT and a ST all we need is someone to bathe mom. I encouraged him to talk to mom's HHA and ask for aide assistance. He told me the agency couldn't send out an aide due to the distance from ***** town where the agency is located. At this point I saw red, but explained that if an agency accepts someone as a patient the agency is obligated to provide for that patient's care. I gave him the number of some sitters in the community and the DHS number to look into provider assist. We are a small rural hosp based agency hanging on by the skin of our teeth and *****agency is a large hosp based agency at a regional medical center in a town approx 75 miles away. They have a branch office in a neighboring town approx 30 miles away and in numerous communities in this part of the state. *****agency is not known for being overly ethical in their business dealings or in the way they obtain patient's. Many small rural towns send patient's into this regional medical center for care that can not be provided in the smaller hospital's. I have heard from countless other rural HHA similar stories. I really wanted to tell this poor man he should call the state and report *****agency but since I didn't know all the details about how mom was functioning I really couldn't. I felt sorry for this guy and his brother having to try to bathe mom just cause ******agency worships money and doesn't care a whit about their patients.

i guess, overall, i am dissapointed in myself; the last three intakes that i took starting 3-22-04 are not complete yet... i hope to do the 485's this afternoon. do the nurses usually do the 485's elsewhere? hey no wonder you are having a hard time keeping up, you're trying to work in the future. :rotfl: i have worked in hh for the past 71/2 yrs and i still have trouble keeping up with all the paperwork. i get behind-then i feel stressed, then feel i tired, then i feel picked on then i feel cranky, then i feel guilty . of course none of that helps me get anything accomplished. so i have to give myself a stern talking to, suck it up, prioritize and organize my work, maybe even throw in a nap for some much needed rest, and take one task at a time. and yep i am still behind. i haven't as yet figured out how to keep up. if you figure out a way to keep up please let me know my pep talks aren't doing much good these days. if home health is a job that is dear to your heart then just keep plugging on. do the nurses usually do the 485's elsewhere? i don't know about other agencies, but we do the 485's (i should say i do since i'm the only f/t nurse). good luck!!!!

What are some of the strangest wildest kookiest ect. situations you have found yourself in in the home health setting. I would love to hear your stories. I know in nursing school I would have never imagined or belived some of the situations I get into in patient's homes. Two come to my mind... The first was an elderly diabetic gent we admitted for teaching. Talk about hygiene issues! His feet were in terrible shape and needed attention. He didn't have running water, so we got permission from a neighbor to run a garden hose over to provide him with some water untill other arrangements could be made (luckily it was summer). The other was very sad. A middle aged lady that had sufferd a massive stroke - was in a persistant vegatative state. Mexican national, no green card, sent home with her daughter who tried her best to care for mom. Mom had a feeding tube, foley,contractres and never responded. Daughter did a good job mom never had decubs. At one visit (also in the summer) I happened to arrive just as the caregivers finished moms bath--- using a garden hose in the back yard. I was flabergasted. I recommended that they not bathe her outside in the yard. At the next visit I found that the whole family had moved lock stock and barrel. I don't have a clue where they went.

All patients (home health patients or otherwise) have the RIGHT to participate in planning thier care and to accecpt or refuse care. They have this right regardless of how much it inconvenices the home health agency. I called my supervisor and was told to "Call them and tell them that you are making 4 more visits or we won't get paid." This would not be a truthful statement. An agency can get paid for less than 5 visits. They just don't get as much as they wanted. Did you contact the physician and find out what type of care and length of service he expected? Sometimes pt's/families do not understand what the physician said & sometimes they fib a little to suit their needs and desires. My suggestion for you in dealing with the agency supervisor is to request that they put in writing how you are to respond to a situation such as this one. I bet ya they won't go on record as saying the patient has to accept 5 visits. Good luck to ya

Yes school is stressful. Yes school leaves you tired and irritable (that goes for your mate and children also). Yes this will pass. As for your mariage???? I don't know. I hope you guys make it work! I can rember feeling like you do right now. It wasn't a fun time. I remember one evening I was feeling so stressed out from school, spouse, kids, work, and life in general that I went and sat in the dark in my closet. My husband and kids found me sitting in there and thought I had lost my mind. Maybe I had, but doing something stupid like that every once and a while seemed to help me get through. I wish you best of luck!!!!:)

Just another typical day in home health. I drove 20 miles to my first patient, a crabby old gent with CAD A-fib S/P 3 vessel CABG has had numerous med changes recently. Called his home before I left the office, but when I got there he went to the bathroom for the first 5 mins of the visit. Then told me to hurry up he had to go to the bank. Sooo 12 mins after my arrival Mr Crabby hops in his car and speeds down the road leaving me and his wife standing there . I had to explain to the poor wife that Mr Crabby nolonger qualified for servies. I wish he had just told me not to come and saved me some time and wear and tear on my car. -NEXT- An admission for a frail eldery female with a stinking pressure ulcer on her heel. O2 sat's in the low 80's, w/c bound can't get out of the house (no w/c ramp) lives with her brain injured son (sweet but clueless). Got an order for O2, got the ball rolling on a w/c ramp then left hoping her home doesn't catch on fire . -NEXT- Drove another 30 mile to dress an open foot wound (at least this one didn't smell) My next pt went to the doctor so it was back to the office for my favorite thing PAPER WORK!

A nurse I used to work with had hand written a list of S&S for a pt's dtr-caregiver to report to the home health nurse. She left it in the home for the dtr to read as she wasn't there at the time. The next nurse that visited could tell the dtr was very upset and asked her why. She handed the nurse the note and said can you believe that nurse said this about my mom. After reading the list of symptoms and not seeing anything alarming the dtr was asked to point out the problem. She replied my mother has never been called a $OB in her life. The first nurse had been very careful to write in pt lingo but had slipped up and written...please call us when your mom is S.O.B. We have had a great laugh over that one.

A rose by any other name would still smell as sweet or so the saying goes. The same goes for RN's. Diploma programs were generally run by hospitals, and had a large amount of hands on nursing experience. ADN programs had some theory and some general education requirements. BSN programs focus more on theory and probably have less clinical experience. The end product is a GN who no matter what program she graduates from has to continue to learn nursing. (there is no better teacher than real life) The only difference is the approach one takes to the NCLEX exams. I graduated from an ADN program and then went through a BSN completion program. I do feel I benifited from the additional educational experience. Not because it was a BSN program, but because the education broadened my view of the world. I plan to continue to learn throughout my life perhaps not specifically in the field of nursing, but anything that keeps my mind active.

If you are a tottering octogenerian, and weigh 89 pounds do not open your storm door if the wind is gusting 50 to 60 miles/hr...you will fall down and go boom. Also if you are an octogenerian (don't know what it is about those 80somethings) and prone to dizzines do not climb a ladder to put christmas lights up on your roof. You will fall down and go boom. Most important of all NEVER NEVER NEVER try to involve your home health nurse in a menage a trois by having your wife stand blocking the doorway talking dirty while you attempt to rub your genitals with your good hand! I felt soooo used.:imbar

There aren't any agencies in our town, but there are other agencies with service areas that overlap into ours, one in particular, a rather large one, is definitely in compitition for patients in any area as well as ours. I wonder why they (the hospital district) keeps us open also. I am thinking of changing jobs. I would like to stay in home health. This is the only agency I have done home health with (for 8 years now). What are the big agencies like? What kind of pay scale is out there? Should a person go per diem, contract, hourly salary etc.? What are the options?

Here are a few I have heard: * I am nearly blind, you know I have that imaculate degeneration. *My baby's nose is constipated. * I didn't take may latex today. (meaning lasix) * What do ya mean I have keystones in my urine? (meaning ketones) *I had my monogram done last month. (meaning mamogram)

Am I stupid or what? I keep thinking that the "powers that be" over the agency I work with will someday wake up and take an intrest in their home health agency (a small hospital based agency that serves a rural area). The staff has dwindled down to 1 full time nurse...me, a prn nurse, 1 aide, 1PT, a contract MSW and ST. Usually things rock along ok but this past couple of weeks has been horrible. The prn nurse was busy and couldn't work and then the aide had a death in the family and has been off. I just finished working 19 days straight, and today was a doozy of a day. I keep thinking the "boss man" will hire more help but I am only fooling myself. Why would they hire any one else when they can get me to do it for one low salaried rate? Am I stupid or what? I enjoy home health nursing. I like the community I live in, and there is a need for home health here. I sometimes feel as if the hospital district is like a dysfunctional family and I'm a co-depedent member of the family. Any suggestions for how to get more help?

you can usually count on the county court house and banks to have clean restrooms...there are no McDonalds etc. in the small towns i go to