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That's great! I actually work in the same type of center....it provides care of anyone regardless of ability to pay, includes prenatal, primary care, pediatric care, dental services as well as a rapidly expanding homeless program that's already at several sites!! Not to mention all the parenting classess, home visits, family center, etc. I LOVE it too! I've done nursing home work, rehab nursing, critical care for several years in the hospital and homecare....I finally feel like I've found my home! Took a big paycut of course, but it is SO worth it!! )

I guess it depends on your situation. Five 8s may be great for a parent, etc. I did 12s for 9 years before going into homecare, I started with five 8s (and every fourth weekend), I couldn't stand not having at least one weekday off so I asked to switch to four 10s, and about a year later I asked to switch to three 12s again...it was a good time to ask for it when it happened, new shift for this place. So now I'm back to three twelves (sometimes they are actually 13 or 14 hour shifts), but I no longer work weekends and they give me my four days off all in a row, which ROCKS! Like a minivacation every week! I have to admit, one of the reasons I didn't like the eight hour shifts in this particular agency is because my days were NEVER eight hours, always more like 9 or 10...if your 8s are regular and you get out on time, I'll bet you'll like it. Good luck!!

Our agency uses laptops, also with McKesson. I LOVE it!! I don't even carry scrap paper anymore, if I have to right a quick note I just type it quickly into the clinical note area so I don't forget it. I don't let the computer become a barrier between me and my patient, and have never had a pt. aggravated with the computer. I immediately document VS and assessment questions in the home (all of it is just check boxes, anyway), this takes no longer than writing it on paper and then there is no need to input into the computer later. I know a lot of nurses who prefer to write the assessments in the home and then input in the computer later, and that's fine, I just found that it took longer for me to finish my notes, and I don't like needing to work at home. I usually finish my clinical note either in the patient's driveway, or as soon as I have a few minutes. If the pt. is complicated, I type much of the note right in the home so I won't forget anything important, and I simply say to the pt., "excuse me while I type a moment, I don't want to forget some of the things you are telling me"...I personally have not had a problem yet. Again, I love it, I type faster than I write, and it's quite easy once you get the hang of the program. There are even prompts on how to answer the OASIS questions! No more looking it up in a book!! I hope things go well for you! :)

I know the type of IV administration tool you're using and it really does hold very little air in the tubing (actually, the type we use comes pre-primed, don't even have to worry about air!), and it's really doubtful this amount of air would hurt anyone. You did the right thing following the incident, covered all your bases, and let's face it, I'm sure you'll never do it again!! Don't worry so much over it, the pt. is fine and this truly is not something you should lose your job over.

I have to agree with everyone, not your fault! I work homecare, by the way, people are sent home nowadays on lovenox until coumadin is therapeutic, both people with DVT and with PE. While I was at the hospital, it seemed to depend on the doctor. Some ordered weight based hep gtt, some lovenox BID. :)

We used to, but stopped a few years ago, it just didn't work that often. I usually kept a Lifepak hooked up so I could watch the rhythm myself in the room with the patient and stayed with the patient during infusion. Personally, I think amiodarone works better, IV or PO, from my experience. Good luck! If you don't feel safe giving it, mention it to your manager. I know medical telemetry units get CRAZY!! When I gave it I worked on a cardiac surgical unit with good ratios and lots of support, I had time to stay with the patient and make sure there were no complications. Good luck! :)

We gave it a handful of times in the unit I used to work on, I'd say out of 5 times giving it two patient's had an anaphylactic reaction, the pharmacy always gave us a hard time about it because they said a lot of people do have reactions to it. I have to tell you, the reactions were quite sudden! Anyway, if any MD ordered it again we had to let them know that the patient would have to go to ICU for 1:1 nursing during administration, needless to say they usually changed the route! lol I never heard it wasn't okay to give it IV, just high risk for anaphylaxis, according to our pharmacy. :)

Every facility has their own policy, but I usually take out every other staple, if the incision looks "iffy" at that point I'll apply the steris where I removed the staples and request the rest of the staples be taken out another day, the next day or so. Sometimes it's even ordered to be done this way. But I've gotta tell ya, I don't think any of this would have helped your patient's incision, it sounds like it was bound to happen! Abdominal incisions seem to dehisce quite frequently, in fact I rarely see other incsions dehisce as often! Chalk this one up as experience, the next time you're supposed to take them out, bring the charge nurse in with you and ask for guidance. Good luck to you!!

Not sure how it works for private insurance, but if they're medicare we're required to supply them with everything they need, until they're discharged. Then we help set them up to have them delivered to their home.

I've never had anyone ask me to wear street clothes, but I have been asked why I prefer scrubs. I simply tell them they are more comfortable for the bending, stretching, etc. that I need to do in some homes. What I DON'T tell them is the state of some of the homes.....I would not want to wear my street clothes there. My scrubs are washed seprately even from my street clothes. I work is some less than hygienic areas, poorer neighborhoods, I'm just more comfortable in scrubs and crocs!

You're in a tough situation! I did work full time and go to RN school, but I was a CNA and my job at that time allowed me to work two back to back double shifts...so I worked from 3pm Friday afternoon to 7am Saturday morning, and did it again from 3pm Saturday afternoon to 7am Sunday morning. It was nice because I got 5 days off in a row, and I got full benefits since 32 hours was considered full time. I'm not sure if you have a job that will allow this, but they may be able to work with you in some way to help you out! Wishing you the best of luck! :)

When I worked cardiac surgical we used them to clamp chest tubes (when ordered, of course!), I had to use them once when a patient ripped his chest tube apart at the joint....I clamped until we got another clean chest tube set up. I've also used them for unscrewing tight IV connections, I know I've used them at home for stuff, like picking up stuff from small areas that I couldn't reach with my fingers, I got my husband some big ones for fishing (I guess of them fishies have sharp teeth! Need the clamps to take out the hook), etc. There's always something! I'm a VNA nurse now, I've still used them to disconnect some caps off of picc lines. :)

First of all, I'm glad the testing came back negative!! I have stuck myself with a contaminated needle before. It was the end of my shift and I was in a hurry and broke one of my own rules. Safety needles are meant to be operated with one hand, right? I always told my students and preceptees to keep one hand on the patient while covering the safety needle with the other hand, that way you keep track of where that hand is. I was in a hurry, gave the shot, and took my hand off the patient before the needle was covered, rammed it right into the needle. :icon_roll Thankfully the guy had a small history and was willing to be tested, everything came back fine for both of us. I did learn in subsequent conversation with this man that he used to be an EMT in a very high risk inner city area! I thought he had no risks, I guess he did! You never know!! :) Anyway, glad it's coming out well for you, and as always, take away the lesson!

I don't know a lot about these programs, but I do know someone who chose a 10 month sonography course over a 2 year (she already had a bachelors in another area)...sounded great, BUT she had to find HER OWN clinical area, and NO ONE in the area took students from the 10 month program! Big pain. Ask a LOT of questions! Good luck! )

Our agency gives us whatever the IRS allows, we were getting the max of 50 1/2 cents per mile, and the IRS raised it to 58 1/2 cents per mile from July 1 to January 1, just got the notice. We don't get paid going to first visit or going home from last, unless we start and end at office, then we get that mileage too! :) No complaints, I guess, except for the rising gas prices. Bleah. Luckily I live quite close to my area. As far as pay, I'm geting paid $1.60 less per hour than I did at the hospital, BUT I'm working 40 hours a week vs. 36 at the hospital, so my yearly pay went up about $5,000. Could be worse, I guess. I'm new to HH nursing, and I'm finding that 40 hour weeks don't exist anyway, it's more like 45-50 hour weeks! I may drop to 32 hour weeks, at this rate. But I do enjoy it! :)