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  1. cathrn64

    Elevated temp and dehydration

    I too have noticed a slightly elevated temp when a pt is dehydrated. Usually around 99
  2. My homcare agency did NOTHING!!
  3. I used to have a problem with "going" at a pt's home. I have been in home care for 20yrs. I no longer have a problem with occasionally using a pt's bathroom, as long as the pt's home seems clean. (Sometimes, you will be surprised, you will find a clean home with a very dirty bathroom!) In general I know where all of the bathrooms are on my route and try to use them instead
  4. cathrn64

    Home Health Nurse Safety

    I would say that in 20yrs of home health, there have been little to no times when I felt at risk in a home. The pt's are usually very happy you are there. I had a co-worker who had to go into a "bad" neighborhood. While she was there, the pt's family members "protected" her car. As far as the neighborhoods go, you learn to see the pt's early in the day. This is when it is safer,(the gang bangers are either in school or alseep) Every agency is different, but the ones I worked for offered an escort if you felt unsafe in any area.
  5. cathrn64

    Your Favorite one liner used with patients

    I am a home care nurse. When I discharge pt's I say "I hope to never see you again" or " I"ll see you at Wallmart" I also tell pt's with chronic conditions "I hope to never see you again, but if you need me, I'll be back. You can take that as a threat or a promise!"
  6. cathrn64

    Verbal Orders

    I use a Pt/INR machine. There are MD offices that require us to fax the results to them. Our office created a a form for this. The Dr's usually fax us back with orders. They expect us to fax them unless the results are critical, than we can call.
  7. cathrn64

    new grad RN as DON?

    Sounds fishy to me!
  8. cathrn64

    A couple (okay, a lot) of questions from someone interested in HH

    OK I won't be able to answer all of these but I'll try! Depending on your agency, there should be help available on the phone from your sup. I know I have co-workers calling me with questions (esp the newer ones!) I/we encourage new hires to call their preceptors with questions. I have even had nurses that I have never met call me, because they were told I would help them. At each visit you will be expected to do a head to toe assessment, teach, and do interventions. They are usually expected to be at least 30minutes. (usually longer) At my agency we do get mileage reimbursement. It varies, at times, if the gas prices are high. The agency covers a very large territory. We each have our own area. I am asked to go out of my territory at times, but mostly I stay in my area. The agency I work for strongly discourages us from carrying our own malpractice insurance. They say that their lawyer will not be able to represent us if we have our own insurance. (that being said, I've heard of lawsuits in homecare, but never been involved or even heard a pt threaten one) I see my first pt around 9 (I have a hard time finding pt's that don't think 9 is too early!) I see aprox 6 pt's a day I finish between 4-5 depending on how many and what I had to do. I do aprox 1-2 paperwork hrs afterwards The pt's do respect you. You have a lot more time to get to know them. They can really come to like you and you them. Sometimes too much! Yes I love home care and would not go back to the hospital!
  9. cathrn64

    Is this your survey year?

    In general, the surveyors don't say a word to you if they see you make a mistake. They talk to the pt and ask questions. Last time she asked the pt questions about if the pt knew how to reach the agency, and their nurse, if the pt knew about their bill of rights, and they wanted to see the home med sheet and see that it was up to date. They also watched everything I did in the home. Very focused on bag technique. Another nurse in my agency had a surveyor want to see her trunk supplies. She checked every single item (including lab tubes) to make sure none were expired. At the end of their time the surveyors held a meeting to tell of all of the mistakes they found from visits, pt's and charts. In my agency's case there was a supervisor driving the surveyor around, so she saw the mistakes too, and knew who each came from. I don't think anything bad happened to anyone who made a mistake. I think they had to come in for an inservice. Each time they have a different focus, so it's hard to predict what they will look for
  10. cathrn64

    Dumb requests from the office

    I received a call from an OT "I can't wake the pt up. Should I call 911? DUH!!! I don't know! Might be a good idea, if the pt is not responding and she did before!:doh:
  11. cathrn64

    POLL: How many visits/week

    27points a week = full time at my agency (1 pt regular visit, 1.5pts for a recert/roc or high tech, 2pts for a SOC)
  12. cathrn64

    What grosses YOU out?

    Blueskies, The Pannus is the fold of the stomach (can be very large on an overweight person)
  13. cathrn64

    Looking for tips on Home health clinical

    Hopefully you will be with a nurse for more than 1 or 2 visits. (I like to have a student stay with me for the full day) I usually have my student's observe at first, maybe get a set of vitals at the first or second home. Then the student can see the flow of a visit and get an idea of what happens. Than, depending on the expectations have them do more of the visit as the day goes on. (I have had some schools where the student is just supposed to watch, and others where the instructor wants the student to do a full visit.) As far as teaching goes, it varies on the pt and the visit. Sometimes the teaching opportunity is obvious and sometimes you have to just pick a med or diagnosis and teach on it. Your preceptor should tell you if there is a specific goal that is to be covered on that visit.
  14. LOL!!! I was going to post the same thing!
  15. cathrn64

    Home Care Home Base

    I am on HCHB. I don't really like it.