twokidsmom,rn

twokidsmom,rn's Latest Activity

1. 

   Homebound

   twokidsmom,rn posted a topic in Home Health

   I have a pt that knows that he has to be homebound for care. Has stasis ulcers. But has no family and needs to go to supermarket for food and goes to MD and WCC appts weekly. He does try to do MD and supermarket stops at the same time and supermarket is not far away. Uses a walker and it is taxing for him to leave the house takes hours to do the short trips that he does do. I consider him homebound.
2. 

   Just hired by HHC agency--not feeling very good about it now

   twokidsmom,rn replied to vintagestudent's topic in Home Health

   But the nurse who did the SOC which the 485 is taken from should know what is on that 485. Lately we have not received a copy of the 485 for weeks. We usually see our own cases but sometimes if going on vacation or might see a pt for someone if they are too busy.
3. 

   Job of the BSN nurse

   twokidsmom,rn replied to mmkrn's topic in Home Health

   Most BSN programs I have looked into are at least 10K. My nurse friends that are in classes have to take things like statistics and are always doing research papers. I do not think they have to do any public/community health class. That would be a good thing if they did. At this time in my life I can not fit school in with home life and work not to mention tuition.
4. 

   Just hired by HHC agency--not feeling very good about it now

   twokidsmom,rn replied to vintagestudent's topic in Home Health

   When I see a pt for another nurse I get report from her before I see them. They tell me everything that I need to know and I can ask questions.
5. 

   Job of the BSN nurse

   twokidsmom,rn replied to mmkrn's topic in Home Health

   Many specialties require a BSN in order to sit for there test. I am a home health nurse and I do not have a BSN. Many of my fellow classmates are going for there BSN when asked why they do not have an answer. Too rich for my blood. I will stay a low ADN nurse.
6. 

   open wound care

   twokidsmom,rn posted a topic in Home Health

   Have a new SOC that had a infected wound due to a removal of a cyst. Was on ABX, only rec'd the case late friday. It was OTA, some drainage no orders is getting a I and D on Tues. Had all pre surgical on Friday. I covered it with telfa and tape. Lives in a ALF they will monitor and change telfa PRN until surgery. Will follow her after surgery.
7. 

   Right TKR

   twokidsmom,rn posted a topic in Orthopaedic

   Have an obese patient that had a right TKR. I have to remove her staples on day 14 in her home. They are already pulling her skin. Do not see any room under the staples. Any ideas?
8. 

   Any ideas?

   twokidsmom,rn posted a topic in Home Health

   Now I have a obese pt that had a Right TKR and orders say remove staples on day 14. They are already pulling and I do not see any room under the staples. Any ideas?
9. 

   Staple removal

   twokidsmom,rn replied to twokidsmom,rn's topic in Home Health

   Thanks. Was talking to another nurse she said that if the staples are not inserted straight that no matter what they will hurt coming out.
10. 

    Oasis Pay

    twokidsmom,rn replied to julie0320's topic in Home Health

    I live outside of Philly I get $35/visit, $65/SOC and $22/hr for office work. Lately have been seeing 5/6 pts a day. Our census is low right now. With Medicare cuts do not see any increases for a long time.
11. 

    Staple removal

    twokidsmom,rn posted a topic in Home Health

    I feel horrible. Have a pt with a total hip replacement removed 46 staples on day 15 (Wednesday). Site looked fine, some pink in middle of incision but no drainage and she has been doing alot of walking. Also on coumadin INR is 2.5. Had her take pain med before I came. As I was removing staples some were very easy to come out others I had to wiggle out. She grabbed the bed rail and yelled that hurts. I feel so bad, never had staple removal hurt that much. After it was all done she said the pain is back down to 2/10. No drainage, covered with DSD, used a few steri strips in middle of incision and end of incision. Will see her friday to remove DSD plan on leaving it OTA. But concerned about how much pain she was in during removal. Has anyone had this problem? Called her later in the day she said she is fine and no pain.
12. 

    Low census

    twokidsmom,rn posted a topic in Home Health

    I am concerned again. Was so busy all summer, worked 6-7 days a week, hardly saw my kids. CHanged to a company that paid per hour but my travel was sooooo far from home that I was still getting home late. So went back to my local paid per visit company full time. They had hired a few nurses to cover the far away pts. but now we have too many nurses and not many visits. Alot less stress but not much money. Guess no such thing as perfect. Hopefully I will get more pts after my vacation!
13. 

    Burnt out on HH after 6 months

    twokidsmom,rn replied to R*Star*RN's topic in Home Health

    I know exactly how you feel. I was seeing 40pts a week and working every weekend all summer. I found a company that promised me 6visits a day. So I changed companies. BUT I am going back to the other company. The new company is also a hospice and when your on call one night a week you can be called to hospice pt anywhere and any time and when your oncall one weekend every 7 weeks the same thing. Also they have you leave report and you have to depend on the other nurses that see your pts to leave you report. I am a case manager and have to decide to DC pts that I have never seen? My old company hired 3 nurses after I left. My old boss called me and asked me if I wanted to come back if not she would give my territory to someone else. I decided to go back as long as we will have help. So I do not have an answer for you. The grass is not always greener. Good luck on your decision.
14. 

    Home health and hospice companies

    twokidsmom,rn replied to twokidsmom,rn's topic in Home Health

    When you are oncall you have to answer the phone. No matter who it is a home health or hospice pt. All case managers have to be on call at night once a week and one weekend every 7 weeks. Not an option.
15. 

    Home health and hospice companies

    twokidsmom,rn posted a topic in Home Health

    If you work for a company that has both Home Health and Hospice. Are you ever on call for both? The company which I am leaving has the RN case managers on call one night a week and every 7th weekend. When your on call you can see home health and hospice pts. Of course if your on call and a hospice pt has past or if family wants a nurse there you have to go it does not matter where they live too it can be over an hour away. Recently nurses have had a few 2am deaths and had to be at work seeing there own pts the same day? You get paid time a half for the visit time but not for just being around. Also we were told if there is a hospice question or a problem your not allowed to call a hospice nurse you have to call the administrator that is oncall which is not a hospice nurse. Glad I am getting out before that happened to me.
16. 

    unpaid oncall??

    twokidsmom,rn replied to tx2007's topic in Home Health

    We are not paid on call time unless we go out on a call then it is time and half but still have to be available 24/7 from Friday nite till Monday 8am