twokidsmom,rn

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

I was bit on the ankle by a parrot. Was doing wound care on a patient when her parrot came up behind me and grabbed my ankle. Broke the skin. I cleaned it applied neosporin and a bandaide. Next day feel lousy, red around wound but no pain, no drainage. Has anyone had this experience.

It is a skin tear on his elbow and forearm. Not a stasis ulcer, he bumped into the doorway and tore his skin.

Should I use telfa instead of adaptic? Or will that dry it out too much?

A non approximated skin tear. Caretaker applied adaptic and tegaderm. It now has white area in center.