bdbrdb

Yes, it does have a humidifier and the RT said everything was correct.

Thank you for the suggestion.

I will speak with the parent tonight on getting a order for the Dr. I sent a message to the manager and I'm still waiting on a reply/call back.

I have a 2yo pt who is uncooperative with their Cpap mask. I've changed the mask, have tried getting pt to hold mask, play with with while off to get them use to it and for a while pt was wearing it for 2-4 HR. RT did come out to check on the settings and the machine and everything was okay. But for the past few weeks pt has been refusing the mask, removing it immediately. Last week during their well child visit Parent was told by PCP pt's tonsils were swollen and would need to be removed and this may be why pt refuses cpap. An appointment isn't scheduled until Sept to address this. I was told by the parent not to use Cpap until after the appointment as advised by the PCP. Pt does have a sleep study scheduled this week. In my nurses notes I've been documenting PCP is aware and per parent not to use cpap until scheduled appts and issue with tonsils are addressed. Is this correct to do or does the PCP need to write an order stating CPAP therapy to be held until after tonsil issue is address? I'm not sure what to do or even what to ask from the PCP. I appreciated any input.

I actually thought it would be a good idea if he stayed home with the kids. I've always worked ft and on my own I can support the family. I wish I could stay home with our kids but financially it was best for me to work and he stay home. I just didn't want to leave my kids in day care or be gone from both their parents for 10-12 hr shifts.

I don't understand why they didn't give me any notice. The Schedular was surprised that I had no idea. She said I can't believe the parent didn't mention it, but then again I can't believe the agency didn't give me notice. I've thought about couples therapy, we don't communicate well. I just don't have anyone else to talk to so just needed to vent. Thanks, I hope I get a case that's a good fit. I left a pt I had been with for two years that was great and his mom was great but they lived too far and dealing with highway traffic for 45 min was a huge headache. So switched to those case that was 10 min away and the hours allowed me to spend more time with my kids.

Right, that's what I think. If my pt gets hurt or I get hurt then I could lose my license and who knows when I'd be able to work.

I just got off the phone with the HH agency I work for as PDN. I was asked what shift did I want to work now that my FT is switching agency...?!?!. I had no idea my pt was switching, so I asked when is my last day and she says oh I thought you knew, don't show up again with that pt. The most frustrating part is my hubby, my income supports our family so it's upsetting when he starts on about I need to get a new case tonight and that I need to take whatever case they have available. He doesn't understand that the majority of the cases are pts who are complete assist, I'm 5'2" and 95 lbs I have a tough time repositioning patients who are way bigger than me. He doesn't understand it's not safe for the pt or myself and also he wants me taking high acuity cases. I've gone to the teach/vent training sessions and even after attending the ones work provides I don't feel confident in working those cases alone especially with a new peds trach pt. His thoughts are that I'm lazy and don't want to work those case. Ugh! I've gone to the "training" sessions and I just don't feel like I'll be prepared for an emergency. And I have covered a shift with an adult who had a trach and even though everything went well during the days I covered he was still too big for me to reposition on my own. I just wish hubby would be more supportive instead of just yelling that I need to find work now.

I work 10 hr shifts as a PDN. Two months ago I switched cases and started working night shift 5 days a week. Since then my left calf has been hurting, it's a constant throbbing regardless if I'm sitting, resting or walking. I've taken OTC pain meds which don't seem to help. I have a tough time falling asleep because of the leg pain, and I made the mistake of taking Benadryl to help me sleep that I woke up in so much leg pain. Has anyone had experience with this before? During my shift I stand up and walk around my pts room, I try to stretch my legs and move them up and down whenever I'm sitting. I tried on some dansko shoes that felt really comfy but I'll have to wait til after the holidays to purchase them. Would compression socks help? My feet do swell up during my shift and at first both legs would hurt but as of late only my left calf has been in constant pain and my feet do still swell up. Any advise on shoes or what else I could do? TIA

He complains about the taste. Just the thought of taking his meds makes him gag. That's why I try applesauce, yogurt, pudding. Sometimes he does fine and swallows his meds without any complaints and other days he just says he can't that they taste bad and make him sick.

I have a 9 year old patient who refuses to take his liquid and pill form meds. He spits them out and vomits when they are given. He'll refuse saying they make him sick. I've made his mom aware of this and she said she will notify his Dr. There are days when he takes his meds fine and then other days they make him "sick". Even with one antibiotic per order that says to crush and give PO he still says he can't take it. Apart from letting his parent know and charting when he does spit meds out or refuses I'm not sure what else I could do to help him take them more easily. I've tried apple sauce and he takes a bite but then spits it out. Does anyone have any ideas or tips for taking meds? TIA

I work PDN for a 9yo pt, I've been with him for almost 2 yrs. some days are good and others are very trying. My pt becomes upset with his parent when he's told its bed time, I'll try to assist him to wc and get ready, being he's upset with mom he takes it out on me. By being uncooperative, yelling, being rude. Mom usually tells him to behave and to listen or else she'll hit him. I've never seen her hit him or am aware that it happens. But he apologizes and says he'll behave. Which he will at least for a few but then goes back to that behavior when it's med time or what not. How am I suppose to handle this type of behavior? I know the main reason he gets upset is because his iPad is taken away so that he will go to sleep when mom says it's bedtime. Talking to the parent is not much help, as long as she's in the room he's fine, nice, cooperative but once she leaves home he's back to that type of behavior. It's to the point where I no longer look forward to working with him, and I've asked the agency to be moved but keep getting the run around that they'll find a replacement and find me a new patient. Hubby says just to deal with it being I only work with him one day out of the week, but it makes for a very long and difficult night shift 😕 I just document what he says or does. Any suggestions on what and what not to do? TIA

This will be my first annual eval with this company. I work for a home health agency and do PDN. Could anyone tell me what exactly happens? Before this I worked at a nursing home and did get an eval but didn't seem like a big deal, I was given a raise and told everything was good that I didnt have complaints and never called in or was late. This is the first time I work at a pt's home, and I'm on as PT but I work 50 hrs a wk and have two pt's. I guess my questions are what should I expect, is it okay to ask for a raise and if so do you just come out and ask or do you give an amount? I not sure how to go about with this. Thanks for any advise or input.

I do try reading other nurses notes but I know at 6am mom wakes up signs your paper and doesn't want to give you time to place it in his binder. I try placing it as fast as I can being that I'm only there once a week I don't want to take their copy home. But I know his regular nurse will take notes with her and placed them at the end of the week.

In October he had back surgery and I had no idea he even had that scheduled. I went in for vague report from mom during my assessment I saw his back bandaged up and my pt told me he had surgery recently. I looked in his notes nothing was mentioned and when mom came home I asked and she said oh yes he did but he's doing good and has had no complaints. Or one time he had fallen out of his wheel chair and mom didn't mention it wasn't during assessment and asking about his day he told me what happened and that he had been seen by the dr.

Thank you.

I've been working with a HH agency as PDN for over a year now with the same pt's. My night shift pt at first mom would give me reports and keep me up to date on what was going on being I only work with him once a week. Lately mom hasn't been giving me reports. If I ask what's going on she says nothing, no changes and then leaves to run errands and what not. And recently I showed up for work and wait for them and I'll text and end up getting a reply if I can come into work an hour or two later. How can I get mom to give me a report and Should I just notify his case manager? My other pt's mom gives me detailed report and has all his appts and notes and BMS posted on the fridge. I wish the other mom was more like that.

Thank you. I'll ask OT see what they suggest. :)

He doesn't have a trach and MD is aware. MD stated do PRN Zyrtec and neb if pt continues with increased secretions she will then increase the Zyrtec. I try not to suction and encourage a lot of coughing. But I do think mom has been suctioning a lot more. He already sees OT/ST right now they are working with getting him to eat PO since he had a gtube. He is terrified of even seeing the suction machine and this started just recently even with brushing his teeth he fights, and before he was okay with it.

I need advise. My 2 yo pt has asthma and seasonal allergies. Lately he's had increased secretions, he has order for prn sx, neb tx and Zyrtec. Before, I would sx orally and nasally without any problems but being he's had increased secretions he's been getting more suctioning by mom and also nurses, he has 2 PDN. I've encourage coughing, done manual cpt and give prn neb tx. I've tried swaddling which is what our case manager suggested, but that didn't work. He kicks and pushes himself up, turns his head and bites on yaunker. I'm not sure what else to do. I'm afraid of hurting him if he pushes up or turns his head while suctioning. Does anyone have any suggestions on what I could try?

I work private duty nursing with a peds patient that has a feeding tube. He's up and about, we play with toys or read books. I work 10 hours with him and he naps for 3 of those hours. The mom is great, it's nice not being so busy running around wishing for more hours to get everything done. I use to work LTC for three years and had 40+ pts. I don't plan on going back to that. I get paid more and I am not as stressed as I was before :)

My best friend passed away on March 21, 2014 at 0630. I've been lost since then. I have been trying to keep it together for my kids but I'm not sure if I can do so for much longer. I feel guilt because I moved out of state and did not return to visit in three years. I talked or texted with him daily. He would spend over an hour talking to my three year old on the phone. She misses him but only knows that she can't talk to Jonathan because he's sick. For a week before he passed he told me he was scared asked for prayer. I told him that I would pray for him and that it would be okay. I did ask his friends for prayer and I went online and requested prayer from two different sites. My best friend was dying and I just thought he would be okay. I had no idea. He has been a diabetic since he was 17. Three years ago he had his foot amputated and recently had tore his chest wall muscle. He was lonely and broken and I wasn't there. I tried bringing him with me. I tried tough love. I baby him. I tried to bribe him. Hoping that he would start taking better care if himself. That he would take his meds eat better get out of the house. But all he would say was I know buddy, I'll be okay. The day he texted to tell me he was headed to the ER because he thought he pulled something and was in sever pain, I begged him to listen to the dr and to the nurses and let them him help. And of course he said I will buddy. For the entire week I tried calling him tried texting him no response. U went in his fb asked his friends if anyone knew his moms number. Told them I was worried. The day someone messaged me her number he texted me. Said he had been on meds, sleeping mostly still in pain. I wish I would have dialed his moms number, but I was so glad that he had replied. And texted me I am alive. After work I called him and spoke worth him shortly. He sounded so tired and I figured it was the pain meds he was on. He said thank you for the pics I had texted him of my babies. Said I love you guys. I told him I would let him go and get some rest and to call me as soon as he felt better. He said ok buddy. And that was it. That was the last conversation I had with my best friend of fourteen years. I don't have closer. Wish I would have stayed on the phone with him longer. I miss the hours of conversations we would have. That week my DH was going up to check in on him and to visit his brother, I had planned on going with him and taking the girls so that they could visit with him. But at the last minute I didn't go thinking that him being sick if he sees us and when we have to come home he'll be upset and he'll feel worse. And with me having to work we would have only been there one day to visit and the other for driving. I had promised him we would visit and I did plan on visiting this coming July. The day before he passed I didn't call him, I wanted him to rest and start feeling better. The day he passed u was awake with my baby nursing her and I looked at the clock and thought of him. I wanted to call him but figured being 0600 he would be asleep. So I waited and went in with my day. DH arrived and had texted me said no one is answering his door. So I called him and he answered and I was so glad that he had picked up the phone immediately so I figured hey he's feeling better. The pastors wife answered the phone and I asked hey is Jonathan awake?! I feel so stupid now for probably sounding so overly excited to talk to him. She told me he passed at 0630 that it was his heart. I got sick to my stomach. Crying uncontrollably. I spoke to his mom and she told me how the day before he had turned his phone off and told her he wanted to rest. She said he had been doing badly but that she felt as though he was getting better. She said before he passed he had been talking about my babies and that they had been singing songs that my oldest had sung on the phone with him. She said that it had made him feel better and that he laid down on the bed next to her and told her he was tired and was going to sleep. He passed in his sleep soon after. I'm angry because his mom said he had been to the ER 4 times and refused to be admitted. I was angry because she said that in five days he did not eat or drink that he had been hallucinating and she thought it was the pain meds! I'm angry that the whole time I kept telling him get adm let them help you stay hydrated take your meds eat! And he said I will bud. I know he suffered a lot due to his diabetes and I know after his father passed he was depressed. I'm glad my best friend is no longer suffering. I'm glad his is no longer in pain. I'm glad he's with his dad now. But I wish I could give him a hug. I hope I was as good of a friend as he was to me. He didn't have a funeral or memorial service. His mom decided that was something he would not have wanted. She asked for his friends to mourn him in their own way. I plan on paying for his tombstone and once his mom passes I plan on having all if their ashes placed near his sisters grave. That's something that I want to do for him. I don't know how to deal with this. I stop myself from calling or texting his phone. I go to text a pic of my babies or call to tell him something funny that they did and I get reminded that he's not there. I need to know he's okay. I need to know that he's in a better place. I just need closer.

Thank you

I did licensure by endorsement and took the jurisprudence exam. So I was exempt that first time renewal but his time around I need to do my CE courses.

Hi, This is my first time doing CE courses. My license expires August 2015, can anyone tell me how far in advance can I do my CE classes in order for them to still be accepted when I renew my license? Also are there any sites you recommend I go to for CE courses? Thank you in advance.