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Home Health CM
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adventurous critical thinker

Kim, HHRN's Latest Activity

  1. Kim, HHRN

    New grad, new to home health - overwelmed

    T your concerns sound a lot like mine have been except I have outstanding support behind me and the lpns I work with r great. If ur in Oklahoma email me. That's where I am too. Would love for u to come work with us.
  2. Kim, HHRN

    new grad with unknown HH agency, complicated pt case

    I don't think you are giving yourself much credit. Will you be nervous? Sure, everybody is when they are new and there has to be a first time for everything, no matter if it is the hospital or in HH. I have been a HH nurse for 2 months now, had 3 months hospital experience, and a year as an intern in a hospital. I was a COMPLETE basket case working in the hospital. I hated every minute of it and felt rushed the whole time and felt I wasn't doing a very good job. My point is this.... I have learned SO much more in the home health environment than I EVER had in the hospital. The thing that you have going for you in home health is you have more time to spend with the pt and can do a much more thorough job. You have time to research things out before going to their home. Plus your coworkers are just a phone call away. In the hospital, they show up on your floor while you are trying to take care of 5 other patients at the same time. Lovely situation, isn't it? No thank you!!! Not for me!!!!!! Have I been nervous at times? Heck, yes. Did my first foley catheter on Friday and another one today. I was terrified the first time. Now it's a breeze. Did my first trach teaching and care about a week ago. I was shaking in my boots but I did my research prior to get me prepared. Have you done any OASIS assessments or been trained on it? It basically spells it out for you in black and white on what to assess the pt for all from the pt to the pt's environment (barriers to the home like steps). Use that as your guide. Do your homework on trach care, cath care, and feeding tubes. Find another RN you trust and ask your concerns. You can do it!!!! You're gonna have to start somewhere, might as well in HH.
  3. Kim, HHRN

    Wet-to-Dry Dressing

    When I was working med surg, we were taking care of a guy who had thick scabs and appeared to be infection underneath, so they were tx with wet to dry in order to debride.
  4. Kim, HHRN

    Wound classification?

    Taking care of a man who has had weeping BLE distally from knees to toes and covers almost the entire leg surface, area red, edematous 3+, hard, endurated,bronze brown, looks like skin peeling around what perimeter remains. Is this classified as a venous stasis ulcer? There does not "appear" to be skin breakdown because you can not see any line of demarcation. Trying to do an OASIS assessment for HHA. Did not know if this technically classifies as a wound since there is not observable ulcer but we are having to tx with wound care. Any advice would much be appreciated!
  5. Kim, HHRN

    New nurse OVERWHELMED

    When I read the OP thread, I thought it was me posting......my floor is too fast, too busy, not enough time to teach a new grad.....guess med surg isn't for me. I gave it my best. I like all the people I work with, but med surg literally ate my lunch.........talk about TOTALLY overwhelmed!!! I DON'T think that med surg is for new grads, just my opinion, unless you are born an adrenaline junky. Too many new things to learn all at once and not enough time to learn it.
  6. Kim, HHRN

    Leaving an agency, giving report

    This isn't advice but I know I have been to several hospitals where report was taped for the next nurse coming on duty. I have also seen on several occasions where a nurse had to leave but left written report with the oncoming nurse. Wouldn't that qualify as giving report? You offered report and she refused to take the information from you. It seems that the responsibility now lies in her lap. She refused to take report on the very report she requested in the first place. She sounds unprofessional to me, asking you to go out of your way, and then when you do, doesn't jot anything down and then states she must cut it short. Wouldn't speaking with your administrator regarding the situation suffice? Afterall, you gave someone who is a representative of the company the vital information to care for the patient, which is what any prudent nurse would do. Good luck!
  7. Kim, HHRN

    People think you are rich because you are a nurse

    Some cell phones have the option to reject the call automatically, yours might as well.
  8. Kim, HHRN

    Transferring total assist clients, how to?

    We need more training in transfers.
  9. Kim, HHRN

    Have u ever??

    That's horrible! I had a bad experience, too but not as bad as yours. I was in my last semester of nursing school, doing my ICU rotation. My mom was sent to the ICU and I had stayed up with her all night long. I came home to sleep for a few hours because I was sleep deprived from being a student and staying up all night with my mom. I got a couple of hours sleep, woke up and checked my phone for voicemail. There was a message on there from the day shift nurse asking when I was coming up there because she needed me to be with my mom since my mom was disturbing all of the other patients in the ICU. She acted really annoyed about it, too. My mom was scared and confused and kept calling for me. I had to get some sleep too, though. I am not superwoman. I thought that was really rude of her.
  10. Kim, HHRN

    Good idea to take micro and anatomy together?

    That depends.....did you take anatomy in high school? If so, and you are already familiar with anatomy, you have an advantage and can probably handle them both at the same time. On the other hand, how much of the prereq courses do you want to retain? Both courses lay a foundation for nursing and if you want to have a good, solid foundation, I would suggest taking one science course at a time in order to retain the material and giving you a better chance at excelling in the nursing program. Good luck!
  11. Kim, HHRN

    So frustrated. Need advice!!

    Hi, this is advice coming from a newbie, too but it sounds to me like you are doing a great job. Learning how to manage heparin drips takes a few minutes and when you are working under pressure, it makes it that much more difficult. At least the next time you have them, it will go much more smoothly for you. The same thing with the PCA, too. At least those are 2 less types of treatments for the patient you will have to learn how to use in the future. I am frustrated and appalled at the health care industry as a whole in preparing new employees, in particular, nurses. Personally, I think it is SO stupid to learn how to operate pumps and drips in a pressured environment with no formal training. Do hospitals automatically assume since we have formal education, we don't need "hands on" training? Is our formal education supposed to compensate and automatically make us "qualified" users of the equipment? These are people's lives we are dealing with. Why can't hospitals invest time in a classroom teaching new nurses how to use the equipment PRIOR to being on the floor where it is SO crazy? It would help cut down on nurses anxiety. Okay, just had to vent and give my
  12. Kim, HHRN

    HELP...2 wks left of orientation and I'm still SO slow!!!

    Thanks for the suggestion, I actually almost got one, but in my last week, I really picked up the pace....don't ask me how cuz I don't even know. I have been off of orientation for one week now, with 5 patients, and acutally able to keep pace. I am very happy with that! I still feel like I am running a marathon but I feel in another month, I will be doing better than I am now. The funny thing is, as soon as I went OFF of orientation, everything went MUCH smoother! It was getting to be a HUGE pain when I was on orientation because the techs would come and give my preceptor the finger stick data but would not report them to me, which in turn, I would have to waste time hunting them down, etc......not fun. It also seems like it's easier to do things "my own way" instead of having to answer to someone else with my every move. My preceptor was WONDERFUL , I think it was just time for me to spread my wings and go it alone and I am SO glad I did.
  13. Kim, HHRN

    Did i handle this situation correctly???

    What do you know.....was just reading in my Med Surg Text (Lewis) and it states that "ideally, regimens should be mutually selected by the patient and the health care provider." Now can we just get the health care providers who won't listen to their patients to read and hinder that?
  14. Kim, HHRN

    Did i handle this situation correctly???

    That's what makes me mad about docs sometimes.....there are a few that act like they are the only ones with critical thinking skills and that the patient (or the nurse) doesn't know didily.....most people know their own bodies better than the doc or a nurse does, in this case, the patient. He didn't feel right when his blood sugar is around 100. Although that may be on the high end of normal, that may be his baseline where he feels he can function best. It all has to be balanced and factored in. I agree with the other PP, he does need education about intermediate acting insulins, though because they should not cause his BS to plummet. If he took all 45 units, and then had dinner, his BS should not go too low, I would think. BTW, was he admitted for his blood sugars being out of control or for another reason?
  15. Kim, HHRN

    is nursing fun for you?

    Locolorenzo, that's my favorite part of nursing, too...:) knowing when something is not right, acting upon it, and helping to save a life. It does make it all worth while. I've had to send 3 patients to ICU since the beginning of my short lived nursing career thus far , and it feels good to know that I am recognizing when things are going downhill. My adrenline really gets to pumping. I just hope that I can continue to be observant of things for my patient's sakes.