hoolahan ASN, RN

OMG Karen!! 500 referrals!!!! You know what, let them go ahead and refer to a competitor, when one agency is like this, they all are, and I bet they will also have a delay, but they may not have the courtesy of being told so up front. I have seen thi...

I don't see any reason why you should expect new grad pay. You have 25 years experience. You only need to be honest and say it's been X years since I have inserted a foley, and they will send you out with a nurse to watch one, then again to see you d...

Hi Kristi, not quite sure I am getting your question, but, I can tell you that most of the psych nurses in home health, that I have worked with, are also responsible for the med-surg component of the visit, like assessing vitals, doing wound care, et...

As a licensed nail tech, I can tell you, we are trained in doing both acrylics and gels. Gels are simply another type of artificial nail and are subject to the same lifting and bacterial problems that acrylics are. I disagree with the diet. I take vi...

thanks karen. in my area, we have an increased presence of gangs, unlike the days of old, when you were safe in the city in the early morning, now, they seem to do shift work, are present on every corner at all hours. i for one no lonher feel safe at...

Tomskatt, thanks for that, it was my intention, and it has just taken off, and I am so glad. I hope you find what you are looking for. Kasey, I agree with Alintanurse, it is best to have some hospital experience under your belt. It is brutal, I won't...

If they spent as much time as it would take to orient you to all the nuances of insurances, you'd be on orientation forever. It changes very often as well. The regs can be complicated, not clear cut, interpreted in several ways by different sup's, in...

Maybe she was afraid her posts could be linked to her/her agency and so afraid of getting into a bind at work?? Or with pt's family if they ever found these posts? Just a guess.

Hi Paula, I did some PT intake as a weekend super, I did intake on Fridays, then with another agency, I filled in for those on vacation, manager meetings, etc..., I did a lot of OT in intake. Karen is the intake guru, and has listened to me vent my f...

It takes the newbies a minimum of 6 months to begin to put together the big picture, please don't ever say you're empty headed! You are learning, and like most of the rest of us, we are given the minimum orientation to get the visits done, and the re...

....you open the door, and the odor of urine gags you. Today, I got a resumption for a pt who is well known to me, from when I was her case manager 3 years ago. She was a problem then, and we still keep accepting her back on service. Anyway, one of ...

Dasuper, I get a lot of great info from the manufacturers in the web. So, if you want info on Shiley trach's and trach care, go to their web site, e-mail them or call and ask if there is a video tape for the patient (you don't have to say it's for yo...

DaSuper, I simplify ,my charting whenever possible, so if there is a check box for something, I will NOT write a narrative, it should be assumed that you are following your agencies policy, and that your competencies in that area have been regularly ...

I am doing quality reviews for an insurance co, and I had a case where the mom of a child alledged the nurses gave her child a wrong dose of a med. I read through 6 months of 487's, notes, etc...but I found the documentation very confusing. In this s...

Thanks justbonny!! That was a big help. I am used to doing al my own orders for visits. Plus we don't have a daily medex, just a list we are supposed to update. A new med list is generated with any changes as per prior 487's every recert period.

Bonjon, yes thank you very much, that is exactly what I needed. So basically, cardexes shouod be updated but aren't. I suspect it is because the same nurses stay with a pt for a long time, in many cases, so they "know" the pt. Your answer was very he...

Welcome bonjon. Would you read my thread on homecare shift nurses? I'd be interested in your opinion. Or I can just ask you here. How do you document meds/med changes in the home? Do you use a kardex sign-out type system like in the hospital, or jus...

I agree med erros go on an incident form and do not go in the chart. But say, hypothetically, the nurse charts that she arrived at the home, and was not admitted, because parents said "We didn't know you were coming and made other arrangements." I th...

PS everything you want to know about Medicare can be found at http://www.cms.gov There may already be info that you need there re CHF requirements or standards of care for CHF'ers.

What kind of setting are you in? Managed care? Hospital? You could ask a social worker about resources, but if you are in an HMO type setting, I imagine your area served in larger than say one county. Please tell me more about your position and work ...

Really Ren?? When I was a supervisor, I had to document every call in the progress notes, from family anyway. So, if a family was verbally abusive to you, you wouldn't document that? I always do, in case it happens again, you have more evidence to di...

That is the thing ren, there are orders for that period of time. Also, when we ask for the complete medical record, that should be the complete record. If there is nothing to hide, it shouldn't be a problem. We have all had difficult patient's/famili...

I know of one person who worked for them in PA, he hated it. Said the pay was poor, and workload unreasonable. Mind you, this is heresay.

Hi Suzi, Of course every agency is different, but it is probably the same tye of NCLEX med question test that you'd take in a hospital, etc... It just tests your broad range of med knowledge. I home care you will have pt's taking al kinds of meds and...

Thanks Karen. I always wondered how my agency would get away with that, because when they decided to make that change, because we were so short on HHA's, they told many patients to get a PCA through Medicaid, nothing in writing of course! It was one ...