nursegeorge

I am new to HH, been in it since March '04. Was calling on Saturday evening to set appointments for Sunday. Could not talk to one of the patients but left a message with the person who answered the phone, who would not identify themselves when I asked. I was told the message would be passed on. I also said I'd call Sunday morning and reconfirm the appointment. Sunday morning, nobody answered the phone, so I left a message. I called back around noon on Sunday and got a different person and was told that my patient was not at that number and she gave me a different number, but did confirm that the patient was at the address that I had. So I called the phone number and got an answering machine. I left a message on the answering machine/service that I would be there between 2 and 3. I left the phone number to the office and my cell phone # (which I usually don't leave my cell #) My call was never returned and the patient never called the office. I went to the house at 2:25pm and knocked on the door...no answer to the door, but there was a large dog barking and snarling and jumping on the door. I knocked again, and waited a total of about 5 minutes until the dog quieted down and then I left. I called the doctor and notified him of not admitting the client to our agency and why as outlined above. I documented everything including phone numbers, dates, times, calls and non-responses. Informed my OCC (I had kept her abreast of this all day anyway.) and called it a day. Today, I was again assigned this man, and when I called his home....NO RESPONSE again!!! I called twice and I called the first number that I had with no response either. I called the care coordinator for the area and asked what she wanted me to do. She told me not to go to the house, if he was that hard to get ahold of, we would NTUC him. Then I get a call from the main office that this patient had called the night OCC last night (Monday) and was livid that nobody had made an effort to change his dressing or come to his home. She assured him that someone would be there today! I guess all of this was not passed on to her from previous OCC. She also double checked his phone number, and I did in fact have the right phone number......ARGH........I feel really bad about this, but I did all that I felt that I could to get this guy started up with care. Oh, also, this house is located where there was a quadruple drive by shooting on the Saturday evening before my Sunday visit. What would you have done? Did I do enough? I documented to protect myself and my agency. Now understand, I love HH and I have 20 years hospital Med/Surg experience so I am not a new grad or anything. I am very dedicated to my job and have the highest respect for patients and their needs. I'm not a slacker and have made production since my first day out of orientation! (production of 7 per day) So why am I feeling so bad about this one? I also told my supervisor that if he is put back on the opening schedule for tomorrow.......don't give him to me....I've had enough of this one. (Oh, and I usually only work weekends and am helping out today and tomorrow because they are really short of help!) The other nurses have told me that I went beyond the call of duty and they wouldn't have made this big of an effort. nursegeorge (I'm a female. *g*)

I am currently negotiating with the HHAgency which is affiliated with the local catholic hospital. They (the hospital) has consistantly been rated in the top 100 places to work for working mothers. They are trying to match my hospital salary and I was told by the HHDirector that they really, really want me, so we shall see... Thanks again for your welcome. I hope it works out. G:nurse:

Using the chain of command in your hospital and exacting documentation of specific incidents? If you have been happy up until now, then you have three choices: 1.) do what I outlined above (and possibly be branded as a trouble maker...hopefully not though.) 2.) Stay quiet, leave the unit. 3.) Stay quiet and suffer in silence. I personally have been at this for over 20 years now and agree with whomever said she was ashamed of the actions of your so-called "charge" nurse. It is disgusting that a Professional RN would act like that, but unfortunately, it happens all the time everywhere! Start documentation on what you see, when you see it , dates and times, names etc. Then when you feel you have enough evidence to hang the charge nurse without a doubt, then go to the NM. Carbon copy the director of nursing also. You have now cornered your NM and she must do something about it with the documented evidence!! (If you don't want to take this bold of a step, then present it to your nurse manager first...she will probably try to sweep it under the rug.) Either way, you must be strong enough to endure the backlash that will happen. You had better be prepared to be scrutinized intensely by the NM and the Charge nurse. I hate that it is this way in the nursing world, I wish it would change, but that is the way it is. (And we wonder why more men don't get into the profession? Way too much back stabbing and pecking and eating our young!!) As far as the LPN/LVN orienting a RN. I have mixed views on this. At times the most qualified nurse is a LPN. I work with a few RN's that I really think are incapable of orienting a new grad and there are some LPN's who are the absolutely best nurses I've ever worked with. Whoever is chosen they must be at an expert level in their skills and have enough self-confidence that they don't need to tear someone to shreds to make themselves look better, smarter, you know the kind. I have written an article on this very topic..."Eating Our Young." Hopefully it will be in Nursing Spectrum in the near future. Anyway, good luck. Make it a better world and I don't envy you your charge nurse...Wish I could come there and work with her for a week or two, I'd go toe to toe with her for you and orient you on how to professionally take someone down a few notches! LOL LOL.... Best of luck, nursegeorge (btw, I'm not a male.)

Thanks for posting so much about your days as HHN. I am interviewing for a HHN position. I have 20 years of Med/Surg hospital experience, 4 years of OR, 1 year of private duty in the home and for some reason considering going in to HHN scares the wee out of me! I think reading through your posts has been a wonderful education and humbling experience for me. You all sound so dedicated and right on the ball with all of your patients. Your humor has really touched my heart too! Someone said they needed to get out of the hospital atmosphere....I agree with that. I've been there for 20 years and the pace is killer!! I can still run circles around the girls half my age, but for how much longer. After reading through what all of you do...ya'all aint no slackers, that's for sure!! I'm not afraid of hard work, nor long days. I guess, just the learning curve! As far as pay goes, I'm being offered $42/visit and $60/admission plus mileage if I do the per diem. They are trying to match my hospital salary of $30/hr basepay plus premium on weekends. (I can only work weekends...2 small daughters and a workweek husband.) I really can't affor to drop my pay much from the hospital, but if I don't do something, I'll drop from the stress at the hospital, (as well as the 18 hour shifts without a wee-wee break or food!) God Bless all of you here. You are truly an inspiration to me and I love reading your posts in this thread!! Your honesty, devotion and professionalism really shines through your words, and as I think Hoolahan said a doctor said: "Your patients are really lucky to have you for nurses!" Thanks, Nurse G. :)