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Kyasi

Kyasi

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Kyasi's Latest Activity

  1. Kyasi

    Nurses aren't maids!

    The comment I was disturbed by was "I don't OWE them respect or have to do ANYTHING they say!" No matter how you feel about what a parent/patient asks of you, above all, I feel that they should be treated with dignity and respect. Kyasi
  2. Kyasi

    When are you going to get a "real" job?

    That mentality is just infuriating. If I had a nickel for every time someone said that to me, I'd be rich. I have met nurses who couldn't cut it in the hospital and in my opinion, they especially shouldn't have been in home care either. In the hospital you are supervised. If you have problems with a vent or your patients biox is 85%, you call the Respiratory Tech. If there is a problem making a nursing diagnosis, you can pick the brain of another nurse. If you need help with a difficult transfer, you got it. In home care, you have to be it all to that patient. That takes more guts and grit then people realize. Let all those naysayers have those 'real' jobs! Home care was a job that enabled me to work my job around my life... not my life around my job. The flexibility was by far the best benefit of all. I've been in home care for 25+ years now and looking back, I don't regret one thing about my job and wouldn't do it different if I had the opportunity. So if you love what you are doing... keep doing it! Kyasi
  3. Kyasi

    Meds on 485 don't match MAR

    I was talking about the nurses head to toe assessment, not the families. K.
  4. Kyasi

    Meds on 485 don't match MAR

    Just to clarify, by making the charting disappear, I mean having the nurse error out and correct it or rewrite it with relevant information. You just wouldn't believe some of the charting I see weekly. I should start a post with some of the crazy things I have read. Kyasi
  5. Kyasi

    Meds on 485 don't match MAR

    I'm not talking about prescription meds. In most cases, it will be something minor like Bacitracin that was used one time. In a recent case, the nurse went to great lengths to document wound care that was done once by the father weeks before. The MD had seen the wound during a routine exam and knew what the father had done. Then she failed to do a good head to toe assessment and said nothing about what the wound looked like when she was on duty. The nurses were not doing wound care and it was actually pretty much healed. (which we found when we followed up with the family.) So I asked the nurse to do a more complete assessment of the patients skin condition rather than to detail care that was done weeks before and that was irrelevant to her assessment the day she was on duty. I am finding that many nurses today have very poor head to toe assessment skills. But that is a whole other discussion! Kyasi
  6. Kyasi

    Meds on 485 don't match MAR

    caliotter3 This is why I think my company is sort of anal about documentation. If the family gives the med and a nurse mentions it in any way in her charting, then we are required to get an order for it. And no matter how many times I tell the nurses that if they don't give it, don't chart it.... they still do. So once it is documented, we have to address it. So I either have to make the charting disappear or I have to write an order for it. It's a pain in the arsss! Kyasi
  7. Kyasi

    Meds on 485 don't match MAR

    Sometimes I think my company's attention to detail is beyond the norm and some of our requirements in regards to charting seem to border on absurd. But we follow them to the letter and I guess I'd rather have that then to deal with an auditor if things were not done correctly. Our MAR's and 485's have to match exactly. We have our own chart auditors that come and check our charts frequently to make sure they do. Part of my job is to check all 485's before they leave our office for accuracy. So a lot of time and energy is spent making sure there are no errors or discrepencies. What drives me crazy is nurses who chart that Dad put Bacitracin on childs skinned knee. It was done once and the nurse will never be using it yet we have to either write an order to cover that or get the nurse to change her documentation. We can't get our field nurses to see that they don't need to mention everything a parent chose to give their child while they were not in the home. (of course something like an antibiotic that was ordered is different) RN1263, does your company mark medication changes that are found during recertifications on the 485 as © changed DC (discontinued) or (N) new? In our company, meds don't ever just drop off but need to flow over in some way with an explanation as to whether they were Dc'd or changed. Is this not the norm? Kyasi Kyasi
  8. Kyasi

    HH nurse, PDN- private duty nurse?

    I admire the kind of selfless people who will put their personal life on hold temporarily to care for a loved one. That is the kind of employee I like to hire. Best of luck to you. Kyasi Geez! I looked 3 times for my first reply and couldn't find it so wrote a second one. Then when I couldn't seem to remove it, I edited it to just say the above, which I didn't say in my first post and now have 3 posts here. Isn't that a 'remove this post' button??? Sorry for all these replies.
  9. Kyasi

    HH nurse, PDN- private duty nurse?

    I replied to this post yesterday but don't see my reply. I will try again. On our applications, there is a place to explain any gaps in employment. This would also be a good place to give these details if you see this on an application. I take this into consideration as 'experience' if I see it on an application. I would suggest using the oncologist (with his permission) as a personal reference on your application. I admire the kind of selfless people who will put their personal life on hold temporarily to care for a loved one. That is the kind of employee I like to hire. Best of luck to you. Kyasi
  10. Kyasi

    HH nurse, PDN- private duty nurse?

    On our application there is a section to 'explain any gaps in employment'. People often use this area to describe care given to an ill family member. You could then list your mother's doctor as a personal reference (ask him first!) Although this was not an official 'job' I would certainly take that experience into consideration if I were reviewing your application. Kyasi
  11. Kyasi

    Not sure what happened

    As for unemployment, most agencies have you sign a clause saying that due to the variable nature of home care, they can't guarantee hours. You are still employed. These are the reasons I've gotten when I'm asked to remove a nurse from a case: She is always 5-10 minutes late, she talks too much about her personal problems, she signed that she did ROM exercises but I was watching from the kitchen and she never did, I had to stop back at the house to pick up my cell phone and she was brushing my daughter's teeth while she was reclined in the bathtub and wet/cold, she has a bad attitude, she was on her cell phone arguing with her husband all morning, she texts all the time, she was on the internet looking for a new car all day (some of these were reported to the parent by the child that was being cared for... some nurses forget that because a child is disabled, some can still communicate) She never cleans up after herself. These are just the few I can remember at the moment. In almost every case it is because the professional boundaries have been repeatedly crossed moving that 'line' back further and further until either the caregiver or the family becomes uncomfortable. I can usually review our 'code of ethics' and show the nurse exactly where the problem began to occur. It's a very fine balance of keeping it professional yet not treating a family like their home is a hospital and the nurse knows more than the parent. There are also times when there is no good reason given. It's never easy to find you aren't wanted back but try to learn from the situation and move on. Kyasi
  12. Kyasi

    Pediatric patient- home nurse situations!?

    So many marriages of parents with special needs children are so fragile anyway because of the stress of caring for their child. That is what makes this sort of thing so awful. From what I have experienced, it's often the man who books, leaving the mother to raise their child. So having a nurse who becomes part of the problem instead of part of the solution is just terrible. Your scenario may have been a bit different but I'm glad you decided to distance yourself and hope you have the strength and sense to stay away. Kyasi
  13. Kyasi

    Pediatric patient- home nurse situations!?

    I definitely agree that this is absolutely the worst breach of professionalism and trust. Don't for a minute think that the other nurses in the home don't know what is going on. They will turn on you in a New York minute. You can count on that. You are treading on very thin ice. When it all blows up, you will be looking at the situation in a very different way and you will regret what you have done. Kyasi
  14. Kyasi

    Protecting license from negligence

    I would recommend that before you do Home care, you get some experience under your belt first. Most HHA will not hire nurses who have not had at least 1 year's experience. If you are working in a hospital, there is always someone to contact if you are unsure of what to do. A Respiratory Therapist can be called to evaluate an airway problem etc. That is not true for Home Care. If you the least bit unsure of your ability to make a good judgment call when you are in a home alone with a client, you should not be there. Kyasi
  15. Kyasi

    Had to say no.

    I used to have a problem saying with this when I first began Home Care. I often said 'yes' when I wanted to say 'no'. My family suffered as a result. I finally got some backbone and began saying no without giving an excuse. One of the few benefits of Home Care is the flexibility. So for whatever reason you can't/won't work a PRN shift, say no and lose the guilt! Kyasi
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