BillyMae

We use a mars, tx's, vent, task and duties sheets. Just like anywhere else, but each home is different as to style and efficiency. You are trained to the individual home/case.

No good deed goes unpunished.......always hated that saying !! Relates to the work place though.

No, only for WI. but Florida may have their own.

"I also inform my clients that I stay awake on night shift to do my job. I had one client who insisted that the lights be off and he wanted the nurses to sleep. I told him what my responsibilities were and that I intended to follow them. I used a flashlight and had a terrible time sitting there in the dark on that one." Wow, I don't know if I could sit in the dark all night !! Must have been intolerable !! Hope you didn't have to do that too many times Tonight is my last NOC shift, resigned this case, adult vent, going back to peds, a baby:heartbeat I'm sooo excited, and it's day shift.

I stay awake also, but I do know that some cases allow their nurses to snooze if they feel that they can be alert to respond. I could be alert, but feel that if you are being paid, and have chosen to work night shift you should work night shift !! Besides, it's illegal to sleep if you are a Medicaid provider.

In WI. RN's make $32.69 per hour from the state Medicaid program, LPN's make around $21.00 I'm not sure on the exact amount. We are self-employed. It's the same whether you care for vent-dependent or non-vent clients. With an agency you are their employee and make whatever it is that they pay their nurses. In regard to time off, we plan ahead for vacations. Typically a client doesn't live alone, they live with family that is usually trained in their cares as well. They are the caregivers in the absence of a nurse. Not all clients qualify for 24 hr. care either, some only 8-12 hrs. per day.

If you had a child, wouldn't you somehow check in as well ? When I'm out of town for a couple of days I call my 19 yr. old to check in :)

KlsgZoo, are you a member of PHP ? If so, are you going to the conference Oct. 14th? How long have you been independent ?

I'm an independent RN, certified with the state of WI. Self-employed, vent client's, Medicaid, I work full-time. I find jobs by networking with other independent nurses, the job board on the professional homecare providers website, hospital websites, check with hospital discharge planners. I bill my own hours online, WI. has a great website, they direct deposit to my checking account :-) Been doing this for >5yrs. and don't plan on ever doing any other kind of nursing again, been there...done that !!

Procedure codes: vent-dependent 99504, non-vent s9123, these are for RN's. It doesn't matter what you do while you are working, as far as charging your hours. This is for WI, possibly national. The professional homecare providers is a really good resource if you live in WI. There is an annual conference on Oct. 14th at 1pm, at the Kalahari Resort Hotel in WI. Dells. CPR and vent recert are on the 15th. It is only $50.00 per year for membership dues, cheap. Of course the recerts are at cost. Try emailing them again, not sure why you didn't hear back, always prompt for me. Years of knowledge and experience to share, very helpful for the private-duty nurse in WI.

Alprazolam and White Merlot, :ZZZZZ

My comment regarding lack of intervention skills in the hospital setting is because of the condition that some elderly return to the nursing home in. Having fallen or obtained an open area on their coccyx or heels/elbows. Skin integrity and safety are a big issue in the geriatric population. It's offensive to me, the opinion that a nurse that has been working in LTC isn't a worthy candidate to be trained in acute care. Hiring policies are different, depending on where you are. I was hired for the medical/oncology unit with only LTC and clinic experience. For me, I felt that to be an advantage. One of the things that I like about this forum is the opportunity to hear the differing opinions :) And, as the previous poster stated, "No experience hurts"

There is so much that can be learned in LTC, knowledge that is invaluable to a nurse in ANY setting !! Hospital nurses that don't have LTC experience, from my experiences, often lack intervention skills r/t skin integrity, safety, mobility, and psycho-social issues. Many other reasons as well, but I'll let another person address why else LTC is beneficial. This is just one of my opinions, I have LTC and hospital experience, as well as clinic and private-duty. All nursing experience is advantageous !!

Well, it sounds like you've had no problem with lifting, that is good :) The potty training thing may or may not work, time will tell. And, you are definitely right about doing this over and over, opposed to LTC resident ratio's !! Private-duty isn't for everybody, you'll know if you like it or not, but give it some time. There is as great a need as in LTC, for nurses. If you make a difference in only one families life, that is something special. With any case it can take some time to find that comfortable connection, try to keep it professional though and maintain proper boundaries, (important). I'd be interested for an occasional update, if you don't mind :) Good luck !!!

Hi there, back from vacation :) In my experience, private-duty for a child will make a person strong !! As you get to know the child and how they tend to move, you'll know if it is safe for you to manage. Use good ergonomics, your legs will get strong. If you aren't comfortable with the lifting and transfers, don't do it without help or a lift. This may sound crazy, but I cared for a spastic quad for almost 2 yrs., we basically threw her over our shoulder and carried her like a sack of potatoes, she weighed 95 lbs !! Carried her all the way out to the car ! I got very strong, and I'm >50 yrs. old :)

It's nice to work with clients who have a sense of humor, isn't it ?! It certainly makes work more fun, and your client a greater satisfaction with life as they know it.

The 1st visit is so they can see you :) This is what my current clients Mom said, she wants to see what you look like :) Actually, it is a get acquainted meeting to see if both sides are acceptable to work together. You might walk in and say OMG ! I could never work here !! Or, you may feel right at home, and the family will have their feelings about you as well. If you're not certain if you are hired, that they do want you to work, make sure that you ask before you leave. Some families are not used to hiring. Don't be afraid to ask lots of questions if you have many. After you are warmed up to the family/client, ask if you can see the chart/book. It will give you a good idea of the organization of the case. I don't believe it's sink or swim, one of my previous cases took me an hour and a half to figure out if I wanted to work it. I took the case, it lasted 1.5 yrs. Which is good/ok. You will get a feeling during the interview, if you think it is for you or not. If you really think not...trust your instinct !! Good luck :)

Thinking about it again...from my experience. Apply a thin layer of Nystatin creme, allow that to dry briefly, 30-40 seconds at least, fan it with your hand, then without disturbing the Nystatin...apply barrier creme on top. YES, that is what works best :)

Use Nystatin creme.

My thought is that you need to acquire more nursing experience, as a new grad. You won't achieve that taking care of one client. To build your resume, you should want more vast experience, LTC will give you that. Good luck :)

I don't know about other states, but in WI. we, as independent nurses certified with the state, providing private-duty, don't bill Medicare, only Medicaid.

I will send you a few choices of nurse notes, vent and non-vent. I have not billed an insurance company, so I'm no help in that regard :)

Yes, you need an NPI number, but also need to be certified with your state in order to be able to bill your hours to Medicaid. And, just a notebook would NOT cut it in WI. You need a nurses note that covers a full assessment of your client, it is a skilled nurse visit. You may be an independent nurse, self-employed, but still have to abide by your states requirements, and the nurse practice act. One more thing, in the event of an audit you better have more than a notebook and log of your hours. The state can recoup money !! And, the poc that the family has in the home...was created by a nurse and submitted to the MD for approval and signature. Good luck !!

Sorry that was a different post offering forms, but were for WI. You really need to find a local resource, I am not comfortable advising you about NY requirements. Good luck !!

Hi there, I haven't billed a private insurer, only Medicaid, but I believe that you can. Every state is different, I live in WI. and our website is very user friendly. It has the plan of care form required that the MD must sign, the instructions to complete it are also available. You can use a billing service which are reasonably priced, but I bill my own hours because as I said, the website is user friendly. The hours required for each client is to be determined by the MD on the poc. There are a number of nurses notes that are used, vent-dependent or not. Maybe you have a state association for private-duty nurses in NY. We do here, and they are an excellent resource, also provide CPR, and vent re-certifications. I would strongly advise you to find a local resource to make sure that you are able to meet all of your states requirements. If everything is not in order, you will not be paid or they also have the right to take back money paid. As far as finding clients... check with hospital discharge planners, if you have a state association they may have a job board, check Craigs List, or also word of mouth. I see that the following post has offered to send you forms. Be certain of everything that is required, there is no almost when dealing with the government health care system. Hope I was of some help :)