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momsnurse1

momsnurse1

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  1. momsnurse1

    CEU's

    Ha anyone used nurse.com for all of the 30hrs of CEU's for PA? Did the state take them without an issue or did they reject any/some of them? Any help would be greatly appreciated! Thank you!
  2. momsnurse1

    School camping trips

    Anyone else go as the nurse on school camping trips overnight? I have a few questions on how you do things. I'm pretty new to this in a school setting. Here have been a few issues I've run into. I generally stay in a cabin by myself and use it as a homebase for meds, first aid, ect. Teachers usually stay with the students in their cabins and act as chaperones for a group. What do you do when they send a "sick" (usually homesick) kid to you to lay down/rest and you are the only adult there? This posed 2 issues for me, 1) being left alone with a kid while they are in a bed, 2) what happens if I have to be called to go out into the camp for an emergency? I can't leave the "resting" kid alone in the cabin. My second question is how do you get paid? Is it just 8 hrs a day even though you are responsible 24 hrs a day or do you get paid for the whole 24 per day that you are there? My SD has no actual policies for the nurses that go on these trips and I'm trying to develop one since I like going on them and would like to continue to do so but in a way that is safe for both me and the students. Any insight to these questions is greatly appreciated as well as any other tips you may have. Thank you!
  3. Hello All, I am looking for a nursing mentor as I come to the end of my MSN Health Policy track at Chamberlain College of Nursing. The requirements are that this person holds at least an MSN (DNP preferred) in nursing, at least 1 year of directly working with health policy creation or similar tasks, 3 years as an RN, current RN license in PA and be willing to share their resume/CV with me and the college. If anyone is interested or knows another nurse that fits these requirements, please let me know! This has been the hardest part of school so far, finding a mentor that has an MSN as opposed to an RN with an MBA! I can be reached at momsnurse@gmail.com or on here. Thanks for all that took the time to read this, I greatly appreciate it!
  4. momsnurse1

    Chamberlain University: RN-BSN Online

    I took their BSN online program, graduated in 2013, loved it so much I have continued there for my MSN. I took 2 classes per 8 week session. Definitely doable, I worked full time and have 4 school aged children. Sometimes laundry didn't get done on time, but every paper did. I graduated with President's honors and would encourage anyone to go there.
  5. momsnurse1

    Homebound Status

    Actually, HB status has been relaxed over the last few years as I understand it. Clients are now allowed to drive if they have to one else to help them obtain supplies such as food, meds, MD visits. Attending Adult day care no longer automatically excludes a client from being homebound. When I started in HC almost 17 yrs ago, reasonable and taxing effort was defined as causing the client the need to rest when returning home, stopping and sitting for more than 3 minutes to have SOB resolve, ect. As it stands now, anyone requiring an assistive device may be considered homebound in some instances. The vague wording of HB status now leaves a lot of room for interpretation. IMHO, HB status should be eliminated and HC should be provided to anyone with a skilled need for education, wound care or any other preventative measure that will keep clients out of the already overburdened hospital systems.
  6. momsnurse1

    Homebound Status

    Hello All, I am in the process of getting my MSN in Health Policy and have to pick a topic that I would like to see changed within the health care arena. I have chosen homebound status due to the ambiguous way it is written. My dilemma is do I move to have it abolished or do I move to have it clarified where there is less room for it to be interpreted? My personal feeling is to have it abolished as I think we can provide more short term care to more individuals for disease prevention and management thereby preventing future hospitalizations. My examples would be new diabetics, CHF, HTN patients that with some personal intervention at the time of diagnosis would provide a better outcome in the long run. I am wondering how other homecare nurses feel about homebound status and would they keep the law the same, abolish it or make it stricter. Any opinions and thoughts welcome! Thanks.
  7. momsnurse1

    PHQ-2 Scale

    Just wondering if anyone uses the PHQ-2 scale for depression and what time frame to you refer to when asking patients the questions. We generally ask have they had any symptoms in the last 2 weeks but as you know, most of these patients have just had a recent acute episode and I don't think their answers are accurately reflecting true depression. Any thoughts on how I should look at this differently or any other advice? Also, clients who are grieving a lost spouse, how do you differentiate between grieving and depression?
  8. momsnurse1

    Burnt out on HH after 6 months

    Kate, I agree with you that the world of home care is changing rapidly but the thing that keeps bothering me is the types of patients that are being brought onto home care services. People with transient diagnosises that are usually one time and not recurrent such as UTI, pneumonia w/o other comorbities, are provided with services, same as end stage diagnosises because they fit the "homebound" status. However, people that can really use our services, new diabetics, new CHF, new COPD, wounds that patient may not be able to care for themselves are denied services because they are not homebound at time of diagnosis. By denying the patients that are truly in need of education and support aren't we just taxing an already overtaxed system? I recently wrote a paper for one of my classes that that stated "We send the dying to their grave with all of the knowledge about their disease and no time to use it while giving those that can use the knowledge no time." If the purpose of home care is to be pro-active and preventitive and to prevent rehospitilization, we as a system are not focusing our energies in the right places. I believe this is why the home care system is failing so quickly, right message, wrong audience.
  9. momsnurse1

    1wk9

    Kate, "Medicare home health is for the subacute phase of an exacerbation or new onset of illness." This has always been my understanding of the purpose of home care but I am now being told that it is the "old school" way of thinking. We are now being told that home care is to prevent rehospitilization and it is OK to keep people on service to prevent further decline and to continue to recert them. I do not agree with this new philosophy as I think that it prevents patients from gaining the independence that they need when they think we are going to be around forever. Not sure how to get others to realize what the real philosophy of home care is, or am I really just "old school"and need to modernize my way of thinking.
  10. momsnurse1

    Need to vent

    I hate when I go to oopen a patient, they only want PT, which is within their right and the office tries to push nursing on them, especially when they have a copay per visit. Drives me crazy!!!!!!!
  11. momsnurse1

    Face to face MD visits

    If they have been on service prior to the start of F2F, they are not subject to needing a F2F encounter, whether they have seen the MD or not. Only patients started after the inception of F2F require it.
  12. momsnurse1

    Coenzyme Q10 through G tube

    Market America sells a liquid coenzyme Q10 that is meant to be taken as a drink, not sticky like regular liquid. Feel free to inbox me if you are interested in finding out how to order.
  13. momsnurse1

    Face to Face Encounter

    So tomorrow being April 1st, the new face to face encounter will be going into effect. Is anyone having difficulty getting doctors to fill out the attestation sheets? Patients not wanting to go to or be seen by doctor within allotted time frame? How is your agency handling this new requirement?
  14. momsnurse1

    Helpful Apps for Home Health

    I use Epocrates which is a drug/disease reference tool and has a great med interaction feature which I love. I use it on my iphone and it is so much easier than carrying a drug book in my bag all the time.
  15. momsnurse1

    Skin Prep- waste of time?

    Skin prep is often used to protect heels from becoming boggy or when heels have already developed unstageable eschar (thick black scab) to allow heels to heal from the inside without disturbing scab and thus creating a wound. It may be a pain to apply skin prep BID but it is much easier than doind wound care BID!
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