IMOKAY

@poko Thank you for commenting. The autonomy, one patient at a time, and flexibility were the things that drew me to HH for sure. Can I ask you how many routine visits and SOC, ROC you typically do each week? Right now I only have 1-2 routine visits per day plus 1-2 SOC per week. Many times only 1 visit a day.

I'm 2 months into starting in home visits. It's a lot different from working hospital especially the charting and trying to reach the PCPs. I feel like I have to call the PCP for every SOC and ROC to receive or clarify orders, notify of med changes, notify of every little change in vital signs that nobody would blink an eye at in hospital, notify of med interactions of meds this patient has been on for years, missing meds, med non compliance, every insignificant yet pre-existing issue....and I have yet to receive any return call back from any PCP! Sometimes I feel like I'm spinning my wheels, not really making any impact on my patients. I do so much planning and phone calls on my own time that I'm not paid for. ( I'm paid points per visit). I'm making around $300/week on average so far and I'm supposed to be full time. Is this the reality of HH? I'm still new so the OASIS charting and POC are still daunting. Tips, advice, good/bad/ugly of it all much appreciated. Should I stick with it?

I'm starting my second month in HH and I've only been given 3 visits per week! I get paid per visit, so I've made less than $200/week. Not sure if I should stick this out or not.

I agree with others. Ask for cannulating practice. Find 1-2 patients that don't mind you practicing on them and ask that you be their cannulator when they come in. Hopefully that's possible in addition to doing the job they currently need you in and it's a win-win for everyone.

I wanted out of bedside nursing and I jumped into acute dialysis nursing in the hospital. It has been so much less stressful and more rewarding. I just want to share my experience for others who enjoy working 3 12hr shifts in the hospital but hate bedside nursing. Pros- 3 12 hr shifts in the hospital, working on all units like oncology, med/surg, ICU, ED, ICU step down, cath lab observation. Being on a variety of units with patients of all levels of acuity has provided many learning opportunities. The primary RN still has full responsibility of the patient while I just focus on dialysis, making adjustments on the machine and monitoring vital signs and LOC. I float between 3 different hospitals and do dialysis bedside, one patient at a time. (Some hospitals transfer patients to a treatment room for dialysis.) The patients and their families are usually happy and grateful for you being there. Providing diabetes, hypertension, dialysis and ESRD education has been reinforced into my own education as well. I've become proficient at fistula and graft cannulation, central line catheter maintenance, sterile dressing changes and TPA administration. I have also developed an eye for signs of fluid overload and third spacing in these patients as well. You aren't breaking your back lifting, turning and cleaning up code browns. You aren't giving 100 medications. There are a few cons. A major one is the unpredictability of your hours. Sometimes the hospital census is low which effects the number of dialysis cases. When it's slow you aren't working. On call shifts are required in addition to the 3 12hr scheduled shifts. This can be awesome OT hours if you want more money or it can be a nuisance if you don't want that many hours. Delays like occluded lines or low BP can add extra hours to your shift as well. But this work is pretty easy, physically and mentally) so extra hours aren't necessarily going to drain you like it would in other jobs. Overall this is a great alternative to working as the primary nurse on the floor and I highly recommend it!

Rant: Hating all the APA paper writing. I can barely tolerate the APA referenced discussion posts. So much theory, philosophy, BS fluff. I want to learn anatomy, pathophys, tests, procedures, determining diagnoses. Feeling annoyed. Havn't even started begging and groveling for a preceptor yet. Is it all worth it?

Brilliant insights. I wish you could mentor me in person.

I'm interested in learning wound care and being a certified wound care nurse eventually. I've been looking at wound care education institute and other reputable sites for learning. This specialty looks very complicated with so many wound types/causes, bandages and treatment methods! Please tell me how you all first got into this specialty. Hands on training? Which is better - inpatient hospital floor/SNF or outpatient clinic? Is it really as complicated and overwhelming as it looks? Non compliant patients are always a frustration in all areas of nursing. What are some other obstacles? Pros and cons, liabilities. Thanks!

@time2go. Very helpful. Thanks for taking time to reply.

Hi @time2go. I'm also interested in becoming a hospice NP. Did you have a difficult time finding hospice NPs to precept you in school? What is a typical day/duties expected for you as a hospice NP? Thanks!

@vargasnurse Im considering Herzing AGNP online. Did you have a hard time finding preceptors?

@Elrn I decided to go with Herzing University. It's 100% online. 8 week courses. I'm still in the application process but hope to start in September.

I have my BSN and want to get my PMHNP MSN. Im discovering many programs offer a post grad certificate to specialize in mental health. Are there PMHNP programs that take me directly from BSN or do I need MSN first?

What did the interview focus on? Previous experience or why choosing MSN?

Im working filltime and considering this program. Thanks for the warning.