imelissa1

I worked at a sub-acute with 15 years of nursing experience, but, no sub-acute experience and they gave me 4 weeks. I still needed more. The point is that one week may be good for someone with direct experience, but, for anyone else you need at least 1-2 months. The problem is that there is so much employee turn-around in these facilities, they need to push you off orientation as to not lose money.

In nursing school, I tried to take an apical pulse with my first and second fingers pressed against the chest.

I have a diploma and have never made less than a nurse with a bachelor's degree. They only care that you are a registered nurse. I thought I gained a tremendous amount more hands-on training in the diploma program. We were in the hospital from day one and multiple days a week for the entire three years. It was no joke. Monday through Friday, 7:00am-4:00pm for three years straight. No summers off. Good luck!

"Be nice....I dispense the HAPPY PILLS"

I'm in the same situation as you, mAGGI. I'm looking to start my own business and don't feel as if I should be giving advice in this area. If I were you, I'd include these skills on my resume and post it on Monster. I was saught out by several companies there looking for case managers. I'd be searching 'case manager' and/or 'clinical liason' on job postings and check out casemanager.org. I'm sure you can find a ton of helpful information there.

Maura, did you get a job with Maxum (Centrus)? I heard a new nurse started at a case I am working in Harwich with a Psych history, but, won't be returning. I was just wondering if that was you.

The facility I worked at, it was not uncommon to have one nurse to 40 patients on the LTC floor. They called it "the med pass from hell". Good luck. Let me know what you end up doing.

Well, I've been with them for a month now and can tell you a few things. First, they don't do skilled visits anymore. They are strictly a private duty agency. I like that, though. Rather than driving everywhere, I go to one home and stay there for the entire shift. The shifts range anywhere from 3-12 hours. I have a great case on the Cape and am learning a tremendous amount amount tracheostomies and G-tube feedings. I have also branched out into pediatrics which is also something I have feared in the past. As far as a schedule goes, they don't offer a Monday through Friday routine. They give you a list of available openings and you decide when you'd like to work. I go from working 20 hours one week to 40 the next. That works well for me right now. I'm trying to concentrate on weekend hours so I don't have to pay for child care this summer. Hope this helps. Let me know how you make out. :redbeathe

May I ask what agencies are paying these rates, Alvindudley?

I'm hoping that they are referring to the orientation where they make you watch movies and fill out compliancy tests for three days. If they are not, run. A new grad needs at least 4 weeks one-on-one orientation and then maybe an additional month on an as needed basis. Never three days. I think a skilled nursing facility is an excellent place to learn a lot, but, you have to be your own best advocate. Insist on a longer orientation. And have they told you how many patients you will have to carry? I just left a facility who try to give me 22 patients on a daily basis. It was a danger to the patients and myself. Not to mention physically impossible.

It's sounds like Case Management to me. I subcontract from a company in Maine (I live in Massachusetts) to Case Manage patients that insurance companies consider a "risk". I get paid to meet the patient, interview to determine needs, streamline doctor's visits and ensure consistant communication between the insurer, doctor and insurance company. I become their go-to for any health concerns and have managed to keep them from being hospitalized since my becoming involved. It's a growing field that I have been hearing of more and more. I just had a company who strictly case manages contact me after seeing my resume on Monster. They are in desperate need for any nurses who have experience in this area. Good luck!

Wow! What a tremendous source of information you are. I can't thank you enough and I can honestly say your dreams are coming true....you have certainly helped me start my own business. I live on Cape Cod, Mass. There is one Wound Center that physicians refer to and that's it when it comes to wounds. My hope was to educate the staff of the multple skilled nursing facilities and home care agencies here. I was also hoping to be used to consult on difficult wounds and/or be used to write wound care algorhythms and patient (staff) education materials. Any thoughts on billing by the hour or monthly contract? I have incorporated, but, have not upgraded my current personal liability insurance to one that is more business oriented. I was going to wait until I had an actual contract before I do that. They are usually effective on payment and just looking for a way to save money. I know that I can more than pay for my services with the money these agencies will save on effective wound treatment. Now, I have to get them to believe. Any advice on getting in the doors? My plan was to use some current contacts, cold calls/emails and walk right in the door. I've also heard of small business owner groups that get together to network. Any other suggestions would be greatly appreciated.... Thank you so much for your help and time tropicalfish!

I am shoulder deap in starting my own Wound Consulting business. I have a business plan, web site and education materials. I'm having trouble figuring out how to get paid. I've read on these postings that only a NP can bill Medicare, but, from what I read on Medicare's website, it does not appear the case. My next step is to apply to the various insurance companies and see what happens, but, will I be waisting my time? I am a RN with a Wound Care Certification and 9 years of home care experience. Any ideas on getting paid and/or billing?

Forget the NP unless your goal is work for a medical practice. The NP at my doctor's office told me she gets paid $30,000/year. No lie. Granted, we don't do this job for the money, but, $30,000 is ridiculous particularly when you factor in the increased risks that come with being a NP. I would get my BSN, work and continue until I had my MSN. You can do anything you want with your MSN. I was in the process of getting my MSN through Drexler University online until I switched employers who didn't offer a very good tuition reimbursement program. Many employers will pay for your degree so look for all the money you'll save if you get your BSN first then have them pay for your MSN. And the best part of all, you'll be able to pick and choose your job. No shortage, no layoffs (for the most part :)

I'm still waiting to start, Maura, but, I'll let you know when I do. The entrance process is quite vigorous which I think speaks volumes for their staff. First, I had to complete two very thorough tests on general nursing and pharaceuticals. Second, I interviewed with the branch manager and the clinical manager. They have spent the past two weeks running a fine-tooth comb through my resume, certifications and references. Now, I have to wait on my Cori, my credit report and TB two-step results.......whew. Like I said, I'll touch back in about a month. That's usually how long it takes to determine many of the 'cons' of a new employer.