Goldentea

Hi nurseinstinct, I am still working in home health. It has been a little bit more than a year since I started working at my current job, and I'm deciding to stay at least 2 years here before I start looking elsewhere...When I first started I was part time, but since February I've been switched to full time with benefits, so kind of hesitant right now to leave...

I originally posted this in Home Health nursing, but I thought it would be more appropriate here... I need some advice here. I have a pt. that has CHF that developed weeping with her swollen legs. I initially wrapped it in Kerlix and told pt. to keep elevating her legs; however, her skin got extremely irritated and reddened from the weeping. Pt's doctor referred her to go a lymph/wound clinic that is 1-2 hours away and family is reluctant to drive her there. I asked doctor for an order to use unna boot for pt, along with kerlix and ace bandage on top (along with order for antibiotic and increase lasix dosage). Doctor agreed. It has been one week since applying unna boot and pt's legs are still weeping, extremely red and painful, and now the weeping areas appear more open compared to before. Pt's legs are also extremely dry from the zinc paste. What else can I do for this pt to prevent her from being rehospitalized? I told family to make appt. to see doctor and make appt. to go to the lymph/wound clinic already. How long do I need to apply unna boot to see improvement or if there is a better dressing you recommend? Thanks!

Hi all, I need some advice here. I have a pt. that has CHF that developed weeping with her swollen legs. I initially wrapped it in Kerlix and told pt. to keep elevating her legs; however, her skin got extremely irritated and reddened from the weeping. Pt's doctor referred her to go a lymph/wound clinic that is 1-2 hours away and family is reluctant to drive her there. I asked doctor for an order to use unna boot for pt, along with kerlix and ace bandage on top (along with order for antibiotic and increase lasix dosage). Doctor agreed. It has been one week since applying unna boot and pt's legs are still weeping, extremely red and painful, and now the weeping areas appear more open compared to before. Pt's legs are also extremely dry from the zinc paste. What else can I do for this pt to prevent her from being rehospitalized? I told family to make appt. to see doctor and make appt. to go to the lymph/wound clinic already. How long do I need to apply unna boot to see improvement or if there is a better dressing you recommend? Thanks!

Hi everyone, I was curious about what everyone's thoughts were about the chances of switching from home health nursing into hospital nursing. I started my current home health/hospice job as a new grad and I plan to stay here for at least one year, so far I have worked here for about 4 months. What are your thoughts about the chances of hospitals hiring when I want to get out of home health? Does 1 year in home health count as 1 year of acute experience that hospitals require nowadays? After one year in home health, am I still eligible to apply for a new grad program or is that even worth it? Can I apply straight for an RN II position? Thank you for your feedback.

Hi everyone, Maybe someone can give me some advice. I have a pt that is 103 years old and has severe chf and copd that is currently under home care. MD wants pt to be under hospice but family refuses and when I wanted to refer a social worker for them to talk about long term planning they also refused. This pt is also a DNR. What do I do in this situation? What if pt expires at home under home care..which is seen as really bad. Thanks!

Hey everyone! I have a question about how to care for the drain site after a drain is removed. I have a pt. that had surgery about a month ago, and yesterday was the first night that the family didn't cover the incision site because it was healed, closed, and scabbed over already. When the pt. went to sleep last night, the old opening where the drain used to be, opened up and started leaking heavy amounts of serosanguinous fluid. In school, we were never thought what to do in home care, and what happens after drains are removed. The nurse I'm working with, my mentor, said that sometimes the drain site opens up if the body cannot absorb the fluid, and sometimes these sites don't always close. My question is, what do I teach the pt and the family about this? Do I tell them that this may happen again and that the site may never close? And if it does open up, just use gauze to absorb the fluid? They went to the ER when it happened last night, btw, because the family got freaked out. Thanks for your help!

Hi squeegee! I am also new to HH and would love to get a copy of your cheat sheet. Can you please e-mail it to me? My e-mail is [email protected]. Thanks a lot!

I recently got hired as a home health case manager as a new grad and I am excited but scared at the same time. I haven't gone out to visit patients yet, but I'm worried that I am not competent enough to be on my own. I will be following a nurse for a couple days and then I will be on my own. Anyway, I have a few questions and any advice is welcome! What do you if you are in the patient's home and you are asked a question you don't know how to answer? Or when do provide teaching on disease processes and medications, what if you can't remember a certain side effect? I don't know if we are provided with the patient's medication list or not before you visit. Did any of you carry around med books and textbooks with you into the patient's home when you first started and look up answers?