rhapsodyRN

I've been reading through the board and I'm finding a lot of negative comments lately about HH. I have also read through the stickies and it sounds like a lot of you do really enjoy your job? I know paperwork is a big negative, but what else is driving you crazy? :) I come from a very busy floor and I'll be starting in HH in a couple weeks. I'm starting to get a little nervous now that I'm reading a lot of negativity. I know it comes in waves and that not everyone loves their job, just trying to get an idea if this is the whole of HH, or if it's maybe just the policies/procedures at some of the HH agencies you guys work at? I think this is going to be a good change for me so I hope that at least some of you can reassure me that I'm making a positive move. :) Thanks!

Hello all, I'll start off with a question. How many of you had babies/very small children while working home care and do you feel you were better off doing it that way as opposed to working bedside? I'm considering a change from bedside to home health. I am constantly stressed out, don't sleep well, have gained 15 pounds, and although I do actually love my job, I don't feel it's my perfect fit. I've only been an RN for a year, and my husband and I are trying to get pregnant this winter. I work med/surg and some days its great but I never feel I have enough time for my patients. I know that home health has its own stressors but I feel that I would really thrive in an environment where I could actually have time to teach my patients what they need to know and do treatments without having to worry that my phone will ring with a patient needing their pain meds or needing to "see my nurse" and then going in and finding out all they wanted was a Sprite. My biggest worry is this. If we get pregnant soon, I know that working bedside would afford me 4 days off a week to be with my child. However, as I said I don't sleep well the night before I work. So add that on top of a baby waking us up during the night, trying to coordinate childcare when we both have to be at work early and get home late, and then working 12 hour shifts... I've seen so many posts from people saying they'd never go back to bedside and I feel I'd be a really good fit in home health because my patients are always my primary focus and I really enjoy that one-to-one time. My reviews have always been good with the best marks in rapport with my patients. It's something I'm proud of and I feel like it would be better used in a home health environment. I know there's tons of paperwork but I'm no stranger to that, and it's still easier to do all that paperwork on one patient at a time, than it is to try and chart on 5 patients continually throughout the day (where I work we chart EVERYTHING down to giving a patient a glass of water). Anyway, any advice you guys could give me would be greatly appreciated. Sorry if this post is rambling or nonsensical..I'm still tired from working yesterday :)

I loved nights for a few reasons. Not as many docs milling around, patients sleeping for the most part, having a little more time with the ones that couldn't sleep, not having to deal with meals, 80 family members, etc. The nurses that I worked with were good and helped me out as a new grad. But..... I was like you, where I was turning into a different person and I didn't like that person at all. I was short with everyone, never had energy to do ANYTHING on my days off, the house started to look like a dump, I'd cry at the drop of a hat, and if I got "decent" sleep, that meant 4 hours without interruption. I couldn't sleep during the day for crap. And, our unit goes up to 6-7 patients per nurse on nights. For a new grad I think it was really hard. Some handle it well, but those are usually the ones that were used to a night schedule, or much younger than me. :) I signed up for days at the first opportunity and luckily only spent a few months on nights.

It's usually 72 hours because you work 3 12 hour shifts per week, and that adds up to 72 hours in 2 weeks. I still get overtime if I am asked to work an extra shift that puts me beyond 80. Or a lot of nurses just pick up 8 hours on our floor or another one that has one open. Depends on your hospital's policies.

I agree with Nightcrawler, you are seeing this from the ICU perspective. I work on the floor and I can't put a foley in someone because they "might" decompensate. If they are incontinent, our first move is to put an Attends on them anyway, not stick a foley in them and put them at risk for an infection. If we feel skin breakdown is a potentially serious issue or the patient cannot void, we can get an order for a foley. But it is not standing orders. Even on our stroke set, we have to call for an order for a foley and explain why we are asking. I'm not saying the ICU nurse didn't have the right to ask those questions, but what you consider "basic" care on the ICU is not "basic" care for floor nurses. Foleys on our unit are taken pretty seriously. There must be a real need for it before we're going to place one. And yeah, if I try and stick a Tylenol suppository up a guy's bum who is A&O x 4, I'm more likely to get socked or arrested for assault. :)

Yes yes!! I love my neuro unit. We're neuro/med-surg/progressive and I really like it. I was terrified at first because I felt like I was in a nursing home..LOL..but now I really enjoy my job. There are days, trust me, but you will get tons of great experience while not being totally over your head. Good luck!

RNPerDiem - Neuro ICU and a neurosciences unit are not necessarily the same. We do have tragic situations but we don't have the hugely depressing factor like the ICU. I don't think I'd ever want to work ICU. Neuro stepdowns are much more rewarding. Here's my 2 cents again...I've been in neuro less than a year. I took my job originally because I was somewhat interested in neuro as I'd grown up around a couple of neurosurgeons but just REALLY wanted to get started in nursing and there were no jobs here. I thought I always wanted to do pediatrics. Enter my neuro unit...and 10 months later I don't want to leave. There are the days when you get ETOH w/d patients and you just want to go home and scream because of all the assessment you have to do (and usually ETOHers are just like your psych patients), and most of your patients will require frequent checks especially if they are true neuro patients. We get people in restraints frequently. We get the dementia/alzheimers patients, and like I said before, some of the psych patients too. The best moments of your job will be when you DO get those TBIs on your floor, and see them go from not speaking and just staring out the window to having a conversation with you and walking around the unit. You'll also see the opposite and that's the tragic part. I love when we see a stroke patient helped by tPA or a lami with fusion that can finally stand up straight after years of pain! Guess long story short, what I'm trying to say is that if you give it a try you might really love it, and you will learn SO much in such a short time that if neuro isn't for you, you'll be able to go somewhere else pretty easily. I hope you give it a shot! :)

sonny is partly right. I work on a neuro unit and if your hospital doesn't have an "official" psych unit, neuro is where those people will end up 9 out of 10 times. However, you'll also get lots of experience with back and neck surgeries, seizures, strokes, etc. I was nervous/scared for my first few months working there but I have learned a TON and now I really enjoy it! I'm spoiled though, our unit is probably one of the best run units I've seen and I don't just say that because I work there :)

I drive 55 miles (takes about an hour from my door to the shuttle lot). But when I work I stay with family so it's not that bad. I'm trying to unload my house so I can just move where my job is.

I had a few absence seizures when I was younger. I grew out of it by the time I was in my teens. My neurologist at the time just told us to watch it and of course bring me in if anything severe happened. But usually I'd just sit there like you describe and then I'd go about my business like nothing happened. It wasn't until my grand mal at 13 (completely unrelated to the absence seizures..btw) that they really did anything test-wise. Good luck!

We just finished our OB rotation Friday. I finally got to see a lady partsl birth. I saw a c-section but even though it was amazing, it didn't hold a candle to watching the lady partsl delivery. I didn't even hardly know these people and I was in tears. And the thing is, I can't imagine it being any different any other time. Do those of you in L&D always feel moved when you see a delivery? Or does it wear off after a while? :) I don't know if the emotions I felt were because I had been very involved in helping this woman push or if it was just the miracle of birth, but it really opened my eyes and is making me consider L&D after graduation. I just loved this semester!

OMG..I can't tell you how many times I've done this. And not just in clinicals at the hospital. I do it anywhere! I'll be telling a story and then all of a sudden I'm trying to figure out why I was telling it and where I'm going with it. Or I just forget completely what I'm talking about. It's like my brain reboots in mid-sentence. Luckily most people I know have had the same thing happen and laugh it off, but it can be embarrassing sometimes.

Thanks to everyone for relating their stories. Thanks Blu..I should have said that too...I'm definitely not seeking medical advice, just wanted to know I wasn't alone in the weird side effects. :) The sluggish and tired feeling is what I have today..not so much the disconnection luckily. I have tons of homework to get done today..can't afford to feel weird!! :) If this stuff doesn't work..we're trying Lexapro next..essentially the same thing but my insurance wouldn't cover it because it's the "next step" from Celexa..sheesh!

It will probably depend on your employer's policy. I am not a nurse yet but where I work if you're off more than three days you need a doctor's note to say why and when you'll be coming back approximately. Just so people aren't using their sick leave for "vacation". :) So, check the policy where you work and see what it says. Wish I could offer a more definitive answer but workplaces vary so much!

Anyone here ever taken Celexa? I started on Friday and I'm noticing that I feel a bit disconnected from myself right now. I'm not anxious at all, which is good because that was my problem, but I feel like my head and my body aren't together right now. Just wondered if that was a normal side effect when starting this med. I was not depressed much at all..doc prescribed for anxiety with very mild depression (lots of crap has happened this year..it's understandable. :)). This is a new feeling for me..I'm not sure if it's normal or not. :) Thanks for any help/stories of your own use that you can offer!!