hezasan

Hi, I am a home visiting nurse for pregnant gals, moms with babies, and children with special needs. We happen to be the only program in our public health clinic still using paper charting! I am hoping that we will be transitioning to electronic charting soon, but in the mean time-- Is anyone else using paper charts? How long would you say it takes to complete an initial chart setup? What about a follow up visit? For those recently transitioned to EHR -- how did it go? What is the worst thing and best thing about EHR compared to paper? Is your electronic charting mainly text-based, or check-box based? Charting by exception or not? Does anyone do a "low tech" EHR, such as file folders on the computer? What kind of liability/security issues are present/foreseeable with this kind of charting? Thanks for all your collected wisdom!

In my four months of experience in this position, I'd say the vents, trachs, and G-tubes, while complex, become routine very easily...at least as long as everything stays routine, which of course is no guarantee. The hard part is doing all of the "noticing" essentially by yourself. Even though I have had resources available by phone, as well as whatever websites I could manage to get to work on my phone, there is nothing like a pair of eyes and pair of hands to confirm or set you straight when you see something that's just not quite "right". I think that's true for nursing at any career stage, but it's most especially true when you're new. That is where a wide variety of experiences with different patients, as in the hospital setting, would come in really handy. Lucky for me, starting next month, that is exactly the kind of experience I will be getting Though I would say I don't really recommend the home setting as a job for new nurses, at the same time, I had bills to pay and I'm grateful for the opportunity this company gave to me. Sometimes you have to do what you have to do until the "best" situation finally presents itself. What kept me safe in this situation was CONTINUALLY asking questions of everyone, not being afraid to call the doc even if I might have looked silly (and usually they validated my concerns), and not taking "it's fine" for an answer

I really appreciate your concerns. Thank you for sharing that and I agree with you.

Hi, I have recently started a position nursing for an infant with trach/vent/gtube. I really enjoy it, the kiddo and family are great and the agency, while a little disorganized, is always willing to help me take care of things that come up. I am wondering what others might suggest on keeping up with the variety of nursing skills that I learned in nursing school -- I graduated (second career!) about six months ago. I love providing lots of patient and family-centered care, but the family wants to do most of the work with the trach, vent, and g-tubes, changing the tubes and other regular maintenance. Even bathing, weighing, and other care they prefer to do. I feel I understand their perspective on this and have no issue with the fact that that is the way that they want to do it, however, as a new nurse I would really appreciate the ability to keep practicing those skills in case I do actually need to use them -- with this kid or another! For now, the agency wants me working full-time with this child, and they actually have very few nursing cases (most are caregiving) so there is not a lot of ability to jump to different cases. I keep offering to do these things or participate in them more, but the family politely declines (as with the other nurses). Do any of you find ways outside of work to keep in practice with these skills -- such as volunteer work, or anything else you can think of? I would love some ideas! Thank you so much!

I'm pretty sure, that if you aren't feeling overwhelmed as a nursing student, then something is wrong :) Our loved and trusted instructors keep telling us that no one feels like a nurse until they have been working as a nurse for several years. So not to worry if that's how you feel. It's totally expected. That being said, I still don't like feeling that way! I am someone who needs to get the "rhythm" of doing physical skills, which means I don't feel comfortable until I've done it like 10 times within a few weeks or something like that. That is not the kind of practice we get in school. Sometimes we don't even get that in clinicals. So there are a lot of things that I can technically do, but I still do them with hesitancy and shaking because my muscles haven't got it down yet. It's an awful feeling. But I'm pretty sure it's normal.

So helpful, thanks!