Melina

Melina

home health, neuro, palliative care

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All Content by Melina

  1. Blood clots & IV/central line tubing...When does this become a hazard!?

    Melina replied to RN A's topic in Patient Safety Issues

    This case didn't even involve a central line or drawing blood for lab tests, and no medical professionals were found to be

  2. UCH Pharm and Tele new hire exam

    Melina replied to JuLeSx7d7's topic in Colorado Nursing

    If you want to try out a Prophecy test, Mightynurse.com offers access to a free exam. You can take any of the competencies.

  3. Family/Individual across the Lifespan CNS?

    Melina replied to mursej's topic in Clinical Nurse Specialists, CNS

    This is already being implemented as part of the APRN Consensus model. The move is to a population-focus instead of setting-focus. For instance, the acute/critical care CNS program I am in is now an...

  4. Nurses Talk To Nurses. Doctors Talk To Doctors

    Melina replied to madwife2002's topic in General Nursing

    I love this thread! The LTACH where I work has a lot of the issues you all speak of. I am planning on taking on this issue for my master's comps. I was inspired by the reports by the ACCN (Relevant...

  5. To clamp or not to clamp

    Melina replied to FLGAZRN's topic in Critical Care

    I was wondering the same thing on my last shift! It wasn't covered in our policy, so I looked it up. Depending on the manufacturer, some end caps do not require clamping to function. Clamping between...

  6. Please help with a difficult ostomy

    Melina replied to nabelia's topic in Wound, Ostomy, Continence

    Have you tried Cymed? They have a novel, appliance that adheres to the skin with a tegaderm-type material. Because it is so thin, stool cant easily leak underneath. You can see them at...

  7. ECHMO game?

    Melina replied to jakira's topic in General Nursing

    I found this: ECMOjo Simulator and Trainer - Home by searching "ECMO simulator." Not sure if it is the one you are looking for, but it's kinda

  8. Chafing

    Melina replied to dariah's topic in Health, Stress Management

    There are many anti-chafing lotions on the market. I've never tried the lanacane brand, but a lot of althetes use Bodyglide. There is also a product called Luvees (http://www.luvees.com) that might be...

  9. BP arm VS calf while running pressors

    Melina replied to anarchy187's topic in MICU, SICU

    A calf BP can be significantly higher due to calcification of the lower extremity arteries. We see this all the time when taking ABIs for wound assessment. I would be hesitant to to use this to take a...

  10. Calling all current cns students

    Melina replied to nicolein's topic in Clinical Nurse Specialists, CNS

    I'm currently enrolled in University of Cincinnati's online CNS program, but I am transferring to CU Denver this Fall. Nice to connect with you

  11. Please help pt with leaking colostomy

    Melina replied to ditchdoc's topic in Wound, Ostomy, Continence

    Have you tried switching brands? Cymed makes an excellent product that uses a transparent film instead of a hydrocolloid wafer. I've used it with great success on several

  12. Memorial Day weekend night shift - canceled w/only 4hr notice?!

    Melina replied to itri4vt's topic in Home Health

    I have worked intake, and I can tell you that we would often not get d/c notices until after 5pm the evening of discharge, especially on the weekend. There would be know way to let you know by Friday....

  13. Wound Vac Tips and MRSA sterile dressing

    Melina replied to garciadiego's topic in Wound, Ostomy, Continence

    As long as the infection is being treated a wound vac is appropriate. Silver foam seems more reasonable than sterile technique. You can always call and ask the doc for his or her rationale.

  14. LPN's...how's HH working for you?

    Melina replied to peacetou's topic in Home Health

    No caseload? How many nurses will see a single pt? I've never heard of this either. Is there any issue with continuity of care?

  15. homesolutions.net/sansio charting, scantron charting

    Melina replied to hhrnohio's topic in Home Health

    I chart vitals and make notes of anything exceptional with a pen (a fine tipped TUL gel pen, in fact) in the pt's home then bubble everything after the visit, usually in my car before I leave for the...

  16. homesolutions.net/sansio charting, scantron charting

    Melina replied to hhrnohio's topic in Home Health

    Our agency uses them. We are currently transitioning to their electronic version, but right now it's "bubble, bubble!!"

  17. How many is too many?

    Melina replied to twokidsmom,rn's topic in Home Health

    My agency researched what an "appropriate" patient load should be for a full time HH nurse. They came up with 5-6 visits a day, with SOC counting as two and other oasis visits as 1.5 I don't have the...

  18. Awkward area to dress: adjacent Labia majora

    Melina replied to Sterlink's topic in Wound, Ostomy, Continence

    Can she wear some sort of girdle that extends down the thigh a way? Something snug enough to hold a dressing in place without tape.

  19. If new grads can't find jobs in hospitals...What about Home care ?

    Melina replied to Back2Nursing09's topic in General Nursing

    I wouldn't call it relaxed, but I definitely feel like I am giving better care than I was ever able to in the hospital. I have 15-20 pts, but for the hour or three I spend with each every week, I can...

  20. pay per visit?

    Melina replied to GRnurse57's topic in Home Health

    We get $45 a visit; $75 to admit. Meetings, case conferences, CE classes, and other non-billable hours are paid hourly @ $36. We don't get mileage, tho, so I definitely keep track for tax purposes. HR...

  21. pain with mesalt - advice, alternatives?

    Melina replied to nursekelly217's topic in Wound, Ostomy, Continence

    Oops, sorry. You did mention the vac. Is it only because they are shallow that you are ruling it out? There are dressings for shallow wounds

  22. pain with mesalt - advice, alternatives?

    Melina replied to nursekelly217's topic in Wound, Ostomy, Continence

    Have you ever considered a wound vac? I didn't see it in your list. You can even instill lidocaine into the dressing prior to removal to ease the pain of dressing changes.

  23. Colorado New Grads- Do you have jobs?

    Melina replied to Work in Progress's topic in Colorado Nursing

    What's the opposite of

  24. Quality/ Performance Improvement

    Melina replied to caeRn's topic in General Nursing

    I think you nailed it when you said staff doesn't understand your role. How can you change that? What can you do to show staff that QI is about improving quality for everyone, patients and staff, and...

  25. To report or not to report?

    Melina replied to spejsa's topic in Home Health

    Do you have social workers at your agency you can bring in? What about Protective Services? If you suspect abuse, not only physical but financial or emotional (and stealing pain meds is abusive) you...