cherricka

The on call nurse, who takes on call during the week from 4 pm to 8 am Monday to Saturday, gets a regular salary. Depending on the Position Grade of course. Within my own Position grade, that would mean between $54,171- $69610 a year

I am a home care nurse, and I have never run into this question before. I know of a close friend of the family that had one kidney removed because of cancer. He recently had some issues with a blockage in his ureter. Before he had his surgery, they told his wife that if they found cancer in the remaining kidney, they would remove that also. Luckily, everything turned out fine. I just have never heard of anyone relying soley on dialysis, without any kidneys. Has anyone actually seen a patient with both kidney's removed?

I agree with the other posts. I do not miss the company of other nurses 90% of the time. I go to the office once a week or so, and get my fill of socialization then. I also am a preceptor, so I do get a welcome break of solitude once in a while. Man, there is nothing like traveling in the car, listening to the radio, rather than gossip on your breaks!

Answers to your questions. 1. I work part time, 20 hours (yeah right!) a week. I am expected to see twelve patients 2. I would say I average about 200 miles for three days work. We get something like a .25 point if you go over so many miles a day. I have not received a clear cut answer to that one. 3. I spend about one hour on each visit. 4.We are offered a 75 cent increase a hour if we meet our productivity expectation quarterly. 5.I spend about one hour at the end of the day on paperwork and phone calls, up to 3 hours if I had an admission/recert/roc. Yes I charge them for it. 6. We get time and a half on the weekends, no matter what. We get overtime only after working over 40 hours in a week. 7. We have specific people doing chart audits, which I like. I have learned a lot from my mistakes! 8. Typical case load for regular full time people- 25-30 visits a week. Admit and ROC are counted as two, recert as 1 1/2 9. We are all on computer now. Some nurses hate it , I love it. It reduces mistakes and med errors, I think. 10. No one is denied O.T. in our agency. If you are willing to work, they have it for you. Our company continues to work on what is considered fair productive expectations--as you said, we have a lot of meetings we are expected to go to, etc. I am also the go to nurse that they ask new nurses to go with, or students from the local colleges to go with. I don't get paid extra for this, but I think they are going to change my productivity expectations when I do this, since it takes so much time. Home care---you either love it, or hate it! Thank God I love it!

Medicare will not reimburse an agency for a "lab only" visit (so I have been told). So this visit is combined with a regular visit. If I were to just draw labs, or just do a PT/INR, I would make it a non-billable visit. We also do not bill medicare for blood collection supplies or tubes, along with not charging them for the long ride to and from a lab, so this PT/INR machine saves our agency money.

No where in motorcycle mama's post, do I see her "bashing" anyone. I see that she is venting her frustration about situations that she has come across. Unfortunately, as a community health nurse (home care nurse) you see some people possibly at their worst, or in horrible situations. When you see this over, and over, your thinking does slowly change. The difference between a good nurse, and a bad nurse, is how you treat your patient, even though you may disagree with their lifestyle, choices, etc. I also have a few patients (never mind what insurance they have), who try to squeeze anything they can out of me, including paper towels and hand cleanser.

Our company has just upgraded to the CoaguChek PT Test machine. This is much better than the older ones with the cuve (I think that is what those strips were called). You use a capillary tube, after you use a small lancet--thus needing much less blood. It is so much quicker than the old machines, I have less problems. I have been told that it is more accurate than venipuncture, because you are using whole blood, without as much interference, such as how the person draws it, how much time it takes to get to the lab, right down to how the lab performs their test. I love it, especially on the days where I would have to drive 40 minutes to the closest lab. Of course, you have to fight one another for the machine, even making deals with each other, just to get it.

I know this is an old post, but I finally found the word I was looking for-Lipodermatosclerosis- This color change is due to a buildup of hemosiderin in the interstitial tissue as the RBCs that have leaked into the tissue break down. The fibrin causes skin and subcutaneous tissue to thicken and become fibrotic. I would highly recommend Wound Care made Incredibly Easy from Lippincott Williams and Wilkins to any home care nurse-It has been very helpfull to me. Cherricka

Thank-you Karen, just what I was looking for. Cherricka

I would like to ask if anyone has a risk assessment tool to use for their Long Term Home Health Care patients, to reduce the likelihood of re-hospitalizations. Any input would be greatly appreciated. Thanks, Cherricka

I was 31 when I went back to school for my RN. Boy am I ever glad I did. I was just looking through my old pay stubs, and I have almost doubled my salary. I am a single Mom, and thought I could never do it, but with the help of my parents, the government and a wonderful neighbor and friend to help me with my son, I did it. I was surprised at how fast the time went! Good luck, and go for it!

I was an LPN before I became an RN for several years, and that included working as a charge nurse responsible for 40 patients at one time. When I went to go work at the hospital after getting my RN, I thought-hey what's 5 patients when I use to take care of 40? Needless to say, over one year, my 5 pts. turned into 10 in one day. I got the heck out of dodge. I love nursing, but almost once a week, I would come home crying, and it would take me two days to recover from a 12 hour shift. I don't regret working in a hospital, I needed it , and was lucky enough to work with wonderful nurses and preceptors. I now work in home care, and for a small cut in pay, I gained peace, knowledge, and the satisfaction of really being the nurse I always wanted to be. Yesterday, I got a call from my supervisor, telling me that a patient called her up to say what a great job I was doing in their home. Now you don't get to hear that often in the hospital! Hang in there. I won't kid you, and say it will get better. But after one year of med/surg (or tele) , most employers will hire you for different positions. By the way, here is my one hint to stay organized at the hospital. I use to carry a binder with me everywhere- Each page was dedicated to each patient (or you could use 1/2 page). In the right sided margin, I had 12 boxes, one for each hour. If something happend in that hour, or if I gave prn meds, emptied a foley, did some teaching (yeah right), I would jot it down, that way when I charted, it would make sense, and be chronological. It had Pt's name, room, Dr., Dx, tests, labs, last IV insertion and night report.

I used my local library, and checked out any NCLEX book they had with a CD. THe CD's come with "mini" explanations of the rational of the answers. It is the same format as the computerized NCLEX exam, so you get used to it. Practice, Practice Practice! When it comes down to it, you have to study the way you feel most comfortable. I wish I had time to look at all my text books, but I just didn't. (SIngle mom, working full time, blah ,blah, blah). I say the following as encouragement only-remember, you can always take the boards again. I promise you , that no one will know, or for that matter care. Your new employers will have no idea if you took them once or fifteen times. And here is another tidbit. They also don't care if you got all A's or all C's. All they care is that you have a valid licence! I was a 4.0 student, and got the same job as someone with a 2.0! Good luck-and remeber to breathe and eat before the exam!

When I took my Nclex exam, I only did the cd programs over and over for hours daily, even taking my computer to the beach and camping over the summer. I never looked at my nursing books. my computer at the test turned off after 75 questions, so I must have done very well. Good luck

Currently I am using a piece of luggage, and need a new nursing bag. Any suggestions before I do a random search on the internet? I need two outside pockets for soap and paper towels, and a section for my file and 10 x 9 inch computer. And then just a place for my "nursing tools". Thanks Cherricka