Anewby

I believe she is getting close to needing a hospice consult. As far as family, the nurse said her family is not involved in her care and rarely visit. She was not able to ambulate unassisted. She was A&OX1, could not even tell me her DOB. I truly believe PT/OT would not have done her an ounce of good.

I am fairly new to home health, but have been a nurse since 2010. Yesterday, I went to an assisted living facility to see a patient on the Memory Care Unit. When I arrived and assessed the patient, I realized she was an end-stage dementia patient, and had no nursing needs. I spoke with the Charge Nurse on the unit who informed me she'd had multiple falls without any fall reflexes/safety awareness and also believed she was an end-stage dementia patient. So my thought was that the patient would not benefit from PT/OT due to her inability to remember any skills that would be taught during sessions. I called the office to let them know, and my manager was not happy with me for not admitting the patient to our service. It just does not make sense to me to admit her. What would you have done?

and this is exactly why I am starting a PRN HH position next week! I have a feeling I will be leaving the floor soon!

I am a second degree nurse, earning my degree in 2012. I was a lot like you in the beginning, researched every facet of nursing I could. Still, nothing prepared me for what I was in for. Nursing school does not teach you about multiple discharges and admissions while still safely caring for your patients, they don't teach you about core measures, they don't teach you about a lot of things. Also, I recently left a job at one of the best hospitals in my area (my dream job) because the personalities on the unit were awful. The nurses were fantastic, but the PCAs and unit secretaries not so much. I had critical VS go unreported (70s/50s), blood sugar levels were not reported either. One PCA even decided she did not have to chart VS until the end of her 12 hour shift. I witnessed a unit secretary have major screaming matches (sick patients would come out of their room to see what was going on) with a PCA simply because the PCA asked for some help with something easy. When asking a PCA to do something, there was always an excuse why they could not help the nurse or patient. I decided no amount of money or prestige was worth enduring that sort of behavior from people who are supposed to be professionals and it wasn't worth losing my license because someone "forgot" to report such critical values (even though they charted they informed the nurse). Now, the place I worked before this hospital was amazing, and I am returning there next week in a charge nurse position. It will be great to be back home, even though it is a small community hospital. Good luck, whatever you decide!

Thank you for your reply! I'm doing a ride along today. I don't expect it will be easy, however, I am hoping it will be less stressful. I was offered a full time or a PRN position. I'm thinking I'm going to keep my position at the hospital and work HH PRN until I know if I like it or not.

I was wondering if any of you would have input on HH in Louisville, KY. I am leaving acute care (3 years) because I just cannot take it anymore. I have an interview lined up with Caretenders/Almost Family and wondered what your experiences have been with this or any other HH agency in KY. Thanks!