Oskie06

Hello Everyone, Well I actually have various questions. I was recently appointed ADON for an agency I have been working for. Unfortunately my DON is on medical leave the day right after I was promoted. I NEED GUIDANCE! So our administrator recently informed me we are going to get audited by chap. I was wondering what exactly do they audit? As soon as I got into the position she has gotten me doing QA on our charts and our Nurses visits. They aren't too great unfortunately...:\. I only got 2 years experience as a RN, I had my first 3 months of experience in a hospital and the rest 1year and 9 months has been Home health, which I LOVE!! I know I'm a quick learner, I adjust very easily to change, and I do consider myself a good nurse. I care about what I do and tend to be very meticulous, but sometimes I do need guidance, ESPECIALLY WHEN ITS SOMETHING COMPLETELY NEW TO ME! Since I really don't have anyone to reach out to at this time as a director, I figured I would try my luck here. As I mentioned, I really would like to get some guidance to see what CHAP will really be looking at while they come and do our audits, and exactly how far back do they look at charting. Like I said, thus far I have been looking at our charts for the past two weeks visits, and OMG! I never realized how bad the documentation for the agency is... It really needs a fixer upper. I already intervened by educating our nurses on the dings we have on our documentation, but like I said I need more guidance to see what CHAP really looks at so I can complete the patch work where it really is needed. In addition currently got a raise to 30.87 a hour for my ADON position, I feel like Im completing a lot of work for my position. Im doing QA, Case management, on top of all my visits which include P.H., SOC, D/C, RECERTS Transfers, REG visits, SUP Visits. Im getting paid P.H.-2.5 points, SOC-2.5 points, Recert-2.0 D/C- 1.5 points, Reg Visits-1.0, Sup Visits 1.0. I need to complete 40points a week for my 40 hours. If I spend time at the office doing QA I get paid hourly. And I cover my city and outskirt cities which is about a 70 mile radius. Do you think my pay is appropriate. I really appreciate everyone's time to read on my thread and guidance!!! Now I need to get back to documenting.. I though Id sneak in hear to post a thread in hope and with gods prayer that I receive some guidance!! THANK YOU ONCE AGAIN :)!!!

Thanks a lot for your help!!! And I do feel like im doing a thousand things at once! Im feeling pretty overwhelmed.

Hello everyone, New to this website. Fairly new RN, and Fairly new to HH. I actually graudated from Nursing school a year ago. Began working as a RN until August after I took a much needed break. Started working in a horrible oncology/medsurge/offsite telemetry unit with awful staff. I must admit learned alot considering I was solo as a brand new nurse. Only lasted till October, when I got a job offer from a Home Health Agency and began working there first week of October. I LOVE HOME HEALTH!!! I did ever since i was in nursing school and did my orientation with a home health agency. I love the one on one I get with my patients. I really feel more involved with their care and more independent and feel like I could educate them alot more... Anyways, with that being said I love home health. Only thing Im having trouble with is with some of the conflicts im experiencing currently. I dont know if its the norm for Home Health and just the bad side of home health, or if Im literally just being jipped. Let me being with the pay. Currently im getting payed using the point system with Hourly wage. Got started off at $27.50 a hr and getting payed 150$ biweekly for gas, and 50$ a month extra for Cellphone coverage. I love my job, love my bosses, not sure if im getting my legged pulled though. My current point system works this way. SOC-2.5 PH-2.5 RECERT-2.0 DC-1.5 REG Visit-1.0 That time includes driving time, documentation time, and visit time. I have to complete 37 points a week, 3 points are given to me already for our weekly case conference. So is that a norm? In addition on Recerts im incharge of completing Case Conference reports, physician orders, transfers, etc. IDK if that is considered norm for a field nurse. Next thing im having trouble with is, sometimes im being sent to do SOC and find that once I get there after driving 50-60 miles to a location they arent home bound, and I have to depart after I spend about 20 minutes assessing them and had spent about 30-45 minutes driving there. I dont get paid for the time devoted. Im driving about 600miles a week, having to complete a oil change monthly. I love my job, love what I do and I have become so devoted to my patients and trying to help them in all possible ways. I just want to take away that feeling that I feel I might be getting jipped or taken advantage of. As I said im a new nurse, the administrators know that, and they are so helpful and all, but just want to be sure things are fair. All input and suggestions are appreciated, thank you guys :).

Hello everyone. Help needed here. I have a patient with a 1.8x0.8x0.5 venous stasis ulcer. Originally places bacitracin with dressing and compression to insure no infection was present since md did not place patient on antibiotics. Then I placed a Coban 2 layer compression system. Had to stop that, patient didn't like it.. since it was bulky. After first treatment there was a lot of granulation present. So I was set that this wound would be a breeze. Well wound has haulted. Compressions have to helped. I had started to use purocal dressing in hope to stimulate healling but no luck. Going to put multidex gel next visit in hope maybe something can start happening. Any advice??

If patient could bear wait and pivot with transfer they are chair fast. If they need complete assistance to transfer, they are bed bound