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adreamdeferred ADN, MSN, RN, APRN, NP

Home Health, Case Mgt, Geriatrics, Women's Health
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adreamdeferred has 4 years experience as a ADN, MSN, RN, APRN, NP and specializes in Home Health, Case Mgt, Geriatrics, Women's Health.

adreamdeferred's Latest Activity

  1. adreamdeferred

    What software are you using

    I have used it before and I wasn't a fan. It was very tedious and redundant. It was the worst. I have also used Devero, Mckesson, and Epic. I liked Devero and Epic, Mckesson was just okay...but I loathed Home Care Home Base. Wish I had a better opinion but this is based off of exposure to the other software.
  2. adreamdeferred

    The Degrading "Meet and Greet"

    I think of this as private duty. I was a home health nurse and did intermittent visits. I performed the skill I was there for and left. There are some families who like to take advantage of nurses like we are housekeepers and such. This is why I did not go into private duty because I once was a HHA and people like to take advantage. Sure I have ran late for visits because I showered a patient I found covered in diarrhea and started a load of laundry so it would not smell up her house, but I couldn't make that a habit especially when the patient has loved ones sitting there staring at you (that particular patient didn't). If it were not for the the nursing skill needed (packing a wound, IV, wound vac, etc insurance would not cover the visit. The point of my rant is there is this trend to take advantage of and abuse nurses as well as some ignorance as to what we are supposed to do. I recognized early on private duty looked too "abusive" prone to me and stayed clear but nursing in general is being disrespected across the board, constantly adding ridicules things to our job description. Don't put up with it or it becomes the norm.
  3. adreamdeferred

    Regarding Adult Gerontology primary care NP

    If you already know you want to work inpatient then you should prepare yourself properly and complete an acute program.
  4. adreamdeferred

    Walden University FNP

    I agree with RNtoFNP20yrs. I live in NW Ohio and work for a large healthcare organization. They hire Walden grads all the time and they are on the list of schools they provide reimbursement for. As a matter of fact I belong to a state NP organization and there is a nice size group of Walden graduates in the area, all employed. There are lots of University of Cincinnati students here too. If I had to do it all over again, I may have given their program a harder look. One of the U of C students was from Columbus (2.5 hr drive). She could not find preceptors in her area and my preceptor learned of her through the NP organization and agreed to help her so she would not have to sit out. I am a current AGPCNP student completing final two clinical courses at the same time. You have to petition for permission to do this.
  5. adreamdeferred

    Thinking of giving up FNP program

    If you like what you are doing, there is no point in torturing yourself. We definitely need RN's who love what they do. As far as becoming a NP, you gotta pay the cost to be the "boss". Not everyone wants to be the "boss", and that's just fine.
  6. adreamdeferred

    Four month in. Ugh.

    If this is your first rodeo I would say to give yourself some time, like at least another six months and your improvement will be like night and day. That is the best thing you can do because you need to alter your expectations and adjust for the learning curve that comes with going into home health. That may take a little of the frustration out of the picture if you have a talk with yourself and say, "you'll get it, you're getting better every day". Talk with your family and explain that you are in a learning stage and things may be a little different until you get your rhythm. How long are you spending at your visits? When at all possible take the extra time and chart as much as you can in the home, it makes a huge difference especially for the routine visits. Try to develop a systematic approach to your visits so that you can accomplish everything you need to and concentrate on improving efficiency. The less "unnecessary" time you waste in a patient's home the more time you have to chart "on the clock". Go right in and get vitals and do assessment, whatever skill or teaching you need to do, this should be the bulk of your visit. Then chart and make small talk. I used to do the opposite and try to glean information while we talked or I did some teaching and chart. I would leave my vitals, assessment and skill for last. Yeah...I was in the home an hour or more. If it's not an Oasis visit or an emergency I have no business in any patient's home for an hour is how I look at it. I average thirty five minutes including charting for a routine visit. This will take time because not every day or visit is the same but if you like home health at all you will have to give yourself a chance. I think we all share your frustrations with the doctor's offices. I don't understand the 14 days in a row, can't help you there. I hope things get better for you.
  7. adreamdeferred

    Brian Short News

    I am in complete shock. Condolences to the families and friends.
  8. adreamdeferred

    I don't have time for this!

    I sent you a PM.
  9. adreamdeferred

    I don't have time for this!

    Update...I resigned. Way too much going on. I have learned I can only control myself. The funny thing is I communicated the issues I was having and my supervisor claimed my resignation shocked her and I should have been more vocal. When I did that I was told I wasn't being cooperative or I was being difficult. I was tired of my entire day being hijacked by the scheduler. I mean give me at least one visit to start with while you figure the rest out. Now I'm starting my day at 10:30 and you're wondering why I'm ticked off when you call me to make yet another change? Regular visits should not be changed all the time. The only visits that should be scheduled last minute are SOC, ROC, PRN visits. I hate calling patients for same day visits for a regular visit. Back to per visit and self scheduling I go. Plus full benefits including tuition reimbursement.
  10. adreamdeferred

    I don't have time for this!

    Okay, I just need to vent real quick before I get knee deep into my paperwork. So my supervisor calls me into her office and talks to me about being too thorough or detailed. She says she got a call from a patient's loved one stating I was there too long and I asked too many questions. It was a recert. I cut the visit short because I knew we were not wanted there so we were out in 38 min which is less than the minimum of 45 min required and I had a trainee with me. Seriously?! You really called me on the carpet for this? So I guess everyone else has been starting their visit in their car and running in doing 10 min visits. Anyone else been chastised for doing their job? I can definitely do a recert on a pt I have seen before in a half an hour or less including assessment and vitals, complete charting not included, but then after a while I'm sure they would look at my times and wonder what I did with the rest of my day. You can't win for losing.
  11. adreamdeferred

    rate of pay in ohio

    If I could absolutely guarantee anonymity I would be more specific, with that being said if you look up home health RN salaries on glassdoor it will give you a really good idea. I actually make more than I would if I were full time in a hospital. I am salaried. I get mileage reimbursement, hourly if I pick up extra, on call pay is available plus the hourly from time leaving home until back at my doorstep if I have to go out. I used to work for a company and was paid per visit. I liked the company but could not make the per visit thing work. Some people can. There are many types of agencies, small, large, and they may use different models. I prefer the case management/team model. I prefer to see the same patients and get to know them and not all agencies follow this model. No matter the size of the agency whether it fits you or not will depend on your local management team. I am lucky, for the most part they try not to kill us even though it's out of their hands sometimes.
  12. adreamdeferred

    Charting help

    That's what was missing. In home care you have to justify why they still need skilled nursing in every note and the documentation should be able to stand alone. If someone randomly chooses to read one your notes it should not leave a lot of holes. Give a brief overview of why the pt is being seen, what skill was performed, any problems or coordination/communication with other members of the care team and what they still require or additional goals from plan of care that need to be addressed at future visits. There has to be a need for skilled care and all nursing skills including education fit that requirement. Does the pt not understand their medication or not take it properly? Do they have a new diagnosis such as diabetes, COPD, or recently started taking coumadin? Can they not perform their own wound care or lack a suitable caregiver? Also make sure you address what makes them home bound if this is a requirement of their insurance. These are some of the things that separate home health narrative notes from "regular" charting in other specialties. Don't get discouraged. Like Caliotter 3 said, look at some examples of good charting then you will get the hang of it. Best wishes.
  13. adreamdeferred

    Anyone hiring in Ohio?

    Not a hundred percent because each office is different but try Great Lakes Caring.
  14. adreamdeferred

    Banker to nurse - Would you make the switch

    Right now a hospital in my city is recruiting for a part time day L & D RN which would be two twelves a week, 16 hours of on call a month and every third weekend. So a little more than part time but still way less if you were full time. It just depends on what's available in the area where you plan to work. Not often but sometimes they throw new grads a bone. I know first hand. :)
  15. adreamdeferred

    Newborn Nanny, Should I Return to School for Nursing at 48??

    I think if you want a better shot of getting your hands on some babies you should do nursing. I precepted in OB and they loved me and have been trying to get me in there ever since.They received surveys back and my name kept coming up in a good way. The only reason I am not there is because I realized OB was my second love to home health, way better hours, but I know where I could get a job if I need one. Also, maybe you need to research other schools. I attended a school 40 miles away because it was away from the congested one closest to me. I didn't have to "fight" anyone to get in. Best thing I could have did, wonderful school, but the drive was a sacrifice. Don't worry about your age, it's a non-issue. Also, I'm not a whiz at math or science, just had to put a little more effort in than some. Don't talk yourself out of your destiny. If it's meant to be things will fall into place but you have to take a step forward. I wish you the best.
  16. adreamdeferred

    BE HONEST! What part of your job do you hate?

    Paperwork, paperwork, paperwork is number one for me. Cigarette smoke, pests, pet hair, and people who allow their pets to climb all over me. I understand I'm a guest and they are going to approach me but after that please intervene. I try to politely explain that I have to see other patients and I need to keep myself and my bag as clean as possible. I hate when my first patient of the day leaves me smelling like smoke or covered in pet hair for the rest of the day. If I know where I'm going ahead of time I'll make them my last stop.

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