tktjRN

I work for a HH agency that pays us per visit. We are very slow this time of year. I interviewed at another HH agency for part time to supplement my income. Word got out, that I applied for another agency and my boss told me I'm not able to do that. ...

I've changed a trach about 5 times and I'm still not comfortable doing it alone and don't know if I will ever be comfortable doing it by myself. I have made everyone, I work with, aware of this fear. You're not incompetent. You're looking out for yo...

Unfortunately, every job description that I've had stated "and duties as assigned." Yes, bruises are part of skin care, but I do agree that it should be separate charting from wound care. Bruises of known or unknown origin should be monitored by staf...

Nurse4wounds I totally agree with you A lot of people are obsessed with letters behind their names, thinking that will get them to the top. I'm not saying continuing education and degrees are not required for advancement, but you are where you are be...

DavidDudley was very well said and 100% accurate.

Oh yes.

A pre albumin level is not usually ordered unless nutrition is an issue. A nutritional assessment should be conducted first. Any weight loss, how much is the patient eating at meals are they on nutritional supplements. Is the wound chronic, look at ...

Look at the tread "Can you have a life in HH."

I would get her a speciality mattress and a roho cushion if she doesn't already have them. Ask yourself, is it really necessary to send a pt in there 90's to a wound clinic for sharp debridement?? Please start with santyl, hydrofera blue or medihone...

Date of last visit is the last time you saw patient. Date of discharge is the day you found out about it. Example: I saw patient on 11/5 for wound care. I called patient on 11/12 and pt stated he does not want to continue services.. My discharge date...

I recommend staying in the hospital for a few years and get comfortable with your nursing skills. Acute care is the best place to learn.

We use paper scale liner towels from Medline.

We use paper scale liner towels from Medline

We have about 150 clients and we have 8 RN's, 1 LPN, 4 OT, 8 PT, and 1 HHA. I think 20 HHA's is way to much. Our HHA is steady, but not overly busy. We also have to many nurses with not enough nursing cases. It also depends on the time of year. Summe...

1. DON should be doing DON duties, not case managing patients. 2. Our LPN's do none of that, but it would be nice if they did. RN must co-sign all MD orders for a LPN. 3. That's called Medicare fraud for unnecessary visits. No need for nursing, the p...

All the nurses, at my agency, carry a bin of supplies in our trunks. Our supply room is locked at all times so if we need something after hours or on weekends we're out of luck. We leave enough supplies for at least 2 dressing changes, then we order ...

NC29mom, Just for clarification. The flagyl gel would be the primary treatment? Could you just use it for Odor control and then apply( for example) prisma dressing over it? What kind of pouch? If I have a sacral wound, with a large amount of drainag...

Hiring and firing and insubordination make up about 75% of your job. Like Orca said stick to your principles. Work with the staff who cares about coming to work everyday and caring for the residents. I am very good to my staff and my door is always o...

Respect is earned. Show them that you do care by getting your hands dirty. Answer lights, help with the dining room or food trays. I'm not saying this is an everyday thing, but it helps them realize that you're a nurse first and making sure the resid...

You need to rewrite the order and say contact md if patient pulse ox is below 92%. Patient is on continuous oxygen.

Home health is a very demanding job. Paperwork is endless and no you're not the only one whose doing paperwork, until 11pm at night.. I'm with you, on the daily wound care patients, they drive me nuts!! If I was in your situation ( my kids are older ...

I disagree. I work for a home health agency that has hired new grads and they're doing great! I work in the field as the RN case manager. Basically, you're making sure all the disciplines are updating you, at least weekly, and following the plan of c...

I have a patient with a stage IV pressure ulcer to her coccyx. The patient has had this for over a year and I've been the primary nurse. When I first saw the patient it measured 6.0cm x 6.8cm x 1.3 cm. Now, a year later it's 0.5 x 0.3 x 0.2. It's bee...

Would I put the silver nitrate just on the wound edges or on the wound bed as well? Pt only stays up in the chair for a 1-2 hour period and then lays down. Spouse does not reposition Pt at noc, which I could write a book about.. Pt had the roho cushi...