St_Claire

I keep the laptop on my lap and go through the OASIS then the care plan. I put the laptop in my bag and do my assessment making notes in my notebook, I also note what I taught, issues, etc. then when I get to my car I do the nursing note and put in the vitals. Make the laptop your friend.

Yes. It will require time management skills but it is doable. You will need a back up plan for those days it doesn't work. I would suggest being honest with your employer about your availability.

You need 2 years of full time experience to test for this.

I work hourly so I'm paid for all hours the same including time I spend doing paperwork. Travel is from your house to the patient then subtract the miles from your house to the office. It sounds counter intuitive but if your first patient is a mile from your house and the office is five miles from your house then you will not get paid for the first visit. I get my hourly rate for the drive time plus 55 cents per mile. I work for a not-for-profit in Salt Lake.

I work for a not for profit and we are offered $30 per month or a company cell phone.

My message is intentionally long and I speak slowly so it takes forever to get through my message: Hi This is Kym Last Name at Best Home Health & Hospice. If this is an emergency please hang up and dial 911. If you are calling between the hours of 5pm to 8:30 am please call the office at 555-555-5555..otherwise please leave a message and I will call you as soon as I can.

Congratulations Nurse, you passed!!!

All of that sounds very unprofessional. I would not be comfortable putting my license on the line. My company pays for everything: mileage, mi-fi, cell phone, laptop, and .55 per mile.

That's less than half the hourly wage and per visit fees are MUCH higher than that. It was a complete waste of your time.

Maybe this is true in certain areas. Thankfully it isn't true in Utah. Also there isn't a mandated one year rule here either.

I disagree with awheat. When a home health company hires a newly licensed nurse they accept the responsibility to train them, the same way any facility or hospital does. What you want to do is ask about the training. How long will they let you do ride alongs? Will you start with chronic vs acute patients? I think it's old school to say you must have experience first and then shrug your shoulders when asked how to obtain it. It keeps the notion alive that nurses eat their young.

Okay, everyone chant with me: Vast is the robe of liberation A formless field of benefaction I wear the Tathagata's teaching Saving all sentient beings. (Chant the above three times in a monotone; once for Buddha, once for Sangha, and once for the Dharma. ) Now, how meaningful was that to you? For me it is my morning ritual that puts me in tune with my spiritual beliefs. It has great meaning. To me. For you it may sound ridiculous, or nonsensical, you may look around for robe-wearing bald-headed men. How about joining me for morning sitting before every meeting or at the start of every day? Now stand in my shoes and tell me how your prayer, your belief system, should soothe and comfort me.

As a Buddhist I do not believe in hope the way you define it here. Hope means I am looking to the future for my happiness instead of being present in this moment (and this one...and this one...) therefore holding hope out to me is meaningless to me and you are taking away the very essence of my belief: Presence in this moment.

There's even more research that states meditation does all those things and MORE.

And when this white girl says she's a Buddhist it becomes the most interesting thing about her. :-) not the fact that I do 100 mile bike rides on the weekend or volunteer for everything under the sun. If you aren't working in a place that is owned/operated by a particular religion then I think it would be respectful to all to have a quiet moment or some other similar wording. Or take turns! I would love it if someone chanted a morning gatha with me! As a Buddhist I do not want to be prayed for, I do not want to answer the question of "have you accepted..." I do not thank God for my successes. But I do respect your beliefs.

That was a huge concern for us as well. You are taxed on the amount of personal miles you drive. We off set the vast majority of that with the money we pay each month for the car.

It turns out to be an incredible offer. They will supply the car, full coverage insurance, gas for personal and business use (we get a credit card), and we keep the car just like it belongs to us. We drive it like its our own car. We weren't allowed to transport patients before and we still won't. We were given three models to choose from. The employee pays $300 per month and that includes everything. Right now I pay more than $300 a month for just gas, not to mention my insurance. I test drove one today and I'm thrilled

The home health agency I work for is considering getting company cars for the nurses. We have a meeting about it Wednesday and we can ask questions. I don't even know where to begin aside from "can we use them for personal use?" And "what are the tax ramifications and cost to us?" What else should we be asking?

I am new to home care case management. This week I did four SOCs and they each took about 4 hours. That was including the initial visit with the patient and all the charting on the computer. The first one actually took 6 hours. Everyone promises that will decrease to 3 hours for a routine admit as I get faster. You never know what you will find during a follow up visit. You may go in to assess and do an INR and find other needs that have to be addressed. I love it. I love the drive time between patients as time to myself and you fall in love with the patients. Be flexible. One week isn't a lot of time to do ride alongs if you have never been in home health. Try to get out with several nurses so you van see different styles. Everyone has their strengths and weaknesses. Every day I think, "I can't believe I get paid to drive around and visit interesting people and take care of them" I feel very blessed.

Communicate with the nurse at the facility about changes or concerns. It always irked me when the hospice nurse came in for 10 minutes, left new med orders and disappeared. I loved working with hospice patients when I was a nurse at a LTAC. However, I had 12-15 patients that required acute care, some with extensive wound care procedures. The hospice nurses would leave orders for their patients to receive morphine Q15-30 minutes as needed. There was no way I could assess a patient for pain every 15-30 minutes and dose as needed. Something to keep in mind when getting pain meds from the doc. In the LTAC and LTCs families and visiting nurses cannot give meds so it is all on the shoulders of the nurse on duty.

Ask if you can do a ride along for a day.

I never borrow. I call the pharmacy to see if it has been ordered and when. If they have had plenty of time to get it to us (ordered 3 days ago and still not here) I ask them to bring it right away. Notify DON whether its on the way or not. If the DON suggest there may be extra in the cart I tell her I was unable to find any. I've seen nurses get thrown under the bus for this one.

We have a handout that we do on admit that I really like. It's called My Emergency Plan. It covers: Breathing/lungs, Heart Failure, Chest Pain and a bunch of others, 9 total. As an example: Breathing/Lungs Call Nurse at Agency Increased shortness of breath A couch that gets worse Change in color, thickness, odor, or amount of sputum You become restless or agitated Fatigue/weakness Loss of appetite or weight Fever, oral greater than 100.5 Call 911 Difficulty breathing Severe shortness of breath or wheezing that does not respond to inhalers or breathing treatments Change of color to your skin to gray or blue OR if you become blue around the lips You develop confusion During the admit we go through the ones that pertain to that patient. This chart is then put on their refrigerator door with our magnet that has our on-call number.