MessyMomma

Not really a inclement weather situation, since I am in Texas. But for one patient's house, I have to park at the liquor store!

Malpractice insurance: usually you are covered by your facility if you are within their policies and procedures. Some people say that if you get malpractice insurance you are more likely to be sued than if you do not. It is personal choice I think. This is NOT true. Your employer, their insurance and their lawyers will not back you. You really need to have your own insurance. It is not very expensive, and can provide you with so much protection.

Good luck! Don't sell yourself short!

I remember that Landau tope were more generously cut.

I've been in HH for about 2 months now (but had 12 years on med/surg) and I love it! Before I go see a patient, I review the chart to see what the teaching plan is. We're computerized, so it's easier to find diagnoses, meds, comorbiditities, etc. Then I find a reputable source online and print patient education. We do have some basic teaching tools, but we are free to find our own--as long as it's not WebMD or Wikipedia, ;-). If a patient has a question I can't answer, I tell them. Then I use my company-provided Ipad and look up the info. I haven't had anybody "mad" because I didn't know everything. They appreciate the honesty and my willingness to fibd the answer. I find that doing some prep work the day before helps out greatly.

From what I've read on here and researched on my own, I believe it's way better to self report instead of waiting for the BON to mandate.

Is it actually an epidural or a peripheral block like a femoral nerve block or lumbar plexus? If it is truly an epidural with one side noticeably more affected, I would definitely notify the MD or CRNA. If nothing else, at least s/he would be aware. I did see a hematoma around a insertion site--just looked like a ugly, oozing bruise. I "bothered" the CRNA enough, he came and looked at it, it was pulled. The hematoma was still funky looking on discharge a few days later. Hope this helps some.

I do have it, unfortunately. And the stigma sucks! I had to get out of Med-Surg nights--that was killing me physically and mentally. I am now doing Case Managing for Home Health. I still hurt, of course, and still have my 'flares', but it's so much better.

That's understandable and totally not what I was meaning. If you call off for Uncle George's funeral in February, June, August, and December--that's a little bit suspect.

What about "Gramma" or "Uncle George" in the hospital/dying/died--once a month???

Thank you all! Will work on my staging. Gonna try the Santyl.

And I need some ideas on what kind of dressing to use. Patient in her 90's, very thin and bony; sits in WC or lies in bed. I did a recert visit on her last week--my first time to see her--and discovered this new wound on her ischial spine. The wound is approximately 6x4x2cm; wound base is 30% red and "healthy" looking, 70% yellow, adherent "slough". Scant serous drainage, no malodor. My first thought was to get rid of the slough, so we started daily wet to dry dressings with NS. After a week or so, it actually has developed more slough, so now I need some ideas. MD open to our suggestions, which is great. Another RN suggested Aquacel AG, but I'm concerned that the wound isn't "wet" enough for that to be effective. She suggested that I wet the Aquacel with NS first, then cover with gauze. How does that sound? What about Santyl? Any other ideas?

There are many threads about this very topic. Read those and I bet it'll help a bit. Just remember--everyone (nurses included) makes mistakes! If a nurse says s/he hasn't--either it's a lie or s/he is too stupid to know. Use it as a learning experience---I'd be willing to bet that from now on, you always pay closer attention to reading orders, especially range orders. Learn from it, put it behind you, and go on. You're gonna be okay!

Or get them a really pretty "Congrats" card or balloon bouquet and sign it, "Love, YourName, RN".