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Psych, LTC, Home Health
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nurseinmo has 8 years experience and specializes in Psych, LTC, Home Health.

nurseinmo's Latest Activity

  1. nurseinmo

    On-call hospice nurse

    jeannepaul what is the census of the hospice you work for? I just interviewed for a job that sounds a lot like what you are doing. I was told they would pay an hourly/salaried rate for the time and a per visit "bonus". The current census is 47. With that, can I expect to be pretty busy?
  2. nurseinmo

    Worried about tomorrow

    I have seen this happen as well. I think sometimes when those "other" hospice agencies are trying to build in a new area they go above and beyond what they would normally provide to try to boost their reputation if you know what I mean. I am currently working LTC but trying to get into hospice within the same corporation and I see it all the time.
  3. nurseinmo

    Home Health!! Need Advice!!!!

    My situation was a little different. As a new grad, I did about 3 months of med surg nights and then I worked in a long term care facility for the developmentally disabled, the same facility I had worked at as an aide and an LPN. With about one year under my belt total, I applied for a HH job and was hired. I have been there for 2 years now and I have never felt like I was not capable of taking good care of my patients.
  4. nurseinmo

    LPN's being on call

    Until recently our LPN was on call as well, with an RN back up in case of something outside of her scope. She is the only one of us who doesn't live in town and several times would call whoever her backup was and have them make the visit so she didn't have to drive over because it was "faster for the patient". Partly because of that, the discontinued her being on call. She is the only LPN in our agency with 3 RN's....we are all paid hourly.
  5. nurseinmo

    Home Health Teaching Guides-HELP!!

    Here is one with several useful things on Diabetes.... Diabetes Education and Research Center - Teaching Materials
  6. nurseinmo


    Anyone know of a good 485 builder that can be used?
  7. nurseinmo


    Anyone out there use this system? What are your thoughts on it, any advice or tips? Our agency just installed it with the plan to "go live" on July 1 (the day I started) but there were so many flaws we had to go back to the "old" system for a few weeks there in between. Now we were told we had to "go live" again as of Aug 1 but many of the problems are still not fixed. We have visits sitting around for days we are not able to get put in the system because no one knows how to operate the system. We are a very small agency with few resources so any input would be greatly appriciated! :)
  8. nurseinmo

    Unlocked Doors at MRDD facility

    I feel you pain! I worked at what sounds like a very similer facility until recently and we went through this very same struggle with the management. The way our facility was set up we had one building on each side of a main highway that runs through town and had more than one occurance where lower functioning individuals left their areas and crossed this road unsupervised. Thank God nothing ever happened to one of them (yet) but after what I felt were some very poor decisons on the part of the managers and another incident were we "lost" a deaf autistic man for about 10 minutes and found him alone outside...I finally decided that it was in my best interest to leave the facility. I loved my job and the individuals that I cared for, but the people making the important decisions about their care at this particular facility do not have medical training and there was too much happening that I felt was jeopardizing my licence for me to be able to stay. As far as where you are now, you can only do the best you can do. Teach you staff and stress how extremely important it is that they know where their individuals are at all times. Maybe as for the garbage disposals they could cover the switches somehow? In one of our buildings all of our light switches were only able to be turned on or off with a key and we got away with that so it's a thought at least. Our facility kept a seperate kitchen and the individuals only had a "cooking class" every so often so no knives or food were kept on the areas where they lived and I can see how this would be a concern....I don't really know what other advice to give but keep us posted on how it goes.
  9. nurseinmo

    Ideas for med for MR/Psych pt?

    I work in an MRDD long term care facility that is operated by the state and we have an individual who is somewhat MR but also has numerous other issues. He had been on Clozaril but had to be taken off due to agranulocytosis. We went through months and months of decreasing the dosage and trying to find a "happy medium" with it but his WBC finally got too low and he was removed from it all together. Currently he is on Haldol (both oral and IM), phenobarb (seizures), topamax....I can't remember what all else. He has been on Mellaril in the past as well as Thorazine, Abilify, and Risperdal that I can think of. We had a recent brief stint on Valium but NOTHING is working. Right now, he won't take any pills that are white (he thinks we are poisoning him) and half the time he won't eat and is already underweight. His behaviors have never been "good" but he was much more controlled on the Clozaril. The Dr. is going to wean him off the Haldol and try Prolixin next; but after that no one knows what else to do for him. Sometimes when I am giving meds and he is upset and starts with the "I'm not taking any of those **** white pills" I can talk to him before I punch them out and explain *sort of* what each one is for... this one is for your blood pressure, this one is for your heart.... and sometimes he will take them, and sometimes he won't. Today, he hasn't taken any meds all day.... Any ideas about newer meds that may help this poor guy?
  10. nurseinmo

    Graceland University?

    Has anyone attended Graceland University? I am thinking about their online RN-BSN-MSN program but wondered if anyone here had any experiece with them. I want a good school, but I don't really want to have to spend a lot of time on camups and I really dread having to do clinicals again....
  11. nurseinmo

    January 2008 NCLEX support thread

    Took NCLEX-RN today, and for all those people who told me that the LPN test was harder....you lied! I had the min questions for the PN test 4 years ago and passed, left the test feeling ok; this time I had close to 160 q and felt like there were a LOT of things I didn't know. This wait is going to kill me it feels like...
  12. nurseinmo

    Need an NCLEX question r/t RSV

    That is perfect! Thanks so much!
  13. nurseinmo

    Need an NCLEX question r/t RSV

    Anyone got any ideas? Thanks in advance!
  14. I have to come up with an assessment for my on-line transitions class and I am having some difficulty following some of it. 1. what is pupil consensuality, and pupil convergence (on a neurological assessment form) and what do I put in the blank. Then it says "Gaze: (presence of nystagmus)" what would you put there? Or Attention span/ Calcualtion:___ I hate that they give us these forms that no one has seen before and expect us to figure it out on our own and it is due by MN tomorrow! I will be sooo glad when this class is over!
  15. nurseinmo

    Nursing diagnosis questions

    That makes sense, thanks!
  16. nurseinmo

    Nursing diagnosis questions

    Working on an assignment that states, formulate a nursing diagnosis for each of the following: Problem: Boredom, etiology: isolation Anxiety, hospitilization Unable to sleep fear of surgery These are the three that I am having the most trouble with, input of any kind would be appriciated! More questions later I am sure! Thanks in advance for any advise!