paulinejoyRN

OASIS documentation can be tricky to learn, but if you really invest the time in learning it in the beginning, you'll save yourself time in the future. There are books that explain the various intricacies of OASIS, e.g. when documenting wounds, what is classified as a wound, which I found helpful when I first started and continue to refer to occasionally now. OASIS changes every so often, too, but I don't think documentation requirements should stop you. I think the most helpful thing I could suggest about enjoying home health and keeping yourself happy is to really focus on keeping your documentation accurate and limited to POS and during service hours. You have to be able to manage your time and your energy so that you can really enjoy the flexibility in HH. As for "units", it really depends on your agency, but typically visits are assigned units. Example: regular visit= 1 unit, SOC/Start of Care (aka Admit) =2 units.

You're a new grad but hired as an RN Supervisor? How long have you been at your position? Your work environment is definitely unsafe for you.

I feel so much for your experience. This is the terrible reality for some nurses at some units. Don't take this experience as the only experience possible for you. I understand the frustration of your situation, but don't think that your short resume will completely keep you from future nursing positions. You were put in unsafe nursing environments. Spend your time recovering-- your body and your mind. You deserve to regain your personality, drive and sense of self before looking for another job. If you need anyone to talk to, we are always here. I'm sorry for your experience. This is not right.

Yes! Objectives are an antiquated resume element! Everyone knows what your objective is-- GET A JOB!

Nursing is stressful, yes. But learning and experience changes how one reacts to the stress. Negative work environments typically do not change unless you become the leader. Don't let this experience turn you off from nursing. Learn what you can from it-- skills wise and what you don't want from your next job. Then leave when the time is right. The right work environment will do wonders for you, your mentality, and your happiness.

All orientation is usually insufficient in small offices. Learn as much as you can, but also be friendly to your coworkers-- they will be great resources to learn from. Always approach them with gratitude and prepare to learn whatever they can teach you. Take a deep breath, and have an awesome first day! You survived nursing school, your past jobs, you can do this!

I have no idea why she made those comments, but I do know you have worked hard and deserve to be recognized for it. Have you sent a thank you for the interview email/note? If not, why not politely address her concerns and then attach your recent productivity/case load for the last few months? Email is best bc then you have a digital copy in your sent box

Honestly, if I were you-- your contract ended, focus on getting a permanent position. Focus on that, and when it's less stressful and you feel more comfortable due to your competence, then add the BSN. Focus on one big learning adventure at a time so you can give yourself the most energy and time to really get the most out of each experience. You'll do well, just remember to make time for self care!

Right on!!! I love home health. It's a different beast, but sooo awesome

I agree with the first reply. To answer your questions myself: 1. Stay in the hospital but different unit? - Stay where you are. You're learning a lot, and yes, it is stressful, but you're also learning a lot from your everyday challenges. Like the RNJedi commented, all nursing jobs come with similar stress and the need to juggle work/life/rest. You've already got 1 year of experience in your unit, why not continue to improve your practice there. I'm sure you'll feel more confident, slightly less stressed, and more marketable when you decide to look for a new job. Jobs for new grads are rare, and having a resume that proves you can commit to a unit/facility for more than the required contract term is a good sign for future employers. You will continue to learn and master your skills on your current unit.. then almost every other unit after will be easier. If you want to try other units, why not stay at your current unit, but offer to be part of the float team so you can moonlight on other units and see how you like them. The grass is always greener on the other side, but not always that great once you're on that other side. 2. 8's or 12's? - 12's all the way. If you think you're tired from working 3-12's, think about working 5-8 hour shifts. By 12-1pm you'll be struggling to catch up on charting, completing afternoon tasks, and next thing you know.. change of shift. Some ways my colleagues have made 12 hour shifts work better for them and their lifestyles: - switch to NOCs.. you still get to see your kids in the AM and take them to school. Then sleep while they're away. - OR-- stick with a consistent wake up time, even when you're not working, and a regular workout schedule. It'll make a huge difference for your body and mind. 3. Try something all together different with 'normal hours' in something like clinic or HH? -- HH may seem like it has "normal" hours, but trust me, you will be charting after 5pm at home. You will be performing follow up phone calls that don't necessarily fall in normal hours. Also, having more acute care experience will benefit you for when you decide that you want to try home health or outpatient care. One of my previous colleagues even told me that she spends so much time charting at home that her kids barely see her face. Something to think about. Opportunities like the one you're in (working 12s in the PCU) are harder to come by without your BSN. Nursing is evolving, and many initiatives encourage nurses with their ADNs to pursue their BSN. Many hospitals here in CA won't even hire applicants without their BSN. You're on the right track. Don't question yourself too much, Nursing is stressful, but you're gaining the experience to eventual gain mastery over your practice. Believe in yourself! I believe in you!

Your replies. spot on. RN Jedi indeed, *bows*

What supplies to you always have? Any trunk organization tricks? Any help is so appreciated, thank you!

If you are on a tight deadline with the other school, just call USF's School of Nursing and inquire about it. I know you're probably stressed out waiting, but just call and ask. It wouldn't hurt, especially with your deadline.

I'm just finishing my last semester and working on my project. I was part of the MSN-CNL Cohort 4, we present our CNL project posters this August. I found this thread while looking into the presentation info. Good luck to all of you! If you need any help, feel free to send me a message and I'd love to help you if I can!

Writing orders is different for each case, but the bottomline is that you take orders from the MD, not mom, and need the paper trail of orders to cover your license. For admissions, I always call the MD and let them know if I found anything different. Then I write a sup order, "During admission visit, updates to medication profile were found..." then send to PCP for signature. For recerts, I always write orders, "During recertification visit, updates to plan of care found:" then list the med changes you found during your med rec, changes to the 485 orders (like family only uses warm soapy water to clean the GT), etc. Just make sure that you let the PCP know that these changes will be coming, and that he should call you if there is anything he would like to modify or clarify. Then write the order, because at least you called the PCP to let him know.