spurs21550

I agree with you its sad about loved ones thinking loved ones will live forever, and it is not natural to break ribs, insert needles and tubes, and we are not miracle workers. We also cannot make the decision on who should live or die by withholding treatment based on if we feel the person has has a fulfilling life, and we don't want to cause them any more pain . What you are saying makes perfect sense to me, as nurses we see these situations every day, but without a DNR order, the nurses should have started resuciatation

Sounds to me like your administrator needs to brush up on his regulations, and he clearly doesn't know what he is doing if he told you the surveyor doesn't read nurses notes. With the small amount of patients at start up, it's not uncommon for an RN to be the DON, sometimes even the administrator, as well as doing the patient care, in the interest of saving money until you pass survey and can bill for services. He should have listened to your concerns when you told him you had concerns about never being a DON, particularly since this was a start up agency. Do not feel bad, it's not your fault he was incompetent, and it is HIS fault the agency didn't pass survey. The owner will eventually find out as they will have to spend more money to keep the agency going until the follow up. I don't understand what you mean by having another RN pass you off on the skills(?). The patients don't have to know survey wasn't passed, their care should not be impacted. I am sorry that your first DON experience was a bad one, but you trusted he knew what he was doing when he clearly didn't. You as well should have known per regulations what your role was , as the surveyor does not accept "I didn't know"as a reason not to have followed regulations.

I am a RN in Texas, and although I do not have a psychiatric diagnosis myself, I have a daughter who wants to enter nursing, and she has a diagnosis of bipolar disorder. I just renewed my license and the Texas BoN has a quite detailed set of questions regarding mental illness. Judging by these questions, it seems it would be difficult for her to get licensed. I would hate for her to go through all this schooling and then not be able to get a license. If any of you are licensed with a disability in Texas, can you give me any input on what the process is if you disclose a psychiatric diagnosis to the Texas BoN?

You need to verify with your employer what units are for that particular agency. Generally they count more lengthy visits as more units, such as an admission being 2.5 units, a regular skilled visit 1 unit-to give an example. For a regular skilled visit you should spend at least 30 minutes with the patient to allow for assessment and teaching/performing treatments, and or giving meds. For visits requiring OASIS assessments they will take longer-usually an hour or more.

Thanks for the detailed information, and congratulations to you! I am also considering WGU, and have read a lot of good things about it, but you have now given me a student's perspective on it.

I'm also very surprised that a Home Health agency would hire a new grad. There is no safety net for support out in the field for a new grad. You don't have someone you can access with you for help if you need it. All the home health jobs I have seen require at least 1 year experience or more, as stated by corlackan.

Once you get some nursing experience ( as stated most likely in SNF or LTC) there are a lot of jobs in Home Health, if that is an option for you.

Wow, that's an eye opener! My millennial gen daughter would rather eat glass than take me with her for a job interview lol

Agreed. All the case management jobs I see require at least nursing experience, most require specialized nursing experience (ICU, Oncology, Home Health, Hospice), and prior case managing experience.

I agree! Congratulations, hope it works out well for you!

Home Health is no place for a new grad because you are out in the field functioning by yourself with no safety net of support. You should have some nursing experience preferably acute care prior to Home Health nursing.

My advice to you is not to worry. I have never heard of any insurance policy covering you retroactively, so to my knowledge you can't get insurance to cover you the 3 weeks before you had the insurance. All you can do is continue to practice nursing safely, diligently, and within the scope of practice, and move forward knowing you are now covered with malpractice insurance. Possibly your employer had you covered prior to the insurance policy being effective, but you shouldn't stress over a situation that will most likely never materialize.

I know I have some hearing loss even though I haven't been tested for it. I have a Maxiscope, and yes you will hear sounds you have never heard before with more inferior scopes. Just as good if not better is the Allheart cardiology scope, it has heavier durable tubing, and a bell and diaphragm, and costs $29, or less on sale. Maxiscope and Ultrascopes are more expensive, and do require a learning curve as they have a pressure sensitive diaphragm, so you use varying pressure for cardiac, lung, abdomen, and B/P assessment, but they are excellent scopes. I never have owned a Littman, so I can't speak for those. I guess it really depends on how much hearing loss you have.

I too am re-entering the workforce after a 3 year hiatus, and took a general nurse refresher, not because I was required to but because I had been away from primary nursing for a while, and felt it would help me brush up. You say that you took a re-entry course, I assumed you meant a nurse refresher. A nurse refresher will give you clinical hours as well ( I had 80) with a preceptor, I assume your re-entry course had clinical hours? Have you posted a resume on job boards? I have gotten offers to apply per email from job boards and I have been contacted by hospitals even though I haven't worked in a hospital for 15 years, as my latest experience is in Home Health. A refresher may help your job prospects, and in some states is required if you have been out of nursing for a period of time, so check with your State Board of Nursing. Job markets for nurses vary so much from location to location as per this board with saturation in some and shortages in the next. I wish you luck, and hang in there, I did and I have an interview tomorrow at a home health agency.

What is the point in requiring a DNP for a nurse practitioner? Might as well become a MD. I'm all for education, but that totally makes no sense.