Kaisu

I have no problems obtaining whatever narcotics my patients need. It is so easy that I have had the thought that at some point, things are going to get tougher. I can't imagine the regulatory agency will not look at the amount we go through and start to tighten things up. I hope not. Our patients are dying and deserve all the comfort measures they want and need.

I think it depends on the agency and the service area, the competition, etc. I started out making more in hospice than I did in med/surg.

I would present these "higher ups" with the details of the methods you mentioned, as well as the fact that you came to a forum looking for ideas, that unless they can come up with ways to "make" adults conform to corporate goals they can kindly stop harassing your overworked butts. Makes me angry when some dimwit sits in a meeting and comes up with so called solutions that are not solutions at all. Whew - Rant over.

Medic to RN here.. not in Georgia but I can tell you - Go for the RN. I knew when I started nursing school that hospitals/floor nursing was NOT for me. My 4 months on med/surg after I graduated drove that point home. I worked home health and now hospice. It is wonderful. I have autonomy and a team. I get all the excitement I want, and the job is immensely fulfilling. The fact that it pays much better than even critical care transport is a bonus. Nursing is a huge field. It may take people time to find their niche, but when you do, you won't look back.

I'm using HCHB on my phone. Android Samsung Note 5. I find it works very well. I love having everything I need on one device. It did take getting used to , but I have no major complaints.

I spent 20 years as my own boss in systems consulting. I was the expert. I was the one that was called when others had taken a shot and failed. It was comfortable. I left that and became a paramedic. Not only was I a new medic, I decided to get my first job 2000 miles away in a different state in a different system. Some people felt I would never make it. It took 3 years before I was considered "solid" and a few years after that before people were telling me that if their loved ones needed EMS, I was the one they would want to respond. I was honored. Then I went to nursing school. First med/surg job was beyond scary. Then I went to home health. I scrambled like crazy - again. When I became comfortable, I went to hospice. Of all these new starts, hospice feels like home. Nevertheless, I am scrambling again. I think there is something wrong with me... LOL.

Black. Death called - He wanted the uniform back...

I'm pretty sure I know what you guys are going to advise, but I'm putting it out here anyway. Although we do get close to patients, I try at all times to remain professional. Today, I was shocked that one of my hospice patients sent a friend request. I do not want to offend him in any way, but I don't think it's appropriate to blur the boundaries. My plan is to blame company policy. What say you?

I am delighted to hear this. I too am absolutely privileged to work in a wonderful agency. It really makes all the difference in the world. Please post again to let us know how its going.

Working in pairs would be amazing. I saw a lot of gnarly stuff running 911, but I always had a partner with me who had my back and vice versa. I have thought often that with some of the situations we run into we are in as much danger and we have no one to bounce stuff off of. A second set of eyes would improve care substantially. I don't imagine that is an achievable dream tho...

1. What best describes your job? RN Case manager - uh I guess that means nurse 2. What is your #1 Achilles Heel in this industry Currently it is brutal driving times because of the area I work in. The reimbursement is excellent and the company is a real joy. 3. Do you work for multiple home care agencies? Just the one 4. Do you currently use an electronic form of documentation? Yes - We use Pointcare 5. Do you track mile for reimbursement? Yes. easy to document on the chart and add non-visit travel as well 6. What do you love about home health? The autonomy, being out and about in the community, the time I can devote to teaching, focusing on one patient at a time and the money. 7. If you could eliminate one aspect of your job which would it be? I detest non-responsive PCPs. 8. If you could design or change an item what would it be? I would love a specific nursing bag with custom designed pouches to organize all the wound care supplies, ostomy, foley, blood draw stuff etc etc. 9. How long have you worked in home health? 1 year

It sounds like you have many of the big factors for success in place. It is key to work with a supportive and reputable agency. I cannot over-emphasize that. Another important thing to remember is that while you are alone in the home, you have a team behind you. Especially while new, reach out. Find mentors and go to people that you can run things by. A good agency will hire good people that will be happy to help. Be prepared initially to spend a LOT of time on your job. The first OASIS admission documentation took me 2 1/2 hours. EEK. (I can do one in about 40 minutes now). I spent hours in the field and then evenings and weekends catching up. It gets easier and you will be amazed at how efficient you become. Gut check often. If it is a good fit, you will be excited and happy to go to work. Everybody has days when work is not fun, but you should feel like what you are doing is meaningful and makes a difference. Good luck.

I bought a brand new car and then was dropped into a rural area due to staff shortages. I have put on almost 10K miles in less than 3 months. On one of my trips over a very bad road I took a hard to see dip at too high a speed. 3500$ in damage to the underside of my beautiful car. I justify it this way. - With the hourly travel pay and mileage compensation, I earn my monthly car payment in just over 2 weeks. I think of the bright shiny thing as a tool - a tool I use to do a job I love. As the previous poster said, it is just part of Home Health.

I may be way off base here but I hear unilateral lower extremity edema and pain and I think blood clot. Notwithstanding, medical evaluation totally indicated. Great assessment data by the way.

This is an opinion based on years of calling APS while running EMS and now in HH. APS in this state is a joke. I have yet to see one effective APS response to the myriads of times I and others have called. I don't know if they are short handed or unable to marshal resources or what the problem is. Calling them is something I do to CYA as a mandated reporter, but as far as resolving situations, I could tell you horror stories that I have personally experienced. It is not an answer in any sense of the word.