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Kaisu

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Reputation Activity by Kaisu

Reactions Given

Like 10
Haha 1

Reactions Received

Like 8

  1. Like
    Kaisu got a reaction from NRNPH in Help. Input. Agree. Disagree. Thoughts.   
    I always answer these with "would I want this to be administered to me or someone I love?".  The answer is heck NO.  I would not administer it.
  2. Like
    Kaisu reacted to aprilmoss in Anti-vax parents sue to keep kids in school   
    DENIED!

    https://thehill.com/policy/healthcare/433987-new-york-judge-denies-request-to-allow-unvaccinated-students-to-return-to
     
  3. Like
    Kaisu reacted to KatieMI, BSN, MSN in would you tell a manager how toxic her floor is?   
    Do you really think management doesn't know it? 
     
    It is only a question of you being able to afford to burn bridges with this place. Realistically, there are pretty few circumstances which would allow you to do it safely. Local nursing circles can be much tighter than one can imagine. But if you, say, move for a good distance or leave for grad school and do not plan to come back to the same level job and feel like doing it, then feel free.
    (foreseeing questions: I did just that in 2015 with the fire burning up to high heavens. A short two years later I was without any problems credentialed in the same place as an NP. Nursing administration people still try to dissolve into thin air when we bump into each other by an accident. And at least in two units the question of new grads abuse is not existing any more). 
  4. Like
    Kaisu reacted to Davey Do in Weird Interview!?   
  5. Like
    Kaisu got a reaction from mommy2boysaz in What is a bad day?   
    For me, there really are no bad days.  There are challenging days, when new symptoms develop rapidly in multiple patients seemingly at the same time, or when team members have car problems, or develop illnesses.
    Generally, even the "bad" days are rewarding.  There is nothing like bringing peace, comfort and calm to patients and families when they are nearing the end of life. 
  6. Like
    Kaisu got a reaction from cardiacfreak, ADN in Opoid crisis and providing hospice care   
    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.
  7. Like
    Kaisu reacted to Tenebrae in Repositioning end stage of life hospice pts   
    Evidence supports that a pressure relieving mattress is just as effective in preventing pressure injuries. Also interesting to note, a pressure injury can start in under 45 minutes
    Bear in mind when the person is dying, they have little to no nutrition in their body, their fluid intake is minimal. You arent going to heal a pressure injury
    And speaking from the point of a nurse and also a family member, if you insisted on turning my mum every 2 hours just to tick your boxes I would be hacked off
     
  8. Haha
    Kaisu reacted to Wuzzie in How to retain nurses?   
    I’m just here for the pizza. 🤣
  9. Like
    Kaisu got a reaction from nurseebol in National Standard Productivity   
    Start of Care is 2 points, Recert is 1.5 points, regular visit 1 point, unless more than 2 cares are required, for example, wound care and ostomy care, still 1 point, add a wound vac and now it is 3 cares and becomes 1.5 points.  60 miles is a point and fractions are calculated.  Productivity expectation is 25 points a week.  Very doable.  Great job.
     
  10. Like
    Kaisu reacted to Wuzzie in 23 Employees on Leave from Ohio Hospital after giving Excessive Pain medication   
    2000 mcg of Fentanyl is not comfort care. 
  11. Like
    Kaisu reacted to vampiregirl, BSN in ACHPN exam?   
    For the CHPN exam in 2015 (different exam/ certification, same credentialing agency), I used the candidate handbook and purchased the core curriculum. I also purchased practice tests from HPNA, which included 2 practice tests. I took the first one as I was beginning studying to identify areas that I needed to focus on and took the 2nd practice test about a week before my "real" test. I think I prepared for 4-6 weeks total. 
    As for the areas represented, I seem to recall the candidate guide pretty much gave an accurate picture. I also know several other nurses who have taken the test and all of us had either different tests or different perceptions of what areas were more represented.
    Good luck! I encourage any of my hospice colleagues to pursue certification. I learned a lot from studying for the test and I think it has positively impacted my practice. 
  12. Like
    Kaisu reacted to poko, LPN in First job home health RN advice   
    I live in Canada and work in Home Health. I have for four years now. It is definitely the most unpredictable job. But we can say no to a point. We get out schedules the night before, but as our days go on we get new referrals from the hospitals, or someone calls in sick, or patients call with needing an extra visit due to a problem, or we call patients and they decline or cancel visits. This causes constant shifts in our workday. With that said we are only expected to be available for the duration of our shift (day 0800-1600) and after that any changes are dealt with my the next shift.
    is this the norm in HH? I would say it’s a common theme and it definitely happens often, which is why people tend to leave. I personally don’t mind the erratic scheduling, but it’s not for everyone. There are good days where everything aligns to your planning.  And bad ones where everything changes on a whim. I try to keep an open mind despite feeling reallly frustrated at times.
     
    all the best to you :)
  13. Like
    Kaisu got a reaction from Nightshade1972 in The Essentials of Medication Reconciliation in Home Care   
    Critical part of the admission process.  I believe medication issues are a major reason for hospital readmission and/or patient harm and a prime teaching opportunity.  I have taken out literally bucket fulls of medications from some homes.  It is one of the best ways to do good and potentially save a life.  
  14. Like
    Kaisu reacted to Libby1987 in The Essentials of Medication Reconciliation in Home Care   
    Thank you for discussing such an important topic.
    Perhaps it’s implied but it seems some steps are missing.  This is how I reconcile medications:
    Gather all meds in home. 
    Verify which meds patient has been taking since last medical encounter. (ie since home from hosptial)
    Compare these meds against most recent MD ordered list of medications. (ie discharge instructions)
    Note any discrepancies, notify MD and correct with changing, adding and/or omitting as indicated  
    Have patient/CG teach back reconciled list and identify container and how to take.  
    Request/suggest how to safely set up/organization/storage of meds if needed (ie remove discontinued meds and store elsewhere, correct mediplanner)
    Leave legible med schedule written in layman terms with patient. 
    Follow up for understanding and compliance next visit. 
  15. Like
    Kaisu reacted to Melissa Mills, BSN in The Essentials of Medication Reconciliation in Home Care   
    I agree with you completely, Kaisu. I think where we often run into problems as a nurse is having the time to dedicate the time to reconciliation that it needs truly.  When you do have that patient who shows up with meds in a bag that should have been tossed years ago - it can take a significant amount of time in the home and then you still need to call each prescriber and clarify what the patient should be taking. But, when you know, you have five more patients to see and 50 miles of ground to cover - this process can get pushed to the side. 
     
    Thanks for sharing your thoughts!!
  16. Like
    Kaisu got a reaction from Nightshade1972 in The Essentials of Medication Reconciliation in Home Care   
    Critical part of the admission process.  I believe medication issues are a major reason for hospital readmission and/or patient harm and a prime teaching opportunity.  I have taken out literally bucket fulls of medications from some homes.  It is one of the best ways to do good and potentially save a life.  
  17. Like
    Kaisu got a reaction from Nightshade1972 in The Essentials of Medication Reconciliation in Home Care   
    Critical part of the admission process.  I believe medication issues are a major reason for hospital readmission and/or patient harm and a prime teaching opportunity.  I have taken out literally bucket fulls of medications from some homes.  It is one of the best ways to do good and potentially save a life.  
  18. Like
    Kaisu reacted to TAKOO01 in job forcing app on personal phone   
    I agree with JKL33. This is wrong, but it happens because we tolerate it
     How badly do you need this job? I would say start looking for new opportunities immediately. 
  19. Like
    Kaisu got a reaction from TAKOO01 in I Must Be Missing Something   
    I have to say that you found your way to a really crummy agency. It is so different from where I work that I don't even know where to begin. Firstly, I purchased no equipment. It is all provided and it is top notch. Secondly, everyone in the agency from the home health aides to the DON up to the CEO (a nurse) are truly amazing, supportive, helpful people.
    I love this job. I pinch myself every morning because I can't believe I'm not dreaming. I am out and about in my community, enjoying fresh air and beautiful scenery. I practice at the top of my license. I spend all the time I want and need with my patients and spend more time teaching (which is my passion) than checking stupid boxes on charting software.
    That is not to say this is not a challenge. OASIS starts of care are tedious and time consuming. I get through them because I know that until that chart is completed and goes in, my patient does not get services.
    I could go on and on -(OK, I've gone on and on).
    Find a better agency. It is a truly wonderful branch of nursing.
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