HHN2472

For a routine visit there would be no way I could spend a full hour with my patient. I have sometimes 5 a day and have to drive upwards of 20 minutes to each one. I am not saying I haven't with the ones who like to talk, but most of my patients would be like... uh, what are you still doing here? 30 minutes for a routine patient I can do everything I need to and then document fully in 30 minutes. Not including my IV patients and extensive wound care patients....

This is not the place to ask this question. A few of these nurses are over-worked, stressed, cynical and fearful of newbies stealing their job. Nursing is good. It is good money, there actually are jobs... everywhere. People just don't look hard enough. Yeah there are a ton of new nurses pumped out every year, but not all of them are employable. Some are stupid, some are criminals, some will decide its not worth it, established RNs retire, established RNs change career options... Morally, no I DON'T question myself when I go home at night. Maybe its my job, maybe its my attitude... Nursing to me is the most ethical career I could have chose. Now needles... Eh. I thought the same thing. You get used to it. Blood, you get used to it. It is EASY to make mistakes. We all do, they are lying if they tell you they don't. Yeah, you can make a mistake to end a life, but mistakes you make, as a good nurse you will catch it before it is life threatening. I would never dissuade a person from nursing out of fear of them taking my job and you will see a LOT of nurses doing that to youngsters with the nursing dream. I see it all the time. Nursing to me is a dream job. Good and bad, I love it and I hope that you will too.

I have never really thought about it until today when I had a SOC and the patient's family told me that the patient was embarrassed and afraid the neighbors would start asking questions with my car out in the driveway (which has the company logo on it). This is the first time in all my home health adventures that I have heard this one.

2 stethoscopes, a PT/INR machine, a glucose machine, pulse oximeter, thermometer, scissors, butterfly needles, lab tubes, gloves wound care supplies, vaccutainers, blood pressure cuff, santi-wipes, pens, pads, food, money, gas card, cell phone, map, drug book, pepper spray, OTC meds, CPR mask, goggles pen light, and an AED in the trunk... but then I am a Home Health nurse so my bag is pretty stocked and pretty massive.

I feel your pain. As a home health nurse I draw blood (in the patient's home no less, so no help) on a daily basis. I have gotten to where it is second nature, however if I can't get it, as much I fear they are going to be mad, I will fish for it. If you give up before you take the needle out, then you cut yourself short. Take a breath when you don't see the flash, and then fish for it. Eventually you will get it nearly every time. Good luck to you.

Never heard the words "nursing shortage" before deciding on nursing school... Honestly, when I went to a MD visit, or to the ER with a broken this or that, or saw a nurse in the community 9 times out of 10 they looked rich. Bling rings, Yukon Denali, nice homes. Maybe they had rich husbands (because now I know the reality)? Either way, they looked like they weren't hurting and I though nursing=rich and went for it. Luckily I love my job and found a passion for helping people rather than my original plan of cashing out.

Not sure where to put this, but I am looking for other health care professional opinions on the matter. I have noticed when making appointments for my patients that when I call the receptionist at MD offices she will always say... "So... what exactly is going on with them that they need to see the Doctor?" Maybe I am just paranoid, but I find that to be none of their business. I know that they are trying to figure out how much time to schedule out, but I don't see how a receptionist should be allowed to ask questions about what is going on with a patient. It is harmless yes, and you can be vague I know by saying "Not feeling well" or "Just needs to follow up" or what have you. Am I being overly nit picky?

I never comment, but *** man? Meaning it leaked down the wall from a floor above and on through to the pizza oven through the pipes? I am so mind boggled as to how dialysis waste can get in Pizza first and second ****** ******* that is beyond gross to think about and I have seen some good stuff in my day! SO sorry for you. I am sure you are fine, but Gawd. What else was contaminated?

We are going to electronic charting in July of this year. We have several nurses in our office, but most of our time as RNs are spent charting and doing the OASIS which are so long and then we have 2 nurses designated to do record audits. When we go to charting and we are not tied down by all the paperwork, will that hurt or help us? We are all hourly and get plenty of overtime due to charting and record audits. Just curious.

The loves: I work on a per-hour basis, so I really like that. I love my patients, and I love the autonomy, the ability to run an errand if need be, and the way that our office closes for bad weather because they care about us (where at the hospital, you are SOL because you *have* to be there). I love I can run to my son's school if need be or sleep late occasionally and leave home to see my patients. I love the sights I see driving in the country every day. I love the extra mileage I get for driving when I have an old car that is paid for; that makes me money. I love the laid-back atmosphere at work and the way it is laid back. I do have stressful days when I have paperwork, but I don't know if it is just my office or what, but I can get my paperwork done in no time because I don't chitter chatter all the time. I never let it pile up, and I get done. I RARELY take stuff home with me because I am always nonstop when on the clock. I love the way my patients feel like family. I love the 8-4 hours. I love having major Holidays off with the option of seeing my patients later in the week to have the day before a Holiday or after a Holiday off. I love seeing the difference I make. I love knowing that I can use my critical thinking skills to make things work when I am all alone in a home, like figuring out a sterile atmosphere to change a catheter or a central line dressing. The Cons: Sometimes I get the feeling other nurses I am in contact with at the bedside think my job is sub-par because I am not chasing the excitement of bedside. I hate that sometimes families are CRAY-CRAY, and there is NO helping them, and it is scary to see. I hate that sometimes patients get on my nerves, and we have them for months on end sometimes, and the thought of seeing some of them makes me cringe. Sometimes the roaches or the disgusting homes with filthy dogs and smokers, I hate that. I hate that sometimes no matter how hard you try, you know you can't fix some patients who have broken family lives. It's a very emotional job as you are forced to be a part of a patient's daily life. I don't like phone call follow-up calls either because I am not a phone person, and the patients will keep me on the phone FOREVER. Well, that's about all my pros and cons, LOL.

I have a "friend" and by friend I mean she used to work with me way back before we were nurses who worked for a home health company that closed down unexpectedly. I keep asking her why she won't go to work again and she hem-haws around the subject. I know her full name and I cant find her name on the BON website license verification. I am starting to wonder if she was ever a nurse at all, meaning if she ever passed her NCLEX, but then how could she have worked? She has never been married and I know her well enough that if she had changed her name, I would know. It all seems so shady the way she is acting lately. I asked her if her license is current, and she said "Well I guess. I think it expires in March. My old company always took care of that for me." I said you need to take CE classes to renew your license and pay, and she acts like she has no clue and that her job took care of it. I told her to give me her license number and I could look it up real quick to see if she is active and she stutters unable to provide it after saying it was in her purse earlier. Idk. I know she worked as a nurse for a HH company that was shut down or "went out of business." I feel like calling her out because I have seen nurses whose licenses have been revoked and they are still on the BON website with a status of revoked. I feel like she is lying about everything and it makes me not want to even be around her.

"OP, don't let ANYONE tell you what you are or to define you. Don't feel guilty for not doing what's not in your heart. I rather you stay out of the clinical floor, than to resent your job and for it to show in your quality of care. You can get a job out of college in public health, corrections, etc. Floor experience does not necessarily benefit or lend to non-floor positions. Good luck" I could not have said it better. The person who said you are not marketable is a grouch and trying to make you believe that nursing is some sort of lucrative club with only certain positions available for certain people when fact is that the whole field is a crap shoot. Apply everywhere. I was hired in Home Health right out of school and was more prepared and skilled than when I left it and went to the Hospital thinking that was the only way I would be seen as a "real nurse". I went back to Home Health after putting in applications everywhere I could find and it was no time before I got a call back. You ARE marketable. You have your license and you are picky! Yay for picky nurses. Who wants a desperate nurse who hates their job?

Don't know what to tell you I drove 45 minutes one way for 2 years and the clinicals were 75 miles away from my house and some were over 100. I just made it work. I had a then 3 year old at the time. It got easier the second year because we were in school less than clinical but it was still hard because you have to be at clinical at 6:15 and that means leaving the house sometimes a 4:15, but I did it! Nursing school really teaches you to be resilient.

I work in Louisiana HH and I started out last year with a census of 25 to CM and I am down to 14! We are having a hard time getting patients and I am hoping things will pick up since I actually love my job. There are 5 RNs with a case load of 25 max each. We each have about 14-16 each now

Man. I feel you. There are days that I feel like running and never looking back, but then the last couple of weeks our census has DROPPED crazy low, and I got to thinking... OMG what if I get laid off and have to go back to the hospital and omg the thought of that is horrific to me lol. The 13 hour shifts on my feet, never getting to see the seasons change colors, the freedom to stop off at the store if I need to, or to run to my doctor or dentist without it causing a hoopla. At the hospital I felt as if I were in a prison and while sometimes the paperwork feels like a prison, to me nothing is worse than the hospital I can take my kid to school in the morning and work decent hours. I think you need to do what makes you happy, whatever that may be but remember about the grass being greener... there is always something that seems better until you get there and realized what you are missing.

Considering a career change because of an accident? Are you thinking nursing is going to be easier on your back or your health? Just wondering?

I am in HH as well and I pay 64 bi weekly for myself. I did not add my son or husband because it would be $1300 a month for them. I plan on getting my son a policy with the new healthcare plan at $84 a month. My husband will be paying the fine. He has never had insurance. I refuse all this. For car, home, health, life, dental, disability, nursing insurance I am TAPPED OUT! I pay more on insurance combined than any other aspect of my life. Its insane!

Teaching is always a justified reason to make a skilled nursing visit. Why are you selling yourself short? You are a nurse and you know when a patient has an exacerbation don't you? If a patient has had a recent med change, it exacerbates a disease process. Were they started on a new HTN medication, was a dose changed or lowered for example would exacerbate them. Have they continued to have a knowledge deficit regarding a disease process? Have they been started on an antibiotic? Have they had a new wound? Are they in need of therapy? There are so many reasons to recertify a patient. I mean with an elderly person it is pretty easy to find a reason to keep them on services.

I always say "I'm a nurse" and only today has anyone asked me "RN or LVN?" When I worked in the hospital it seemed nobody thought there was a difference and we are all just nurses, as we are, but in the community people seem more curious.

I would have taken the response from the student as a joke, and it was probably intended to be one from the less than warm response of a "mumbled hi".... It probably went downhill from there. As a RN and as the preceptor you are in a position to engage your students and acknowledge their presence... Can't think of any document so important that when a student or anyone for that matter said hello and I didn't take a hot second and smile and say hi. Honey and vinegar I guess. We all have a choice and one gets you further so I have seen. I actually don't blame the student on this but I was raised with manners so....

People really like to speak of home health nursing as some sort of fake, cheap nursing gig, but I am a mother in my early 30's and I am a "REAL Case manager" as someone on this thread so lovingly knocked... and I love my job. I make $28/hr which to most seems like not much but in this area of the South (Louisiana) most hospital RN jobs start at $19/hr. I work M-F 8-4 but they don't mind if I get to work about 8:30 so I can drop my son off at school. I see my patients in the morning and get back about 11 and do paperwork the rest of the day, but I get to be out in the community, not stuck in a building all day. If I want to run some errands I can and they are cool with that as long as I get my paperwork done. No weekends (except that every 4th weekend on call).... It is very family friendly and you will be reimbursed for mileage and on call. And of course you will be able to form a lasting bond with your elderly patients. They will consider you a part of the family. There are nurses in their 60's working with only their diploma or ADN and they make $35/hr. May not be what the MSN or NP pays, but not bad :) Something to think about with your little one.

As an ADN who is struggling to work, go to school and pay for my BSN knowing that its becoming the new requirement, I know that soon it will be MSN required, and then maybe even Doctorate. Hell, why don't we all just become Doctors? You are probably not even safe with your MSN lol. There are those RN-MSNs getting their Doctorate ready to push you on down the line :) I mean we are not qualified to care for patients just for passing NCLEX right? Not without that solid gold edumacashun? Not without those special letters behind our RN? I am sick of paying and going to school lol... TAKE YOUR DESK JOB and leave our jobs alone ) I am kidding. You earned your degree and your license. Work where you are happy.

Well... I work in home health. I have worked in the hospital... the first poster mentions that .45 cents a mile doesn't cover gas, mileage etc... I bought a $5000 car that gets 35 mpg. I MAKE money on my .45 cents a mile. A pretty good chunk of extra cash really. Also, I work 8-4 M-F so I get my nights and weekends. I am balls to the walls, so I don't generally need to carry work home. I have a family I see EVERY afternoon, I can take my kid to school, I can drive the countryside and see the sights, run some errands, make dr. appts around my schedule, and I have an on call weekend about once a month where I get paid extra and even get a 2 days of during the week to make up for my weekend on so I can use those two days to get business done that I wouldn't normally be able to because I work M-F 8-4. I love my patients, and they welcome me in their home. They know me well, I know them, their family, their likes and dislikes. They are MY patient for sometimes months on end and there is a kind of rewarding feeling from that I cannot explain. My elderly patients think of me as one of their grandkids. They know and remember my birthday, my son's birthday... I help them manage their chronic diseases and prevent exacerbations and the feeling of catching something before it gets out of hand is amazing and makes me feel as if I make a difference in their lives. The work is generally light considering there is no heavy lifting, no standing on my feet 13 hours... The documentation is longer, but to me SO worth it. The ability to be able to get up and leave my office and run to walmart if I feel like it is great. I can take time and do paperwork at home if I need to if I want to take off to go visit my son at a school function, I can work around my life. I am telling you what I PERSONALLY feel about home health, but that is me and nobody else. We have our not so sick chronic patients and we have our patients on TPN or vents, central lines etc... I have found it easier to care for people in their home, but again, that is just ME :) I disliked the hospital, I had high blood pressure, stress, felt exhausted with a bad back from standing and running my legs off, I left and never looked back. I hear a lot of bad stories about home health and it is stressful at times but to me the good outweighs the bad.

If that were the case then my Onstar would be a HIPAA violation, or my cell phone, or Google Earth... I mean you have big brother knowing where you are whether you know it or not. Are you going up to people saying... Hey, btw I have this "family locator" app on my phone? Do you expect one of your family members to come bust in a pts home? If not, I wouldn't say a word.

How many patients do you see on a daily basis?