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smrslr

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All Content by smrslr

  1. Our PTs don't do labs, but yes PT's can be case managers, you do not have to have an RN case manager. We have several PT only patients which means they get no nursing at all. If an acute issue comes about that requires a skill of a nurse, then we have to call and get an order from the MD and do a RN add on. It is very common for PTs to do wound care in hospital settings, so monitoring a surgical incision and removing a bandage really isn't unheard of. Our PTs also call the MD and report with any issues.
  2. Being properly trained in OASIS is key. In any home health setting, I would suggest taking OASIS training or reading CMS guidelines and see what it is really asking. Are they asking you to change your charting or change your OASIS....Remember CMS is not asking what they do and how they do it, they are asking if they can perform their task SAFELY. For example M1860-ambulation...what are you scoring them if they use a walker or nothing at all, but have fell 3 times in a month, or you documented they can only ambulate 10 feet without stopping to rest due to pain, dyspnea, weakness, etc....they would benefit from a wheelchair, but do not have one. Per CMS the correct OASIS response would be 5-Chairfast, Unable to ambulate and unable to wheel self, Per CMS-the clinician can not assess the ability to use a wheelchair if they don't have a wheelchair in the home....however they would be safer with one....Your goal is to get them therapy to improve them and make them safer or assist them with getting a wheelchair and making them safer in which you then can improve them to a 4. Their ambulation in M1860 also includes their safety ambulating down the driveway, uneven surfaces, etc...so if you chart any of the mentioned things, then yes you can justify an OASIS change. Then if M1860 is scored a 3 (requires supervision-which all your home health patients should to be SAFER or else they wouldn't be needing home health) or higher, your correct response to M2020 medication management is a 3-Unable to take medications unless administered by another person-Yes, this one gets skeptical from clinicians...however CMS is not asking how they are doing it, they are asking if they are safe...if they require supervision or more with ambulation, then they can't safely ambulate to go to medication, reach cabinet, and take medications. They require another person to complete the activity-SAFELY. Then throughout your episode, your job is to teach medication management and safety and then you can improve your outcomes at the end. You can take a fairly young Post-Op patient and score them very high on OASIS per CMS guidelines, taking into consideration their pain, obesity, comorbidities, functional limitations post-op. Pain is also taken into consideration into OASIS questions. M1800-grooming-this includes washing hair. Can a person with a fresh rotator cuff repair or even a pacemaker placed that has limited ROM to an upper extremity wash their hair without assistance? With one hand? This is just a basic crash course in OASIS to maybe help make sense of some of those things. CMS is all about safety and our goal in home health is to improve in them self managing themselves.
  3. I tested today too, I got 75 but it was sooo hard! Idk why I thought it wouldn't be lol. I'm too nervous to try PVT. I jad lots of select alls and infection control too. Very little drugs, no math. Several psych
  4. The HH company I work for (also in TX) do on call pay, even salaried. They said you they have to give on call pay if you are on call, whether you get called or not. We also have around 400 patients and calls aren't that hectic and our company is really discouraging from having to make any after hours visits. If it can't wait for a PRN in the morning and is urgent, then an ER visit may be more appropriate.
  5. 1000 likes! There is such a big push and pressure to continuously advance and obtain the next level degree, which is great....but what would happen if everyone advanced their careers to the NP or administrative roles? You have to have bedside nurses!! It is definitely not settling, especially if you love what you do!
  6. Whichever side of the fence you sit on, at the end of the day, we all bear the same "RN" after our name and sit for the same state board exam. As far as critical thinking goes, ADN and BSN are expected to graduate with the same clinical reasoning skills that allows you to pass the same NCLEX exam and begin an entry level nursing career. Sure, BSN opens up doors for advancement, but the type of nurse you become also has to do with your personality, ability to adapt and learn quickly, job experience, etc. Not all nursing skills will be learned in either program. A book can't teach you that gut feeling you get when something is not quite right or compassion. AND a little bit of common sense, goes a LONG way....you can be an all "A" ADN, BSN, MSN student, but can you apply that to a real situation? Not everyone is a great floor nurse, not everyone is a great nurse manager. Our jobs are stressful enough, can't we just stick together without arguing over who is better? Leave that to the doctors
  7. Shabba, the transisions first semester is an 8 week class and starts mid October. They don't get to those applications until all the generic students are processed. We start back up on Monday, so they will probably start calling after that, but I want to say I didn't hear anything until the middle of September. Then you have a few weeks to get everything completed; physicals, shots, etc. Lee is SSOOO last minute at everything. I don't remember what exactly was on critical thinking, but it was pretty easy.
  8. Mrs. Bea is actually really helpful, she just has a lot on her plate!
  9. As of now the only summer classes are for the transition students that start in the spring. Generic ADNS take fundamentals/Med Surg 1 in the fall, and the fall transitions take a transition course. Then they all take Med Surg 2 and Pedi in the spring, off summer, OB and Psych in the fall, Critical Care and management in the last spring semester. There are 2 class days a week and one clinical day. Each class is 8 weeks, and in the beginning of each 8 weeks, you will have one or two weeks of having class 4 long days of lab checkoffs and lecture, then after that your 2 class days and clinical starts. Hope this helps
  10. It's going ok. For transition, your first semester is an 8 week transition class, and it's one day a week, and honestly like a waste of time, LOL. After that you merge in with the "generic" class and for the most part you are in class for 2 days a week and clinical one day. Each semester has 2 8 week semesters, so you take one class at a time. Usually the first week of that 8 week semester you are in class 4 days. The only down fall is, if you start in the fall, you can't take your level 3 classes over the summer, so it seems like it takes forever to graduate. I started Oct 2015 and will be done May 2017. I think it's going to go by fast though. Finishing up Med -Surg next week, off this summer and start Level 3 in the fall. Med surg is hard!! Good luck :)
  11. They're really slow with the accepting process...I wouldn't look for them to call until probably July! Hang in there. For transition, it took forever and then they called us to come test like in a weeks notice, and then test again, and then maybe called us a week or 2 later to invite into the program. Transitions star in October and I want to say this was at the end of August when we were testing. Be ready to get a physical and all your titers.
  12. I just started the transitional program Thursday. Did you get in???
  13. I applied for the Fall 2015 LVN-RN transitional. The deadline for apps is May 15. How long does it take for them to contact you to schedule a HESI and what about the blue card? Doesn't seem like a whole lot of time from now until August!
  14. I did not go to Lee College for the LVN program. I turned in my application and everything I needed, so now it's just the waiting game!
  15. I'm going to apply for the LVN-RN transitional program.
  16. I'm going to put my app in for the LVN-RN transitional program
  17. I have been debating on going the Excelsior route for 2 years now! I had initially started out doing The College Network, but realized that it was just a way to get people to spend more money! I would feel more comfortable going the traditional route, but with a full time job, it leaves me having to choose work or school. I am worried about the CPNE at the end. I have heard mixed reviews. Any words of wisdom....stories of the good, the bad, and the ugly??
  18. I am considering doing EC. I have heard good and bad reviews. The clinical portion worries me, based on some of the reviews I have read, and I have not been in a hospital setting for about 3 years now. How long did it take you to complete the program? I have all of my pre-reqs, except my A&P 1&2 are over 5 years, so I have to retake those.
  19. I'm debating on doing Excelsior myself. I have heard good and bad. Have any of you done the clinical part yet?
  20. smrslr replied to kegreat's topic in School
    I am VERY jealous!!! I too work in TX, but my salary is under $20000/year(second year here). And d/t budget cuts there are no raises for anyone in the near future! I work here for the hours and my kids. That is the going rate at schools around here, unless you are the director of health services, and there is usually only one per district. Howe ever you can't beat a week off at Thanksgiving, Christmas Break, Spring break, and of course summer vacation!!
  21. I e-mailed them and was unable to get anything for the boys, but I am still using the same video and it says boys get it. I had a lot of disappointed boys last year :/
  22. I'm in the same boat as you! I wish somewhere local would offer night classes with night or weekend clinicals!
  23. Lamar State, the last I heard is not taking new students because I believe the program was put on probation by the BON. I hope that changes soon, because that is one of my best options for my job and etc. Lamar State College, Orange, still has their nursing program, but does not offer it online. I too have looked at Allgany and it seems good, but it does seem very hard to get into...almost like they try to scare you away from the beginning!!
  24. I had the same thing this week!!!!
  25. smrslr replied to texasbsn's topic in School
    Salary is LOW, but if you can afford the salary cut, the time off SO makes up for it!! If you are an LVN, the state of TX Board of Education does not recognize an LVN, so that is why the pay is so low. If you have kids, the money you can save in babysitters, after school care is also a huge payoff. On your breaks you can work PRN somewhere for extra cash. I stay on one campus. Our district is very blessed to allow all campuses to have a nurse. 3 have LVNs and one has an RN, who is our supervisor and health services director. I know a lot of other districts have aides at some campuses and one district RN that has to travel to other campuses. You should ask that question to whoever is hiring. And like AdobeRN says, the best way to get your foot in the door is to sub, and you will learn if that is the kind of setting you want to be in.

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