JJsMama79

Or do you take a "snow day" and scheduled them for the next day? Just wondering...I'm kind of torn between just taking tomorrow off (my son's school has already cancelled) but then I would have 8-9 pts to see the remaining days...each day. What would you all do?Take the day as a snow day and be SUPER busy the rest of the week (not even taking SOCs) or suck it up...but chance having a car accident....What would you all do?

Yes that's how it usually is. It'd be like getting paid to drive to and from work if you worked at a hospital. I live 1 mile away from the office, so I usually go there first to check my mailbox, pick up supplies, paperwork I may need, and turn in the notes on the visits I made the day before. If you stop at the office FIRST, then you get pain for the mileage to your first pt. (with my company you do, it may not be like that for everyone.) Then if you go to the office last, you can count the mileage from your last pt's house. Like I said, I only live a mile way from the office, so I'm lucky in that area, that I can usually count most of my mileage.

I would not do it.....something fishy.....what if something were to happen and you're not technically an employee? Not cool.

I agree with you guys. I think I am being too hard on myself. Thanks for the responses. =)

Hey everyone, I am new to home health nursing...but have been an RN for almost 10 years. I found out a few hours ago that one of my patients is being hospitalized for a PE. I admitted her to home health on 1/7. (She was actually my very first pt I admitted) I was going over her d/c summary from the hospital and nursing home (she was in short-term rehab. She'd had a mitral valve replacement 12/19) She had a prior history of DVT and had been taking Coumadin, but stopped it a week before her surgery. (So she hasn't been on it since 12/12.) I was going over her d/c summary, and the doctor had told her to stop taking Coumadin, and they didn't reorder it once she got home. Should I have caught that and called the MD and asked if he wanted to restart it? She had seen him at a follow up visit on 1/10, and it hadn't been reordered. Instead, she had been taking 325 mg Aspirin. I feel bad in that I think I should've caught that and called the doctor when I admitted her. AM I feeling bad over nothing? (I don't mean "nothing" cause having a PE is kinda a big deal) but I'm wondering if I'm being too critical of myself. Any thoughts would be appreciated. Thanks.

I think it's a good idea to pick up extra shifts if you're looking for extra money, instead of getting hired on at a new place. On my floor, we were short-staffed a lot, and ICU and tele nurses were often pulled to our floor. A lot of them, I will be honest, didn't really like working on our floor, because instead of having 2-6 pts max, they had 6-8. That can be overwhelming. Some of the med-surg pts are really, truly sick...and you have to be able to pick up on the "subtle" signs that things are starting to get bad. This is where your ICU experience comes in though...being used to taking care of the really sick pts, you'll be able to pick up those signs relatively easily. I used to work on med-surg on nights for years...and don't let the time of day trick you lol. Nights can be just as busy, if not more, than days...just a "different" kind of busy. The night is where those cute little sundowners go absolutley crazy...and being nights, you often have less staff than days to help out. Med surg is definitely the "melting pot" of the hospital....you get a lot of different diagnoses...pneumonia, copd, abdominal pain, acute renal failure, to name just a few. On my floor we also had a ton of post-ops...knee/hip replacements, fractures that were fixed, appys, cholys, colectomies, hysterectomies....basically any surgeries that required an over night stay. We had a lot of CBIs and even some chest tubes! While the pt herself may not have had every line and drip imaginable, we also had ports, piccs, central lines, and vas caths. So yes, they can be medically complicated as well. The big thing about med surg I hated were the drug seekers. TRUE drug seekers...the moment when you walked in the room, they'd ask when they could have their next pain medicine, or they'd say "Just give me all my prns I can have." They'd ask that, while at the same time, be talking on the phone, or on facebook on their laptops, and asking for bedtime snacks...while rating their pain 10/10 and asking for phenergan. That drove me nuts. And sometimes all the pts in your group would be like that. You knew their pain couldn't possibily be a 10/10....but, being as pain is "subjective" and is what the pt says it is....you basically have to kiss their a** and give them what they want and what the dr has ordered. So, if you can handle the bullsh** patients like that, then yes, pick up extra hours. You will still learn a lot since med-surg is a diverse population. But don't expect your assessments (or getting bedside report) to be as thorough..there just aren't many hours in your shift where you can be as thorough as you can in ICU...and there will be days when all you feel like is a glorified waitress and drug dealer. PS..those little med-surg pocket books are nice to have.

mrsmartin, that's what I heard too. Guess I'm too impatient....I want to feel good in it NOW lol. Last Friday was supposed to be my last day of orientation, but the girl I was with had a death in her family, so I was asked to cover her people. Luckily I had seen 3 of them already with her, and I saw 6 total. I did take 2 pts of my own...did their SOC. So far they're good. I've taken over 2 from one nurse who didn't live in the area where her people were, and another one because of the same thing. They're all dressing changes...1 is daily, 1 is 2x week and 1 is 3x a week. I picked up another one that was started on Saturday...and he's a daily dressing change too. And I picked up another one today; she was already with our PT services, not for skilled nursing though...she went to the dr and he ordered nursing to go along with it. So I have a total of 6 people under my care. Doesn't seem a lot, especially when I'm used to having 6-8 at the same time in the hospital lol. There's so much paperwork involved! Caliotter...I've been planning my schedule for the day the night before...and making sure my bag is stocked....extra papers in my files....but by the end of the day my bag, files and car is such a mess...(and I drive a big van lol) I guess I'm feeling overwhelmed and like I'm not doing a good job, even though the other nurses I've talked to (well...not just talked to, but have bombarbed with endless questions) say I'm doing fine....I just don't feel like it. Emptyboxcars...so far most of my pts are wound care. I don't mind so much. I would seriously get 2 years of med surg under your belt, AT LEAST. Med surg you deal with a diversity of people, with a diverse history. The melting pot of nursing, if you will lol. I did med surg for a long time, and always told the nurses I was training that it takes a good 6 months to feel comfortable taking care of your own people. Critical thinking skills are a must in the nursing profession....I'm finding home care nursing is very independent. You are the eyes and ears of the drs. You are in the hospital as well...but there you have other nurses who can come look/listen to your pts right away if you have a question. In the home you don't. What I'm finding I'm doing is asking the person's family members if such and such behavior is normal, as well as reading past notes.

WOW!! I just can't find the adequate words to describe what I am feeling right now. I only had 6 days of orientation, which in and of itself is scary...being in the hospital, I was used to 6-12 weeks. There is so much to learn, and it's very different from a clinical setting. I like deciding who I'm going to see and when. I don't like that even though I call ahead, the pt is still not home and I have to back track. I've been on my own for 2 days now...and I feel incompetent and dumb. It even has me questioning my assessment skills. In the hospital if something didn't look or feel right, I had the advantage of calling my clinical supervisor to come take a look/listen. I'm on my own here! While I enjoy the autonomity, it scares the bejesus out of me. (At least I know to call 911 if some serious crap hits the fan lol) I guess what I'm asking is, did anyone else start hout feeling the way I do? I can't help but think I'm missing important things, even though I tend to write every little thing down so I don't forget. I feel overwhelmed. I tend to be a perfectionist when it comes to my work as a nurse. I've been a nurse now since 2004, so I'm not a "newbie" but this job is making me feel like one! How did you all get through your days without breaking down? And about how long did it take you to get into the "swing of things?" Thanks for taking the time to read and post. =)

Hello all,I finally start my new job as a home health nurse on Thursday, Jan. 2. I would appreciate any last minute tips/advice on how to be successful. I've been reading all these threads and some of it's a little confusing...different abbreviations and nicknames...but I'll learn what all those mean :). I'm nervous, since I've been in the hospital setting on inpatients floors since I've become a nurse (almost 10 years now.) Any tips/advice would be greatly appreciated, many some funny stories too? :). Thanks.

Hello, Just wondering...what are some of the things you keep in your car for this job? I'm leaving a med-surg floor and have had the luxury of having a stock room and everything I've needed. Any particular items you can't live without? What about keeping pt's charts in your car....do you have a box/collapsable box/plastic box with drawers? I'd like to keep my car as organized as possible. Also, how do you organize your bag? If the agency doesn't supply you with a bag, what type do you get and where do you get one? I start in the home health field last week of December/first week of January and wanna be ready!!! I'm very excited....can you tell? Also, what do you love about this type of nursing? Dislike? Thanks so much for your input/advice!!

I wear Alegria...they have slip resistant bottoms. They are priced pretty comparable to Danskos. I've had them since February and they still feel good on my feet.

Hello all, I've been an RN with my BSN for almost ten years and have primarily worked in medical-surgical. I also have experience in labor and delivery, adolescent psych, cardiology, urology, and nursing home nursing. I've accepted a full-time home health position and will start at the end of this month/beginning of January. I am excited about this change, as I am burnt out in medical-surgical. Completely. What I'm wondering is, what do you love about home health? What made you get into this field of nursing? What are some of the things that you do not like? And do you have any tips on how to be successful? I've read many posts about never-ending charting, even in your free time, but I've also read that you are able to finish it in a reasonable amount of time. I've read some horror stories, but for the most part, it seems like the majority of people really enjoy this field of nursing. I'm hoping I really enjoy home health...I don't mind driving, and I like the idea of being able to focus on one patient at a time rather than have 7-8 patients pushing the call light at the same time, asking for pain meds. At my job, I feel like a glorified waitress/drug dealer MOST OF THE TIME. I feel like I am just a "servant" to them, and rarely are they appreciative of someone trying to help them. I want to feel like I'm making a difference, even a small one, to people who really want me to be there. Am I looking at this through rose-colored glasses? Perhaps. I don't want to lose faith in humanity, and a lot of the patients I deal with are making me do just that. Sorry, my post got off on a little bit of a tangent, LOL. Any tips, like what you keep in your bag/car, how to stay organized, knowing when to call docs, etc., would be greatly appreciated. Any tips on how to be successful and on top of it would be awesome. Thanks!

Hi there Sirdearis88, Let me know how your job is going! I've been in the med surg field for 7 1/2 years now, and am starting my new job in home health care at the end of December. I have the same concerns as you...please let me know how you like it, and what you have learned so far. Thanks and good luck!

Hello my fellow nurses, I have been a nurse now for almost 10 years. In that time, I've been working mostly med-surg (about 7 1/2 yrs) and have had experience in pediatrics, adolescent psych, labor and delivery and nursing home nursing. I have decided I am tired of working in a hospital...the 12+ hour shifts and taking care of 8-9 pts at a time is starting to wear on me. I also am charge nurse on my floor about once a week and we are still required to carry a full pt load while at the same time being "in charge." I cry on my way to work almost every night (I work 7p-7a) and about 2 times while I'm there...so I've decided I was burnt out and got an interview with my local hospital in the home health care department. Long story short, I got offered the job, and start in about 3 weeks. I am SO excited to be starting in a field that's different from floor nursing. Everyone I've spoken with said they love home health...the only regret they have is not getting in the field sooner. Any tips from all you lovely nurses who have been in home health awhile? I don't need tips on assessment skills, or really any technical skills, as I've been a nurse for awhile. Tips on how to stay organized, setting up appointments, paperwork, calling doctors...basically whatever is different than floor nursing would be greatly appreciated! Also, what is so awesome about home health? How did you pick this field? What do you love about it? What do you dislike about it? I am very eager to know a typical day (and not so typical day.) I shadowed a home health nurse for a day before I accepted the job offer, but those were somewhat "easy" visits....each lasted about 15 minutes. Any thoughts would be greatly appreciated! Thanks! JJsMama1979