startofcare

This is the unfortunate perception by nursing recruiters.I work in a large county correctional facility, the medical housing or infirmary as its called in corrections operates in a subacute capacity. You deal with with HIV, HCV, TB post op, all day everyday, ambulatory and non ambulatory. From my experience so far is what makes the correctional medsurg appear less than an infirmary is the provider, some providers will send an inmate to the ED for anything, most of these providers are contracted. The provider who are comfortable with their environment will give an order on the spot. Yes I am having difficulty having recruiters understand that my role is much more than pill passing.

I am currently working in a county correctional faculty, for reasons of security all movement is slow and calculated, I have cameras watching my every move, I cope by taking short walks to other clinics say hello and use the bathroom. Also I walk to the trustee cafeteria get a cup of coffee or tea. I come in contact with several CO's which makes for quick hellos. Leaving the facility requires signing out. In my opinion I find going into IM cell ( with CO supervision) feels most closterphobic.

This sounds fair if this is an hourly rate, but make sure if you receive mileage, extra pay for SOC ROC revert, also if you have access to educational material it a clinical educator and not just you tube.

I left the agency about a week ago didn't even get a thank you . Now they are calling me to re do nursing notes .

I have been in home health the last 6 month, although I did not have medsurg background I was confident in my assessment skills. Ask you agency if they check you off on skills or if there is educational reference material. Unfortunately the agency I was with advised you to learn skills off of youtube. The most common day in and day out skilled I do: 1. Assessments head to toe 2. Vital signs 3. Wet to dry dressing 4. Wound vac 5. Wound care (clean with x and apply x cover with sterile dressing secure with cloth tape/ paper tape per POC) 6. IV infusion via PICC line 7. PICC flush 8. PICC line dressing change 9. Ostomy, Urostomy, Nephrostomy care 10. Insulin Admin 11. INR checks 12. BP checks 13. medication mgmt./education You will develop the critical thinking that will make you stronger. Good Luck

So I spent most of last week notifying the agency I need a few days off. As I expected it fell on deaf ears, I was told that all of their nurses work 7 days wk, I informed them that I wanted at least 2 days off, they said that no nurses is going to work 2 days, well all of the back and forth I finally threw out my neck(some of my pts homes are not conducive for good body mechanics). I had enough, told them friday I need a couple of days off or I will take a month off. Come monday fridays conversation was forgotten. Anyway monday's conversation didnt go well either, the admin got vicious she threatened me with patient abandonment and slammed the phone on me (twice), I reminded her that I am perdiem, it seemed to go in one ear and out the other, long story short I notified the agency that I will not be available this week, but worked weekend and monday to show good faith and give them time to find coverage. Anyway after this event I may not come back to this agency. Its tuesday now and I am still getting calls to do ROC and follow up with patient!!! Im done!

Unfortunately I cannot PM as I do not have sufficient postings, I am certainly looking to make a change for the better. My email is [email protected]

Yes I know its absurd, I just made 6 months experience ( i know most agencies want 1 year), I am now looking for a new home care provider to work for.

Yes I know, I'm not at all happy with this situation. As you know im in the process of making my footprint, and then I can have better leverage, but I am acutely aware that I'm being screwed.

Wound vac usually 1hr, sometime more for multiple wound vac. SOC 2.5 hrs

Do you ever have to buy supplies for your patient in order to provide them their care ?Because the DME didnt send enough supplies or the right supplies? .

State : Miami, FL 2. SOC-$40, Recerts $35, SN $14 (wound vacs) 3. Perdiem, no benefits, no mileage reimbursement, nada 4. Perks- Software for SN notes

Thank you ,I'd like to PM you but I am unable to d/t not enough posts. Could you please email me? My addy is [email protected]

I can share from my perspective, I work perdiem but I have had a handful of patients re-admittef to the hospital and upon discharge would specifically ask for me to resume their home care.

Organizationally it sounds like a great opportunity. Im working per diem, M-W-F (5-6 pts, mostly wound vacs), T-TH (2 QD, recerts/soc/dcs) Sa, Sun 2 pts , documetation catch up. Your pay rate looks great, I get half what you mention for SOC. and I dont get paid mileage. As far as bad area, I have to go into a few often. I usually try to go between 9-3, word on the street is "dont be around here after 4pm". I usually do an assessment of the area, if it look ok I park, if I see people hanging around, I greet everyone loudly and say "Im here to see so/so , he/she needs a nurse visit. 9 times out of 10, someone will acknowledge you and tell everyone your here to see so/so. This helps me develop trust and that Im there to help , not make life difficult. Also use assertive body language, get out of my car quick, leave quick. This is just my experience. After a few visits people will recognize you. But never let your guard down, in one bad area, I became a bit comfortable doing some documentation, and a guy out of no where lunged into my driver window and asked me what did I have, told him I was nurse and needed to a sick patient, he asked me if I had anything good in my car, I pulled out my bp cuff , needless to say he wasnt interested. Moral to my story, I zip in and zip out, and find a starbuck or dunkin donut to do any notes.