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.

I know Im not the only nurse as they hired 3 new recently licensed graduates, 1 that lasted a week, another is an LPN who has here plate full and another RN who is very new but not a lot of hands on.

The terms of the agreement simply state that I am a per diem employee and a 1099.And noted to be available for work on short notice, as well as agency guidelines for conduct and professionalism. What may have started all this is that I accepted my first patient outside of my designated area as the agency informed it was would be in my best interest to take the first patient to come my way as this would help me establish myself with the agency which is what I did. I could use a few days off with my family now to neutralize the bad attitude I feel coming on.

I am not too concerned about getting fired, as this agency wont call back the nurse. I want to establish a good resume and perhaps even get a letter of recommendation, as I have reached out to other HH agencies with good reputations who have informed me that they want at least 1 yr exp, and 2 letters of recommendation. As far as the guilt trip it is usually something to the effect that the agency just started receving referrals from large HH agency X and they( subcontractor) have already agreed to accept the patient and it would look bad if I didn't open the case/ follow up whatever and large HH provider wont send referrals their way. Or the patient is unhappy with their nurse and you are very professional with your care and teaching, communicating pls follow up. And yes as an RN BSN Im making far less than a FTE.

I am in Florida.

I appreciate everyones comments. I approached managemnt about reducing my days and the response was that there are no other nurses available. I have a hard time believing that but as i mentioned on a previous post this is a first job in a long time, I had gone to medical sales for a few years and left, and my nursing experience was obsolete. Needless to say I am starting over, I sent resumes all over and the only response I got was from a craigslist ad. I was elated, well Im doing SOC, ROC, recerts, d/c, high tech wound care, IV, etc. The pay is terrible, and no mileage reimbursement,no benefits I am going into high crime areas to do pt care. I feel stuck Im only at 4.5 months, Im not sure I'll make it to a year , Im really trying. Also as far as the agency, I dont even know the DON, I only communicate with an administrator who is non medical, I have never even had a case conference meeting, and the nurses never communicate with each other.

This is correct. I am trying to acquire enough experience and apply to a different home health provider.I feel obligated to take on whatever is assigned to me as the agency claims there are no other RN to open cases or do high tech visits.Since I pay my own liability insurance I want to be mindful of not jeopardizing patient care and my license. I'm just leary of looking at other opportunities since it took do long to find a job..

I am paid by the visit , I have patients with QD visits. I'm also 1099 perdiem

Hi everyone, I am curious, is it normal to work 7 days a week in home health. This is my first nursing job as a HH RN and Im going on 5 month with a HH agency. I am grateful have an opportunity to get a nursing job as it has taken me years to find a position! But the only thing I am concerned is I never have any time off for me and my family. Is this normal in HH?

Hi everyone, Im an RN, Ive been with a home health agency for about 5 months now. This is my first patient care job after applying for positions (all kinds) for years! I am enjoying the the learning process and enjoy most of my patients. There's one component that surprises me. Im working 7 days a week since I started. Don't get me wrong, I am grateful to have a chance at practicing nursing but, I cant seem to have a life with my family, my agency keeps giving more patients and opening SOC, ROC and recert and SN. Whenever I ask where are the other nurses, they say they are short staffed. Also no mileage paid for visits, Is this the norm in HH. Thank you