chitchatkat

I never have had 10 or 20 patients! That is insanity. I have a hard time with 7. I hope things are getting better. The LTACH I work at would never give nurses that many patients. How are things going?

I have been offered $100.00 to complete a SOC visit. 2 years ago with another agency it was $75.00.

I work at an LTACH and have been a slow med passer since I started. I try different ways to set up my day and sometimes I can get the meds passed quickly but it is hard to do. I do my assessment during AM med pass. Then I will do the cares like drsg changes, wound cares, ostomy cares, trach cares after meds are passed. It is very easy for me to 'get stuck" in a pt. room longer than I would like to. Also having to grab PRN meds can become so time consuming. It is challenging to be a nurse in any type of care setting. At my current position, I just can't leave a pt. Who is uncomfortable. For example, recieving tfing and is not at a 30°HOB angle or a pt w a trach whose mask is dirty or may needs suctioning. Even oral cares can really slow me down sometimes. Other nurses suggest I delegate but I know the CNAs are busy so a lot of times I try to lead by example and pray the CNAs will recognize my effort to give great pt. Care. Fortunately, I am still employed there despite my lack of speed. I thk it all depends on what type of nurse you are. You will get faster as you become more comfortable. Try to not beat yourself up as this does nothing but block your ability to provide best pt. Care. Keep a positive attitude. Ensure you are eating well and stay hydrated throughout your shift. Nothing throws off a day like having an episode of hypoglycemia. Also, arrive a lil early if you can to make sure the day is semi planned well. Try writing out a simple template. I usually will make my own and put down what needs to be done then chk it off or cross it out when is done. Keep it simple and to the point w info r/t diet, med times, BS, I&O. I keep an extra highlighter on me to color code my sheet for extra info such as supplies, ?s, family, and new info to update MD and RNs. .

I hate ageism. I hope this changes w time. I am so afraid to apply for positions bcs I have not been in hospital nursing in for10 yrs per my resume.There are no refresher courses near me. I couldn't afford one & I am a unique person. I have difficulty expressing self and projecting confidence at all times. 3 yrs ago took a position at a LTAC hospital. Was let go bcs I was late for 4th time in 6 or 7 wk period. 3 times were during 1st wk of orientation and my difficulty with traffic, parking, and myself. 4th time was not late. Was early(scheduled to started at 8 instead of 7). But it was obvious I was on my way out. I did good work and pts liked me. I felt so hurt and angry at myself. I had been open to having a newer nurse precept me along w a few others. This was how I showed flexibility and also offered to help whenever I could. I didn't take breaks. But was cast out. I tried to be professional at all times. During down times, I,would review pt charts to become familiar w charting and where info was located or practiced w IT software. Kept quiet and only spoke when I was asked a question or had a question. The nurses said I was too nervous or seemed too tired. I believe this was true and agreed when they stated this. I was adjusting to full time 12 hour shifts after being a stay at home momma for a few yrs w/ an on call if RN position. I was staying late and was flexible w my schedule. So, how does one make a consistent good impression when nurses just don't want to like you? I could go I to more detail but it is embarrassing. I just want to be a nurse w active skills! I have precepted nursez before and always encouraged them. I feel to precept is an incredible role and stated my gratitude to each RN who helped me.Has the culture btwn RN s changed terribly in last decade? I feel like applying to another hospital similar bcs I want an in and need the money. I am,so God now so I don't have support income and drive an old car. My current role is good but need to make more money and want to gain,additional exp. Maybe this should have been a separate topic. Any replies would be appreciated.

Congratulations on getting where you are right now. Life is short. If you can allow nursing school to consume your life-do it! I have been out of school for 14 years, but what is odd is how much I rmbr from school. So often theoretical information or certain topics pop in my head. My best advice is to let nursing be your art. You are a student of a an amazing science working to not just save a life but to improve many lives. So, take your knowledge and share w others. Teach others. I used to pretend to teach the pathophysiology to my fake audience. Also listening to recorded classes is so helpful. I needed to do note cards(reluctantly) bcs they were effective for my learning style. I was a gr8 reader but my mind would travel. I have actually referred and read to my books post college graduation. Keep In contact with your professors. Ask them some stupid question that you have. This is because you may need their Reference someday in the future. They will remember you(linkedIn Connection)- and Nurse educators are happy to share info reregarding how much time to to studying specific topics. Pm me if you want to have an audience to teach some of your study material. I am running behind but have more suggestions. Keep Up the Good work!

Thank you! I am so enviois of your critical care. Good job. This work I do is important but not as excitjng as your type. I tried to explain btr in a new post. Thanks for commenting!!!

So I have been a contract/1099 RN for a personal care, non medical home care agency. My title is RN supervisor. Basically equates to what a DON would be for Home Health. The care we provide is to help w people who have difficulty w ADLs. My concern is the state legistlature doesnt give precise info as to my role. Can other nurses working in this feild help me by tellng me how their experience is in this special feild? I only get paid per visit. I want to be in the office more and do more of the training but the owner is not respectful or knowledgable of a RNs role. It leaves me xurious if my license could be used illegally. I love the cts but have no benefits and pay is less than adequate. I habe been searching other jobs, but because there is no skilled nursing care and I'm just doing assessments and some leadership roles such as training, I don't know what to go into next. I just hope that someone out there can provide insight. Thanks for reading. Have a great day fellow nurses!!

I am in the process of getting accepted into Bradley university as well. I am just so nervous about whether or not I can do well. I also wonder if the recruiters who call you get paid if they sign you up for classes. Hopong to start in the Fall!

I am still working in personal care services. Really I'm surprised no nurses have commented on my post. There are tons of agencies especially in Wisconsin and I would like to start a group of RN supervisors to discuss our Rule and details about our job in order to get some evidence based practice going and just the groundwork of how to B able to utilize the nursing process to the best of the ability for the clients served. These services are going to cut costs tremendously. I believe that many people are going to continue to need benefit and utilize personal care. Please share your experiences and information. Thanks nurses!

I believe Bradley University is starting a DNA online program! Way to go work getting yourself up to participate w the Education! I plan to start Bradley University in the fall, but I feel bad doing an online Masters program and wonder if I should do the PHD like you. Either way good luck and God bless you!

I often wonder how many places actually check refrences. It can be so frustrating to have to list so micj infoation for a job. I feel like it takes forever to complete an application and I end up not always completing the application for some places because I tell myself its not going to work out for one way or another. I have had some short term employme.t, have been fired from some jobs just because I didnt fit in w the staff. It is frustrating. Now, I want to get back into a hospital but am so scared they won't hire me because I habe done home care and clinic work. Also had a child and took on giardianship of my mother which was a daunting task to say the least. When you give your references out, how far back you go with the people that you put down for references. I know many advice website state to make sure to contact the reference before hand but I usually don't. And I never have had anyone contacted recently at least... But I don't apply to a lot of positons so thats on me...

Hi Nurses, I am working for 2 Personal care agencies, one does home health as well, but I just do the pcw side. I take vitals signs at the intial visit and super isory visit for one, the other says we are not to do that due to the ct being non medical. How does your agency work? I also have nurses notes for one agency and not the other. Any thoughts??? An RN is required to do the screening for ADL assistance at the home and f/u every 50-60 days there after for supervisory visits. Can any nurses working within this role share their responsibilities?

Contact your states nursing association, ask for help. You may really want this job, but there are other jobs out there. Ask yourself? Am I able to provide safe care for my patient? And ask yourself if you are safe or have been provided the tools to stay safe physically, legally, emotionally...? Don't be shy w agency, demand orientation. Of they balk, show proof. The last thinv they want is to have their license questioned by the division of quality assurance. I was too timid in my last position and I regret it now... I was not meeting my patients needs. I can disrespect myself but will not disrespect my patients care. Just a thought. I still don't know a lot about home health care. Much respect and admiration to all home health nurses. You rock.

, a DON needs to be at the office at all times. I work in Wisconsin and it is imperative for the nurse to be in the office especially if state wereturn to do a visit.A DON has multiple responsibilities and I would be cautious. I was in quite a strestful situation before and after consulting w nurses here and contacting the Wisconsin Nurses Association, I learned just how much I was risking my license. E

I am in the process pf applying at a hospice company the DON referred me to. My resume is being reviewed by a pain mgmt clinic.Also, I have my resume posted on careerbuilder and it has generated daily inquiries from different agencies. State did come to the agency. It was on Monday and I was there to train a new Personal Care worker. They were brief and took copies of our 2 skillled nursing charts. "A" was telling them we had 3 other cts on the verge of admission. It is a joke and right now the consultant the administrator hired has stated that she is going to try to use a cultural language barrier problem to work at getting us out of the problem w state. The admin. Lied to all of us by stating he was going to wait to send in the paperwork.issue not being as the reason for us to be able to get a temporary license. Yesterday I was asked to be the assistant administrator. I'm not going to do this because I know that he lies and I am not ready for that amtvof responsibility.The admin asked me to change my resume to state I worked in homecare for a yr. in the past. The former DON has become a friend and I trust her more than I trust "A". I feel bad for him because he's worked very hard attempting to make this agency work but I do realize he doesn't want to follow the laws and legalities also I catch him in lies constantly. Maybe there is some language barrier/cultural comcern that state didnt try to ensure they understood him. His native language is Arabic. Either way I know he lies and I have wasted time has wasted time trying to get him to understand my concerns w state. On Friday, we should hear back from state. I think they will give us ten days to chang.but realistically it can't get fixed. Will update. Can anyone tell me what or why he would ask me to be assistant administrator and what the difference is between that role and the role of the DON? Kust curious and eager to learn whatever I cma from this experience. In response to the nurse w the documentation , "DON'T YOU CHECk b4 entering POST", Thank you for your concern and example regarding checking documentation. It is a great reminder for all. Thankfully, nurses dont chart from smartphones yet. I can only see 1 inch of the text I write & accidently erase mult. Sentences when editing w the format the android browser uses. When my PC is fixed, I will not write msgs via cell. I spent an extra 35 minutes to try to ensure there weren`t too many errors. I assuming you weigh 120 and the nurse entered an extra 0. Hopefully, IT/ software for documentation will not allow such unbelievable errors to be entered. I bet the nurse felt very dumb when you brought it to her attn. With the way you worded your post, I also felt dumb. I hope other nurses will write or post questions even if they make mistakes. I know that I debating writing something. The time it took to read what I typed was delayed by up to 30 seconds at times and w the app I notice that a msg I posted a few days ago was never to never was posted. Either way, this website is for all nurses to come together to ask for or recieve support, to learn, and to grow with every single nurse out there. I am so grateful for the responses I recieved r/t my concern. All of you made a difference in my confidence to make the right decison and helped ease my anxiety.

Thanks. You are right. The advice is exactly what I needed to hear.

Excuse all my darn typos. :writing:I thought getting the Note 3 phone would prevent me from making so many spelling grammatical errors w it's big screen, but I still am not writing as well as I should be. Guess phone size does not matter.

I do not have a copy of my role as ADON. My payment is just the amt I listed aboce. $35 sup visits and $75 comprehensive asssessments/ renewals. I found out today he considers $25 of that for mileage. It was through a agree birds that I would be paid $30 for office time. Granted this was wanted he just needed someone to fill in for him when he went out of town for a few days. I have no copys of this. I was very pleased to learn the mock surveyor is an RN who really seemed to undestand all of the issues I have. Although I work primarily just for Personal care service cts, the state is coming for skilled nursing only. I just spoke to the DON who has decided to give her 2wks. She said she just can't keep herself there because all the things the mock surveyor stated she had said to the owner in the past and he brushed her off.ex. keeping diabetic care cts past time of dc. Per "A" I am an employee. "A"( the owners nickname, just first initial. "A" is just very cheap. He just doesn't respect the nurses or PCWs. He says he is an honest man but in reality an honest person doesn't have to tell me they are honest. I am going to keep looking at what other opportunities are out there. If he is willing to pay me to train in skilled care and pay me for being the ADON along with allowing me to fulfill the role to the full extent then maybe I will cont. He spoke of pay structure. He may change it to 20 hrs a wk and have me come in the office for the time I not doing visits. I very curious to find out more info about the nurse who had lost her license and went to prison. Home health is much more complicated than many nurses think. Are there any ADON out there that could give me a list of what you do? What is a good hourly wage a visit nurse should be paid in home health? I think in the next wk, I will begin to see the bigger picutre. Again thank you to all who have given their advice. I am listening and wish I could just quit but need the money. I am looking into contacting legal assistance but am unsure whom to call. I plan to call dept of labor tomorrow

I will also make sure to speak to him regarding my concerns tomorrow and make a list with all the things that I feel I wrong. I just wish I had the confidence that I used to have but it was years ago. I may sound naive and dumb but I got multiple awards in the past and did great. Do any of you have experience entering the nursing field after time off? How long did it take to get back in the groove. I am 33 so it's not like my career is over, right??? I enjoy he care, I think it's a smart area to be in and is not too hard on your body. The paperwork and pay are the areas that confuse me the most. And by pay I mean how one should be paid for their time and what is the best way to make money. Not that it's all about the financial aspect. :)

Oh my goodness! I did not expect that type of responses I just feel so stupid right now for even staying at that job. What could i potentially tell the employer to do in order to fix the situation. I have been researching and researching nursing in home health, but it just doesn't seem correct what he is doing. . I think I will stay until I find another position. At least I now have recent nursing experience. I just don't know what I really want to do. Thank you so much for your insught/help!!!! I will be meeting w the mock survey person tmrw. Anyone interested in hearing what transpires? I am applying to new positions tonight!!! THANKS AGAIN. Please cont to share any info you know about situations similar to this. Thank you.

I have had no formal training at aHHA I have been working w for the last 4 months. I have been a nurse for the last 10 yrs, BSN. Did ER private duty, iv therapy. 4 yrs ago had a child and decided to take time off. Was extremely fearful no one would hire me but this agency did. I have been just plugging along and trying to research as much as possible. The RN I replaced was unabl e to stay to train me so the owner took me out on visits. Currently I am paid 35 for sup visits and 75 for comp. Assessment although recently he has stated he would like me to sign a W4. Anyways, is difficult to learn something when you don't know it. I am only staying there for some experience and then I will move forwatd. He has a temp license that exp in jan 2015 but is snedingin the forms for the state to come next wk!!! With Wi state whomever it is that will be visiting us. I am so scared. 2 wks Ago learned that I am the assistant director of nursing. I have been responsible for the comprehensive assessments for the PCW side of nursing but spend very little time in office except to enter cts ADL info into what I believe is the Long term care functional screen. And I also do the 60 day sup visits. the DON is the only other nurse. She does the skilled side of nursing care which I have been told I will be learning. The owner is always in the office but only pays an he here or there unless it's a mtg. I told him my concern.He says" do you know how you do your assessments do tou feell confident?" I said I dont know wjat I dont know.Asked if I could pls spend time in office reviewing P&Ps and to get inf. Control manual in order..can anyone tell me what I should do as far as how to negotiate w the owner and to find out more info ? I feel like he is trying to hide things from me in order to not pay me or does not value nurses. The DON is about to leave. She is nice enough to stay. But only works T&R. HE HAS TOLD ME TO READ THE WI FORWARD HEALTH WEB PAGE AND I will be fine. I am struggling enough just getting my time mngmt in order and figure out how to get around the city, chart according to standards. It is very part time but I am the Guardian for my mom who has a brain injury and always needs me to talk or has some new problem. Please share anything you feel is pertinent to this situation. I don't know many Home health nurses and feel like I should just know this.

Hi, I have an issue similar to this w my mother who loves in a group home w constant supervision. She had a TBA in 2007. She has gotten progressively worse w falls and not following the rules. She is a smoker and I contacted Wi guardianship society, spoke w a lawyer who stayed that no matter what health issues she could face from some of her behaviors, there is no legal way to make her do something she doesn't want to do. She will sneak cigarettes and light them in her rm. She has COPD and falls all the time so just preparing to smoke is difficult.Per the lawyers instrucrion, even w her being incompetent, I can't limit her cig amy per day or stop her from anything r/t to what she does to herself (earing, drinking). Hope I made some sense here.

Any one work as a pay per visit RN for PCW services? I am not paid for office time so it's difficult to get a good system of organization on achedule? Maybe I should have started a new post but I am in a hurry and thought I would just ask to see if any oof you are able to access ct info and what the agency should be sharing with you?