ketchasketch_RN

All joking aside, you have not been watching the riots. Everybody should train and carry. You are negligent if you don't.

What does this mean? The little toys? Handguns? Who talks about playing with them? The hospital people? LOL. And if you carry for self defense, do you carry the big toys?

We would not be comfortable with you carrying either... if you are not comfortable.

I conceal carry... am on security team at church... but have not brought it into my work as it is not permitted. I do, however, park my truck rather close in case of an emergency and have a plan worked out in my mind if every needed.

As a Christian RN, it is firmly my belief that God chooses us, not that we choose Him. With that in mind, my main focus is to ensure that all my patients... Christian or otherwise... leave this world as comfortable as possible... spiritually as well as physically. If they are meant to know about my faith, they will ask... if they are not, they will not ask and I will live my faith but not verbalize it to them. God will provide opportunities if He wants to.

I am a former Vocollect/AccuNurse clinical specialist. I was one who help train and set-up AccuNurse in facilities in Texas. After I was trained, we moved to Texas to take over accounts in Texas and then Vocollect was bought by a larger company and they layed off multiple new employees including me... despite all the money they invested in training me... caught me by surprise... worked for about a month after my training was complete and I loved the company and my fellow clinicians. I believe the model works well with people/clinicians that are inclined to take their job/career seriously. I don't think it works well with people/clinicians that are inherently lazy and lackluster. After I left AccuNurse I became DON for a rehabilitation facility in Texas that used AccuNurse and with my background and training was able to get documentation and useage up pretty well. Where we failed was in keeping track of the devices... nurses and CNA alike failed to take it as seriously as they should and people moving from one hall to another without returning their device to the hall they checked it out on made it very hard to track the devices... I left this company a few years back and it has probably gotten better since then. Overall it is a great company that should be the standard in the industry if they can get the clinicians to take it seriously.

I disagree with the ballyhoo toward the view and I also disagree with the post set forth here. Nursing is hard... deal with it. I have been in nursing for 20 years... ER, med surg, geriatrics, hospice, and now, home health. I have never been bullied and I always try to do the best I can to get ahead. I have faced my overtime and being tired at the end of the day. But I knew this coming in. In fact, I expect it. Otherwise it would not be nursing. The reason we, as nurses, get so much praise from others is because our job is so hard and we do wonderful things... for the most part. I love my career! And I am not disillusioned!

I have been doing home health for 10 years... in Denver and now in a rural part of Colorado... I have rarely had a day where not everything was finished by 6 PM unless I had multiple SOC that day... but routine visits, no matter how complicated, should and are documented and finished before going to the next home. 1. That you had so much charting and stuff to do in the morning and did not get to go see patients until 12 PM indicates that you managed previous day poorly. Just an observation, not judging. 2. I would have finished charting on first patient before going off to next patient... an extra 10 minutes to chart would have saved you guessing when you got home. 3. It is legal and OK to obtain verbal consents and then perform SOC and have paperwork signed later. That would have saved you time. 4. Next patient should have been charted on prior to going to next patient... I don't know how long it takes to chart for your company, but I have not worked for a company where a routine visit took more than 10 minutes... if you do your documentation while you are observing, assessing, etc... the myth that patients do not like this is false... rarely have I had a patient complain that RN was not paying attention to me while visiting... he was too busy typing on computer... if you do it correctly, you can make it a fun and acceptable visit. 5. SOC at 21:45 are rare and we don't usually do them... the office makes sure that the discharge planner is aware that we are 9-5 organization but are on-call for emergencies and PRN visits if needed, and will do the rare after hours visits as long as somebody is teachable in the home so that it is not a routine after hours visit... but I have seen this maybe 3 x in my 10 year career. I pray you find your niche, but it seems like this may not be it... home health requires great organizational skills, good computer skills (or paper if your company is still behind), and a knowledge on how to document while talking while making everything make sense in 10 minutes or less.

Been doing home health, pay per visit, 7-9 visits per day, and I have never had a day like that... interesting.

We use the term in home health. Full Cor or Full Code. I have always used Full Cor vs DNR when assigning this.

This is why I chose home health as my career path in nursing. With the new pay per visit system in place and point of care computer systems, I get out of the home at 10:00 AM each day and back home between 15:00 - 16:00 most days. Seeing 6-7 patients / day if you map your area and route well, you can make 80 - 100 K per year... and with an associates degree, this is great. I also don't have to see my supervisors but 1 x week for case conferences and have a career that changes each day with each different home I visit... challenging and rewarding.... yes!!!!

I think passive aggressiveness is always the best... assign only black clinicians to this patient and have them all explain that they are not black, but may have ancestors who may have had some black in them... but that they identify as white. Of course I am kidding. I say that we should not honor those requests and let the patient know that we don't assign based on color, religion, or sex. Or of course, that all of our white nurses have requested not to be assigned to this particular patient. Again, kidding.

cathrn64... I have heard this and have seen only a couple of agencies follow this... the vast majority of agencies I have worked for... mostly as a Director or Administrator have followed the rule that if it is going on the new 485, the evals have to be done prior to their 1st visit in the new cert period. The logic behind it is that the OASIS recert has to reflect the number of therapy visits on it and all disciplines should eval prior to the cert period to determine in that 5-day window whether or not they are going to continue. The visit should be an eval, or a discharge. I cannot see how this can be accomplished and put on the 485 if they wait till the new episode already starts. Please help me see this better.

Is there a rule (I can't find it) that indicates that all disciplines need to perform their evaluations as well as the comprehensive assessment in the 5-day window prior to recertification? I know the recertification comprehensive assessment must be completed at that time, but what about other disciplines planning on staying on the case?