grateful_RN

I like axxess, very easy to use!

Happens to all of us! Only practice and different experiences will help you feel more confident with f/c insertion. Once I went to a visit for a foley change on a patient I was not familiar with...I have everything prepared, removed the old foley, cleased area and was ready to reinsert the new one and the family member says "She has a different anatomy, the previous nurse described it as 'you go down main street and make a right turn on 10th st'...needless to say I was like WHAT? to myself. I had to attempt it twice to get it in! So just keep at it and perhaps ask if you can go with another nurse who is putting one in? Just for more exposure. Good Luck!

We would use kitty litter or coffee grounds to dispose of liquid Morphine or Ativan. If in pill form, I crush the pill and include in the coffee grounds which are disposed of in the trash in double bag. Document disposal with two signatures (one from RN and one from family member or facility staff) and place in chart.

I have encountered this in the last few months. We have been receiving emails from the person in our office who handles DME requests with the updated medicare required documentation needed to process the order: nursing notes, inpatient stay notes, md notes, authorization and specific wording to justify need. Now that DME suppliers have to win the bid for each type of equiptment, there are less suppliers and for my patients in rural or suburban areas, delivery of item can be very delayed (like only delivering to that area once a month!!) One time a patient was trying to get a new motorized scooter as hers broke and was actually a safety and fall hazard as an arm rest broke off and the foam was falling apart. It took over a year for it to be approved and by that time the patient was discharged from the agency. It's very frustrating. The one item that they no longer cover at all, shower chairs/transfer benches, is the one that really gets me. How is the patient supposed to bathe safely in a shower/tub without a shower chair, especially if with chf, sob, copd or lower limb surgery? I understand a patient doesn't HAVE to take a shower, but why make them have to sink bath or bed bath if they have a perfectly working shower?!?!? I feel a shower has therapeutic qualities for my patients and makes them feel better.

That happens, especially when you think your whole day is planned perfectly. Maybe try to adjust the patients where you would only have to change the visit time for one patient and maybe just adjust things by 30min. Most patients are flexible when they can be seen since they are 'homebound' unless their caregiver or DPOA needs to be present and they have a limited time to meet. We like to give an hour window of when we will be there to give us time in case things come up.

We do manual BP readings, really doesn't take that much more time to do.

Yes it is common to not pay until the notes are in on your part, if the office needs to adjust or QA at least your notes are in. Also, my agency shows malpractice insurance as 'optional'.

I think it all depends on where you live. Try looking up online what home health agencies are in your are. It's best to have a office by in case you need to go in and do work or speak to the office.

I did the ON Demand review. The diagnostic test is just that, a test to see what question topics you are struggling on. Then when you do qbank later you can be sure to focus on those types of questions in which you will be able to review the rationale. Good Luck!

Awesome congrats RN!

I did not do the PVT, I did not want to chance the $200 if I didn't pass...also I didn't really have an extra $200 to spare. My license was posted 48hrs later.

Congratulations!! I read this after I took my NCLEX on May 6, only the first time, but I thought for sure I failed. I said a prayer and kept my head up, found out I passed w/ 230?s.