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tinybbynurse

tinybbynurse

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tinybbynurse's Latest Activity

  1. tinybbynurse

    What do you love/hate about home health nursing?

    I just started in HH about a month or so ago. I’m currently the DON but until another RN is hired I’m doing field nursing 2x week. pros: flexibity - you can run an errand in the middle of the day, meet a friend for lunch, run home if you’re in the area - things like that. Hours - it’s nice working dayshift. I used to do nights mostly. I work between 9-5 so that’s nice as opposed to all nighters. patients - I enjoy being able to go in and not just educate or change wound dressings but actually visit and make these people feel good. They appreciate it soooo much. I work with Medicare ppl only so it’s alot of lonely old folks who love the company. Sometimes I feel like I get paid to just visit with them. Low stress cases - the actual stress level of your patient acuity is so low. Nothing like the hospital, or even an urgent care. So chill and relaxed. make a difference - it’s nice when a patients wound gets better from your interventions or their dependent edema greatly decreases because they’re actually listening to you when you educate about elevating and wearing compression stockings. It’s nice to see positive changes over time that you helped to implement. CONS not as many as pros, but big deals nonetheless. Pay - I was getting paid per visit plus hourly for the actual amount of time I was with the patient. Now I’m salary because I’m DON but still seeing patients. Technically I’m compensated but I’m not specifically paid for the exact mileage I expend nor the time it takes me to chart. schedule getting thrown off - as someone said, your day could be going smooth and then patients need to reschedule and it honestly effs up my whole day. I try to see them in order of distance so I’m not all over the place, and sometimes, like today, where I should’ve been done and charting right now, I’m waiting around taking an extra long lunch until my last 2 patients are ready for me. It’s frustrating when you have to back track and waste gas. My pay might compensate, but I have bills to pay and other stuff I’d like to spend it on, I don’t want all my pay going to gas to go to work. charting - I may finish up at 5 and sometimes before, but then I’m charting at home. And I don’t get paid for the hours it takes to chart. I like finishing up early or mid afternoon because I have time to chart and be done by 5. But on that same note, if you want a full patient schedule, you very well may not even finish seeing patients til 5 or later and then you have to chart on top. And recerts + admits take forever. Even regular visit charting takes me 20-30 min per pt. So you take an average of 6 pts and that’s roughly 3 hours of charting tacked on to my day. no benefits - I don’t have benefits. I don’t like that at all. i looooove the patient aspect for the most part. Not sure I’ll do home health forever though.
  2. tinybbynurse

    General home health questions

    Being new to this area I have a few general questions for those of you who deal with Medicare patients / OASIS charting. The old DON and other RN left recently and it’s a small company - and my supervisor isn’t an RN and has some answers but not all. 1. Say a patient doesn’t need skilled nursing services anymore, but could benefit from continued physical therapy, at time of recertification, can I discharge the patient from skilled nursing but recertify her for physical therapy only? Or would it not require a discharge at all, but simply a recert only including PT visits? 2. Are you allowed to discharge a patient BEFORE the end of their next recertification period? (I’m pretty sure I heard yes...) Thanks!!
  3. tinybbynurse

    Should I recertify this patient?

    Fairly new to home health. Wondering if I should recertify this patient - as far as I know, there are no specific guidelines in place, it’s based on clinical judgement. However, I was told sometime next year Medicare will have a specific guide to go by, which I’m ok with. my patient was admitted to HH with a primary dx related to gait abnormality. Another major issue was frequent running of her eyes from both macular degeneration and corneal dystrophy. While her right eye causes some blurred vision still, they rarely run or cause her anywhere near the major discomfort her eyes used too. Gait wise - she’s been working with PT, and feels she is getting stronger. I do think she could still benefit from further PT visits. Eye wise - I think she’s been taught all she needs regarding that. She also has a dx of HTN, and that’s my main concern with her right now. It’s been high the past few visits - systolic 150-160, diastolic up to low 90’s. So it would make sense to recert her, right? This would be her FIRST recert, so it’s not like we’ve done all we can do quite yet. thank you for your help!! I’m hoping to continue to gain perspective on when I should discharge or recertify patients so it’ll get easier with time!
  4. tinybbynurse

    Fishy, illegitimate contract..?

    I just started working at a HH agency and actually really love it. The only thing I found to be really weird is this week the administrator, who was out most of last week when I started so just had me fill out new hire paperwork this week - had me hand write on a paper the words to a (clearly) made up “contract” basically stating I won’t slander the agency name, speak against them on social media etc, which I was fine with, I remain professional in that regard. The part I DIDN’T like was the part about committing to the company for 2 years or I will be “fined” $10,000-100,000 for leaving early. Oh, and I’m to give a 1 month notice if I leave, or can be “fined”. I clearly remember signing actual legit paperwork stating that this is an at will employer. Not to mention the “90 day” probationary period. The “contract” also included rqnsom weird bits like swearing not to tell ANYONE, including the “law” about the “secrets” of the company. There was other weird stuff in there too. He literally has me hand write what he was reciting. No legit document. I don’t plan on leaving this company any time soon, however, I don’t like the idea of being fined an insane amount if I chose to leave before 2 years. I honestly don’t think this thing he had me write up (which I basically scribbled and was hardly legible Bc he was freaking reciting parapgraphs to me) would hold up in court or actually be legit. But it’s really fishy that he would even try to push it. also, this company is owned by a former non US citizen, and there are definitely cultural/slight language barriers. I just wonder if he realizes that here in America, we don’t just make up hand written documents without lawyers consulted and specific wording and clauses typed up to make it legit. Half the stuff he was reciting wasn’t even proper English. He’s a nice guy, just seems fishy. what do y’all think? ever heard of this? Did I sign my life away for 2 years or do you think it’s truly a non-binding contract that has no actual legal value?
  5. tinybbynurse

    feeling reprimanded unfairly

    Thank you, I’ll look into that. I wasn’t even aware I could get my name removed from nursys - assuming that’s where the bg check pulls my past license info from. Considering I didn’t commit a felony or anything like that, I don’t think it’d show up otherwise if it wasn’t for nursys.
  6. tinybbynurse

    feeling reprimanded unfairly

    Well the hospital FINALLY informs me of the decision *not* to hire me. Had to wait a few weeks just for them to tell me. Honestly pissed. Have offers from a crazy nursing home 1.5-2 hours away and home health where I’ll also be commuting up to 2 hours away. I really didn’t get a good feeling about either place, and home health is the position I was in when my previous license got dinged all those years ago, so I’m obviously very skeptical. I have an offer from a non medical establishment, a spa desk associate, I love the staff but obviously my pay will be 1/3 what I’d make as a nurse. I have an interview with a medical records dpt soon too. feel like I’m stuck between a rock and a hard place. Take a nursing job I feel terrible about that is a few hours commute and give a notice once something better pops up or take a non nursing job til a good RN job pops up? Don’t want to be too picky since I’ve been out of nursing work since I moved, but also have learned over the years to trust your gut about certain places and to put my well being first. super devastated because I don’t feel this is fair treatment, and I have always had a dream of doing an operation smile mission, and now I don’t know how I will if I can’t get back into the NICU.
  7. above is the link to my situation. I have an interview soon and I’m wondering: do I voluntarily bring up my past reprimand by the BON on my previous license? Obviously I wouldn’t lie if directly asked. And I of course don’t want to say a word more than what is required of me and use discretion and privacy to my advantage. My current license in this state is clear. My affected licenses (the reprimand transferred from one state to the other, so both “reprimanded” me over one incident). Neither of my licenses were ever restricted or prevented me from working at any point in time. But as you’ll read in my linked post, I was hired at a facility then last minute due to background check results (that SHOULDVE been processed and relayed to me weeks earlier) my start date was delayed due to the license discipline hx. I’m still waiting to hear what the results from that are and if I still have the job or not but obviously I’m still applying elsewhere and don’t want the same thing to happen at a new facility when they do a bg check if I’m hired - but I’m not sure how to bring it up without being scratched out as a potential hire. yet I hear of people with far worse discipline hx still getting jobs. Advice regarding discussing or not discussing this kind of thing in interviews is appreciated!!
  8. tinybbynurse

    feeling reprimanded unfairly

    I have an interview today with another facility. I’m wondering, should I just explain my situation in the interview? Is there any “good” way to do this?
  9. tinybbynurse

    feeling reprimanded unfairly

    thanks everybody for your replies. I’m definitely exploring other opportunities elsewhere. I know that no matter what happens, I deserve this job, but if they don’t let me keep it, then they don’t deserve me. If if you were to explore a past post of mine, you’d discover that I actually interviewed for this job at a job fair In FEBRUARY, the unit liked me and wanted to extend me an offer, but somehow it slipped thru HR’s inbox and I never got a call. I was persistent and applied for another opening on the unit, got a call from HR, set up an interview which I thought was weird since I already interviewed - and I literally walked onto the unit and mgmt was like “oh it’s you! Yeah we loved you and wanted to offer you the job!” Since id already previously interviewed 2 months ago, i just went home and waited for my offer. The following Monday still nothing - emailed the receuiter - said it was coming and shed contact me within 24 hrs. Nothing. Finally around 2 weeks later I get offered the job. now this. I’ve been toyed with so much - maybe all would be fine and dandy once I were to be on the unit working, but the path to get there has been hell, miscommunication, and disrespectful. If it wasn’t for ME reaching out to different people this whole dang process, I’d never have gotten my actual offer let alone found out what my rights are in submitting “additional info” regarding my situation were. They’d make a decision without even regarding my input. They should tell you these things. ugh. Anyway, here’s to hoping one job or another works out for me super soon...
  10. tinybbynurse

    feeling reprimanded unfairly

    It’s funny, my parents, obviously concerned for me and my ordeal, urged me to go talk in person thinking it’d cure all. Well meaning as they are and as important as face time is, I agree about email. Sure, I could state my case in person but they weren’t going to suddenly change their minds - written back up is ultimately needed. So I have the important info ultimately sent in form of email. Update: Local HR never returned my call. NM finally returned an email (after several + a couple voicemails unreturned) when I mass cced my explanation/extra info regarding the marks on my past licenses. I’m not even sure she read it to be honest. Just said I’d be contacted if adverse action is taken + good luck in my future endeavors and to contact HR HQ for any questions (did you read my email? I already did contact them hence this email I’m sending with my explanation/extra info to be considered...) Eh. Doesn’t sound good. Haven’t got the “you’re no longer hired” email just yet, so we’ll see and I’m praying for what’s right. But I definitely feel like I’m being judged and like the decision to not hire me has already been made... before the explanation email I sent (and was advised to send by HR HQ) has even been considered which is not fair, and so different from “regular court” where you’re innocent until proven guilty and all sides are heard. I really hope I’m wrong though!
  11. tinybbynurse

    feeling reprimanded unfairly

    I appreciate your sentamint so very much. I agree that nursing and medicine are definitely corrupt. I really am not a negative person! I’ve been so happy and excited about getting into this position. I think nursing is great. But I don’t think it’s so great to be disrespected or not allowed a real chance to state your case. Everywhere is supposed to be an “equal opportunity employer” but I’m not so sure. i finally got in touch with a HELPFUL person from HR HEADQUARTERS. local HR still didn’t return my call. Hm. They actually let me know my options. Multiple parties are the final decision makers on whether this affects my employment or not. I’m allowed to submit extra info / explanation helpful in determining the outcome. So I did. And cced everyone potentially involved. It shouldn’t be a matter of “talking to a friendly helpful person in HR” to find out your rights and options.... I’ve also found that to be the case when corresponding with the BON. If you get the wrong person on the other line, you risk not getting accurate info that is in your favor that affects your career. It shouldn’t be a matter of calling at the right time to get the right person on the line (after being on hold for minutes on end) who actually does their job, ya know? And honestly once I got a fresh new license in this state, which took me months to get because the BON had to approve it Bc of my discipline hx.... you’d think that’d be enough for an employer. If the BON did the dirty work of scoping me out and approves the issuing of my license, shouldn’t it be a breeze from there to hire me? I truly want to at some point advocate in some way for nurses who undergo unfair scrutiny.
  12. tinybbynurse

    feeling reprimanded unfairly

    Update: believe me I’d rather not just walk in but I just called HR almost an hour ago, and someone specific is supposed to call me back but she was with someone, so the person I spoke to left a note/msg for her. I am literally sitting in my car nauseous to my stomach waiting for a call back wondering if I should drive there. Legally they do owe me a written explanation for why they don’t hire me if they choose not to. Also, I signed the release for the background check as soon as I received the email, which stated it is complete within 7-10 business days. If that’s true, The background check was complete 2 weeks BEFORE I was told last minute that my start date was delayed, leaving me scrambling to resolve things so I could start orientation the following Monday (which here I sit on that Monday. Not at orientation ..seems fishy. ) if this is a bit of a rant I apologize but I do NOT deserve to be denied a job over this. It is NOT right to make a nurse feel like a criminal from a simple minor NON criminal mistake, if you’d even call it that, early in her career. It’s demoralizing and disruptive to her life and I want to advocate for laws being changed to expunge stuff like that from nurses’ records in ALL states.
  13. tinybbynurse

    feeling reprimanded unfairly

    I’ll look into that, thanks! does anyone have a word on showing up to HR and asking questions? Since I haven’t got a clear answer via email and no one will return my calls. Should I just show up and ask to speak to someone? Not rudely of course, but to get some clarification.
  14. tinybbynurse

    feeling reprimanded unfairly

    Thanks. I agree with everything you said. I do think the boards of nursing need to be rethought / rearranged, but that’s a whole other post. I wouldn’t be surprised if the NM gets around to returning my calls or e-mail, and I may very well send another email this weekend explaining the situation. Maybe I’ll still be able to start later, but it’s pretty screwed up that no one could answer their phone this week to resolve it now, so I could start orientation on this Monday instead of having to wait another month for a hospital orientation start date. we’ll see what happens.
  15. tinybbynurse

    feeling reprimanded unfairly

    While I was previously awaiting licensure, I had communicated to the NM and HR the reason why ... (that I was waiting for my case to be sent to the board to approve my licensure) . There’s been a turnover of NM, so maybe the new one wasn’t aware like the last? But HR was, the same person I corresponded with previously is the one I’ve corresponded with this go around of hiring - and they are the ones who ultimately deal with the politics and rules and regulations of hiring. Ive heard of people with DUIs on their record getting jobs... those with past narcotic stealing getting jobs... so I’m wondering if it could just be this hospital’s system as opposed to another’s, but I don’t know.
  16. tinybbynurse

    feeling reprimanded unfairly

    I don’t need fair, I just need just. I try to remain positive about the nursing profession but I keep seeing all the things that are wrong with it at times like these...
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