VegGal

So sad. They trusted her and she betrayed them, stole their home and even had him taken off life support. Makes me wonder how many other people she's harmed? The really sad part is that the couple had children of their own who were living out of state. It's so important for adult children to know what's going on in their parents' lives.

Thank you everyone. I appreciate all the responses. ?

Hello. I'm an BSN, RN who's been away from nursing for about a year. I'm unsure of what type of nursing jobs I should apply for. I want to avoid IVs and catheters, etc. (I'm fine with med administration without IVs and caths). My main question is if I go into mental health nursing at a small hospital that only takes mental health clients, it possible to avoid IVs and Foley catheter insertions, etc? Am I looking for a job that doesn't exist? PS. I'm avoiding positions such as DON or ADON for now until I'm back in nursing for a year or two. I'm also not interested in teaching. Any help / suggestions would be much appreciated. Thank you!

Hello, my response may be a little late, but I thought I'd respond anyway. I worked in the Nashville area not too long ago and hospitals were paying up to about $40-$45/hr, with some offering sign on bonuses as well. Vanderbilt was one of the lowest paying places from what I've heard from nurse acquaintances. I've come across some ads for hospital nursing positions that were paying about $50+ but I haven't seen those in a while. Seems like when the economy started slowing down the wages in the Nashville area dropped as well. I don't work in the area anymore, but just thought the info may help you.

Wow! Congratulations on completing your MSN! While you were waiting the 8 months to begin the Capstone, did you have to pay tuition each 12 weeks or did they put that on hold until you actually started your Capstone? Just wondering how billing would work in such situations. Thank you.

Hi Evea, did you sign up for the WGU program? If you did, do you like it?

Hi, I'm interested in WGU's MSN Leadership. Just wondering if anyone knows if a lot has changed from the old version last year? Also are there any online tests or is everything based on writing papers? Thank you.

Thank you NRSKaren!!

Thank you NRSKarenRN. I understand that all nursing programs have to be approved but I'll give you an example. Grand Canyon University's MSN program for example is approved by California but it's not listed as an approved program by the Tennessee Board of Nursing. It's also approved in its home state. So does that mean that students in other states (Tennessee for example) shouldn't do that MSN program, because GCU is not listed on the TN Board of Nursing's website as an approved school? There are hundreds of MSN programs approved by different boards of nursing, but what about the ones that have not been approved by a state we live / work in? Thanks.

I just have a general question that I'm hoping some will have the answer to. Do MSN programs have to be Board of Nursing approved? There are so many programs out there and I can't imagine that our state Boards of Nursing would know about all of those, and give their seal of approval (or otherwise) for each one. Is it safe to assume that if the program is regionally accredited and is CCNE approved, that it's OK to sign up for it, or is the Board of Nursing approval actually required even for MSN programs? I'm not referring to NP programs but just a general MSN program, or a Leadership / Management one. Thanks.

I'm going to keep this short because that's how you should respond to them - short and sweet. I've had to deal with some ignorant comments from former patients' family members, and I've learned to say "I'll be happy to discuss anything related to (client) with you, but I don't discuss my personal life. If you prefer a different nurse, I'll be happy to let the office know that my (weight, height, national origin, skin color - whatever they have a problem with) is an issue for you." They generally quickly recover from whatever biases they have and will usually start apologizing profusely. I don't let them feel good about themselves by accepting the apology at once, instead I say something like "If you don't mind, I'd like to do my job now" or "I really have to leave now." And that's it.

Hi Frank, The nurses are all given 24 hours to get their documentation submitted, and it then shows up in QA. Some follow the rules, and others don't. We say that we submit everything within 72 hours, but t's been more and more difficult lately as we are short of nurses and most of our nurses have a full load of clients. So all that to say we give them a little more time, but of course there are some who will still not abide by the rules, even with the additional time. So the only other option is to have HR call them the week their paycheck is due, and tell them that they have to submit all the paperwork before they pick up their paycheck, which has worked so far. As for your question on how they remember everything when they see so many patients over several days, well that's why we request that they document right there on the software using their tablets, but we're noticing that most don't do that as they want to rush on to see the next client. I did ask one nurse how she kept everything in order, and how she'd know if the client was in pain on Monday, but fine on Wed, and remember that a week later, and she assured me that she takes very good notes. I can only hope that it's true. As for QA itself, when it's a new client I do look through the whole plan of care (I'm required to do that as part of QA anyway as I have to make sure that the POCs are valid, and suitable for the client's meds and diagnosis, etc) but apart from the initial intake SOC I generally take notes myself from what I learn from the referral docs, or from the nurses' docs. But for the most part everything is accessible very quickly from the portal. So if I need to verify if the patient is on a certain med, or if he's a diabetic, or if he / she has a wound, etc. then I can click on the care plan or the med section through links from the QA section while I go through the visit notes, or the SOC or Recerts, basically whatever I'm doing in QA. I hope my responses make sense.

I'm very glad to hear that you're considering home health, as an LPN / LVN. You guys are in such great demand right now, and will be for a long, long time. Re experience, it depends on the state you're in. California requires 1 year of experience for RNs but I don't know if they have the same requirements for LVNs, however don't give up for that reason because many agencies will help train you as it is to their benefit to do so The HH LVN can do a lot of what the RN does, but you have different levels of responsibility in some situations. For example, if you're doing wound care, you and the RN would both be doing the same wound care, If you were doing med management, the same there too. You or the RN would be going through the patient's meds, filling in their med boxes, providing patient teaching about meds, etc. You'd be doing the same if you were working on disease management where you'd be seeing a patient because of a specific disease they have. The RN would do the same. What mostly differs is when there is an intake or a discharge. LPNs don't do that. So as you can see from my response, an LPN can do a lot in home health. Also don't be afraid of whether you'd be able to teach the patient, etc. If you take your tablet or laptop etc with you, the software will be in the program you guys use and all the teaching and other info would be there. As for stress, yes it generally is much less stressful, but also keep in mind that you'd be working alone, and there's no one you can call out to if you have a question, or if you need a CNA or another nurse to help you. You do have your agency and access to people you can talk to on the phone though, so it's worth a try. Plus you'd probably make significantly more money, and you'd be able to self schedule, take a day off when you feel like it, etc. Good luck!

I'll try my best to respond to your questions. I work in HH but I'm mostly in the office doing QA there days, although I do work in the field at times, and I also have a lot of interaction with the nurses in the field on a daily basis. 1. Most of the nurses are our agency do not fill out the paperwork at the patient's home although as the QA person who's also an RN, I try my best to get them to do that. The reason why they don't fill it in at the patient's home is because most of them over-schedule themselves for the day, and they then have to rush on to the next patient, often not with our agency (they work for multiple agencies, seeing various patients daily). Some other reasons are because the patient population we work with generally don't want people hanging around. I've suggested that they stay in their vehicle outside patient's home once the appointment is over, as a second option (the first one being in the patient's home) but that's rarely done either. The main reason though is that most just want to be able to get in more appointments in a short amount of time, and they think that they can get the documentation done at the end of the day, in the comfort of their home 2. Each agency is different. Some have support staff who make calls to remind patients to expect the nurse, others don't. Our agency doesn't because it's more efficient for the nurse to be in touch with the patient, and schedule their own appointments based on theirs and the patient's schedule. Not too such what you mean by "balance of work" but we do the QA when the nurses turn in their docs, that can sometimes take some time depending on how responsive the nurse is to requests sent through QA, then we receive the corrected doc, and we either approve or ask for further changes or clarifications (which is extremely rare). As for inputting notes, our office staff does not do that. We do however help with wound care consults and we follow-up with all wound and medication orders for the nurse (apart from the basic monthly med order refills). We also provide phone support, answer all MD and their office calls, take all patient family calls, we also help our nurses report issues to MDs, VA, etc as required in order to help our nurses. Also we write communication notes so that the nurse and other staff are all on the same page, and the communication notes are in the patient's chart (online) 3. RNs decide the frequency only for Medicaid, not for VA patients, and I'm unsure about Medicare patients. As for the abbreviated terms, I think nurses may find it easier to just click on the number of times a week, or a month, or whether it's bi-weekly, or weekly, etc but it would be great if were easily converted to industry standard short form so that others who also look at the documentation can use it in the form they've been used to having it in. Not sure if that makes sense. 4. Can't help with number 4, sorry.

May I ask why you did not like the MSN program at WGU? Anything you could share would be much appreciated. Thanks.