Nursing Program... I HAVE AN INTERVIEW...Calling all Nurses!!*UPDATE**

[supaflyz]

$3.25!!!!!! At least you get to sit compare to working at the hospital lol.

 

[seminolewind]

That is surely funny! The paperwork is torturing me here. But at least I'm not in a hospital. I'm on my couch in my home. Maybe that's worth it to me. I don't know. I've done this for 6 weeks. I hope to get better at the paperwork end so it doesn't take so long.

 

[donrae]

I had a charge nurse that would scream at me everytime I asked her something. It was really getting me upset. How dare anyone think that they are allowed to yell at me! Who gave them the right!

A few times, including once with that person, I took her aside and said "I don't know if you're aware of this but you yell at me all the time and it's really getting upsetting". She was shocked. But I was nice about it and it stopped.

I would not be afraid to take that manager aside and tell her that her screaming at you has got to stop. Be really nice about it, but tell her to please stop. You don't get paid to come in to work to be screamed at.

Hospitals are stressful. If you don't speak up for yourself, you get eaten and pooped on. If you don't stop someone from treating you badly, soon everyone does because they can get away with it. If one treats you like an idiot and you let it go, eventually everyone will treat you that way.

Supafly, when I was new, the charting would make me cry at the end of a shift. I was so confused by it, what to write, what not to write, etc. A nurse rescued me by showing me a system that starts at the top and works it's way down for assessment. What saved me is writing these little systems down on a small pad, and this would make sure I covered all the bases. I carried that for a year. It took the stress away. Also, buy yourself a small pocket size book that lists illnesses or treatments and possible side effects , like with meds. It will help you cover what needs to be addressed according to what the patient has. A lot of that is from nursing school. If a patient has an IV, you have to address certain things in your note. And so on.

I'm just starting out as a visiting nurse, I've had 20 years neonatal experience, and it took me 2 years to get hired into working with adults. But with homecare, there's a thing called an Oasis. It's 20 pages long , checking off things about your patient. At the end, you push a button and it generates another paper that is THE plan of care. It's amazing how this system takes all the blocks you've ticked off and converts it into a narrative. However, there are guidelines to follow when writing what you did at that visit, and QA can keep sending back the form for corrections. It's real frustrating. If I take my $40 per visit and divide it by all the hours including paperwork, I make $3.25 an hour, LOL. But not really kidding.

Hey, another Home Health nurse

I've been doing HH for 4 years now and can really rock an OASIS. My best advice is not to look at it as a nursing assessment, cause it's not. It's a reimbursement assessment. Score the patient as high as you ethically can and QA will be happier with you, and your agency will get more $ for caring for the patient, which means job security for you. There've been a couple agencies here that have gong out of business cause the nurses didn't understand how to score the OASIS and they just didn't get paid enough. I was told to compare the patient to a healthy 18 year old, and if I recall correctly you go back 2 weeks for the ADL section. Heck, I could score pretty high on that some days

When QA sends it back to you, use it as education for the future.

Wait....do you seriously only get $40 for an admit?!? We're hourly here, and admits are generally expected to take 2-3 hours, including assessment and charting, for a "routine" patient. Wound VACs, IV infusions, etc take longer.....

 

[seminolewind]

Rachel, you're a blessing! Yes I get 40 a visit and 50 for an admission. I don't think Florida pays that well. Hourly sounds good, wish I could get that here.

What do you mean by scoring on the Oasis? Aren't they better off scored needy?

Okay, I'm understanding you as scoring the patient LIKE he was a healthy 18 year old. What you mean is COMPARED to a healthy 18 year old meaning they need all the nursing they can get. Correct?

I will try looking at it as a $$ score rather than a real assessment, LOL. Great advice.

 

[donrae]

Yes, compared to. Those lowest numbers are how you'd score a healthy 18 year old. Any assistance needed scores them higher, and higher is better. I score them as dependent as I possibly can, it reflects to Medicare how truly sick they are and how much care they need. Also remember the golden word of "safely'....just cause they can physically do the task, doesn't mean they can do it safely.

Sorry about the salary--that's pretty low. Now, the per visit could work in your favor, once you get your routine down, cause some visits only take half an hour. But I'm guessing you don't get mileage, either? Maybe I didn't realize how good we have it!

 

[seminolewind]

I do not get mileage. They keep me in a 10 mile radius of my house. Florida is really lousy pay especially out here not in a city. In NY I was making 50 an hour in the hospital, and down here 29. And that was 10 years ago.

I do certainly live pretty cheap tho.

 

[donrae]

Well, a 10 mile radius is pretty good. My territory included a few small towns 30 miles away. It was not unusual for me to log 100 miles a day, so mileage was pretty necessary for me.

OASIS aside, I really like home health. You connect with your patients in ways you simply can't in a hospital setting. Plus, flexible scheduling is great

 

[seminolewind]

I got an interesting phone call yesterday. My agency decided to expand their area for private insurance patients. They asked me if I want to cover this area. I was pretty happy with that. It's more or less doing one visit for setting up an aide and equipment and a safe home. Best news is no Oasis! I hope it goes well.

 

[donrae]

How cool! I did a little of that for our caregiver side. Much less stressful, basically a safety check/eval, and set up a care plan for the aide. Med management was sometimes an ongoing issue, but again, no OASIS!

 

[seminolewind]

Yea, no Oasis, but..... the agency said the visits would go quick. But never warned me about the patients being so nice and interesting and wanting to talk. I have a hard time pulling myself away.