Home Health Nursing Resolutions

I know how busy everyone is during the holiday season so I took it upon myself to write some resolutions for you.  You can click on the picture and print the short version if you don’t want to read the explanations.  Please note that I did not specify these are New Year’s Resolutions.  They are good for any time of the year that you are not finding personal satisfaction from your work.

I resolve to recognize my skills as insignificant.

The traditional definition of a skill refers to the ability to do something well such as a task or a technique, usually as the result of practice.  Face it, most heroin addicts can start an IV and those  blood pressure machines at WalMart are pretty accurate.  Our value does not come from what we can do although I hope you are skilled at CPR if I fall out in front of you.  Our value comes from nursing judgment and knowledge.   There’s always the possibility that an unconscious cardiologist on the floor in an empty room is merely napping on a hard surface due to back problems after a long night on call.  (Yes, I called a code.)

I resolve to take responsibility for my ongoing education.

Do not wait for your employer to spoon feed you what you need to know.  Educating nurses in home health is an expensive nightmare.  Furthermore, you cannot function without knowledge of OASIS and PPS and Medicare Coverage guidelines so they get first priority in the education budget.  None of those areas of expertise make you a better nurse.   Learn about a new disease or re-visit one that affects many of our patients.  I see documentation that reflects a serious lack of knowledge about the medications patients are prescribed.  Since skills don’t make you special, go for knowledge.  Collect on a daily basis the information you need to make intelligent decisions about when to deploy your skills.  Sadly, if you don’t take responsibility, no one else will.

I resolve to be grateful for all referrals.

Nurses who get paid salaries in the office have been known to sling a little attitude when a new referral comes their way.  To them, it is more work and when a referral source does not have the information they need right away, they are offended.  2012 is a whole new world in home health and nursing is going to be at or near the frontline of marketing.  If your agency does not have a steady stream of new referrals and the ability to take care of them, you won’t be reading my blog next year at this time.  And remember, it’ all about me.  I like my readers.

I resolve to treat my coworkers with respect and compassion.

I have made mistakes in my career like giving a handful of psychotropic medications to the wrong patient.  I have lost a bag of Pavulon in the ICU (still hasn’t been found).  I have forgotten lab and once gave a patient who was allergic, morphine.  Nobody died except a little piece of me.  (The patient who was doing that flash pulmonary edema thing actually got better as a result of the morphine.)  Doing something that can potentially harm a patient is the worst feeling in the world.  If it were not for the compassion of the experienced nurses who offered comfort more than chastising, I would have gone to work at Taco Bell a long time ago.  Save the chastising for poor or late documentation.  Of all the mistakes I have made, I can honestly say that I have never made the same mistake twice.

I resolve to watch what I say.

Gossip and complaining can destroy an agency faster than a ZPIC audit in a dirty agency.  To determine if you are repeating gossip or complaining, ask yourself if the person who is hearing what you have to say is in a position to change the situation.  If not, be a class act and keep the information to yourself.   If you feel the need to ‘vent’ or ‘share’ remember that is your need.  What is perfectly acceptable in a support group or in therapy is not always professional behavior especially when the feelings of your coworkers are at risk.  (It just now occurred to me that we should have a 12-step meeting for home health employees…….)

I resolve to keep in mind that Nursing is a profession.

It bothers me when I see people in loose scrubs and dirty shoes on the street and I have to look hard to determine if they are escaped prisoners or healthcare professionals.  I would like to offer thanks to the state of MS for changing their standard prison wear to bright green and white stripes for exactly that reason.  It also bothers me that some of our communication with physicians is less than professional because we are not prepared or concise in our information and questions.  When visiting patients, we similarly need to be prepared with wound care materials, teaching tools, etc.  I would fire any professional I hired who was not prepared when I was paying for their time.

I resolve to be grateful.

The benefits of gratitude are not some new-age, hippy sort of thing.  There have been numerous scientific studies with astounding results.  Take the time to click on the hyperlink and read about some of the them summarized in the New York Times prior to Thanksgiving.  Next, go buy some ‘thank you’ notes and find a reason to write one everyday.  By actively searching for reasons to be grateful, you will change your whole perspective on life.

I resolve to live the life I want my patients to have.

We teach our patients to eat well, exercise, take their medications and in general do what it takes to remain in their homes for as long as possible. Although you are significantly younger than most of your patients, you probably would not have met half of them if they had started practicing what you are preaching when they were your age.  On the other hand if you are as old as most of your patients, you probably already know this.

I resolve to have fun!

Your patients are an endless source of entertainment if you get to know them.  Find out who thinks the Moon Landing was propaganda by the government.  Ask them about the town fifty years ago or the first president their vote helped put into office.  How did they meet their spouse?  (Hint:  it probably wasn’t at a bar or through an online matchmaking service.)  Collect the details that make your patients worth knowing.  Vital signs do not do it for me.

If you are periodically overwhelmed with paperwork, find someone else in the same boat.  Meet up at a coffee shop early in the morning and help each other get caught up.  It is always easier to clean someone else’s house than your own.  It is the same way with paperwork.  It is easier to see what is missing in someone else’s.  Make getting caught up a social event.

Listen to music between visits and sing as loudly as you can.

Clandestinely give small presents to your least favorite coworker.  Not knowing who gave them the chocolate or scented candle, etc. will make them be suspicious of everyone and they will feel compelled to be nice to the entire office.  Plus its fun to watch someone who is difficult to get along with accept an act of kindness.  Usually they don’t and that’s funny, too.  Rarely, but enough to make it worthwhile, they drop their defenses and you find out they weren’t who you thought.

Once a year, play hooky.  I mean it.  Take the day off and go to the movies and do some shopping or take a nap.  Go hiking in the woods.  Do whatever it is you do when you are not working and do it with gusto.  It also helps put things into perspective if you realize that the entire world does  not fall apart without you for one day.  Being a responsible nurse 364 days a year is enough.  So only one day a year, play hooky but don’t get caught!  If you do, I will deny everything.

As we begin another round trip around the sun, please accept my sincerest thanks for being such wonderful travel companions.  This is the first blog post of 2012.  I wonder what the last one of the year will read.

Happy New Year from the Haydel Consulting crew.