[pahprints]

I know the title is weird, but I was hoping it would catch your attention!

I am trying to assist a highly skilled RN, with permanent restrictions of no walking/standing greater than 30 minutes without a brief rest, in a Home Health position.

The manager is reluctant to hire the RN, and states the following reason:

"Our home health RNs are required to do complex wound care that can exceed 2 hours of standing during the procedure"

Does that argument make sense? I've worked in the hospital environment for over 16 years, and that type of activity is not usual outside the surgical suite. My assumption is that the average Home Health visit is no longer than 30 minutes to an hour, since travel time between patients absorbs a portion of the day. Most Home Health RNs usually work an 8 - 10 hour day, don't they?

Would you folks please give me the benefit of your experience so that I know how to respond to the manager's assertion? Thanks.

[cny4rn]

I have had some lengthy wound vac dressing changes but never two hours. That sounds like an excuse.

[jnette]

No.. that argument does NOT make sense.. I've never heard this EVER.

There is very LITTLE walking/standing in HH.. especially if you do scheduled visits as opposed to shift/case work.

[dhyser96]

There are some places you HAVE to stand..but I often help myself to a seat - chair, stool, or floor. I often joke to my patients that it is a requirement of the VNA to be able to get down and back up off the floor But seriously, having to stand for time frames like that are the BIG exception not the rule.

[pahprints]

Thanks everyone for your responses. I'm using them to counter the manager's assertions, as well as using them to argue for an on-site job analysis. The JA will further support my case, as well as provide the attending physician with a better understanding of the physical requirements of the position.

[caliotter3]

Your assertion that most visits only require approximately 30 minutes if the nurse is well organized and quck in her work, and the other statements about not having to stand for long periods is correct. Usually, the nurse can find a stool to sit on or somehow accommodate the situation to something she can tolerate. It is up to her to be resourceful in this and to not let the statements keep her from what she is capable of doing. She should be given the opportunity to try out the job, since most companies place the new employee on 90 days probation anyway, try it out and either make it work for her or come to the conclusion that she can't handle it. Excuses are being made to keep her out of the workplace. Furthermore there are positions she could hold (adminstrative) that she could possibly handle without having to worry about standing or bending over for long periods of time. She might consider some of these positions. She could take on the supervisor roles, going on one hour supervisory visits, do admissions, recerts, or an admin job in the office where she reviews documentation, etc. That person does not want to accommodate her and may be breaking the law about hiring persons for whom adequate accommodations could be made. Your friend should look into the discrimination she is facing and how to best deal with it.

[GYPSY1349]

Originally Posted by dhyser96

There are some places you HAVE to stand..but I often help myself to a seat - chair, stool, or floor. I often joke to my patients that it is a requirement of the VNA to be able to get down and back up off the floor But seriously, having to stand for time frames like that are the BIG exception not the rule.

Too funny! I'm a VNA nurse myself, in Northern California, and often go to homes that literally do not have a place for me to sit...I've got the getting down and back up off the floor routine down pat!

Where there's a will, there IS a way..sometimes we just have to be creative!

[pahprints]

There has been a change in this case. The worker had her permanent restrictions changed so that she can be on her feet upto 6 hours a day.

Since the manager is looking for ways to keep the employee from joining her department, I doubt that this new information will make her happy. I agree with caliotter3 that the manager is flirting with an employment discrimination lawsuit. Unfortunately my organization enables managers to ignore the law. Our internal employment lawyer counselled that we can tell the manager that the employee is entitled to the position, but if the manager doesn't want to hire the worker, they don't have to.

I despair!! Some days it's just too hard to keep a happy attitude.