[meriposa]

I am wondering if some other HH nurses out there can impart some words of wisdom....

I am a new nurse to home health. The productivity for my agency is 30 visits per week. Thats all fine and dandy but apparently if you are perfectly capable of meeting your productivity and if your days seem to end before eight hours- they will go ahead and bump your visits up to 35 or 38 without compensation.

So for myself- I am the type of person who likes to start my day early- so lets say I do my six visits for the day and I work 8-3, and end an hour early sometimes- is that fair for me to automatically have to take on more visits, esp without compensation (we are paid salary)?? I feel liek I am excellent with time mgmt. and I have worked with hospital nurses in the past who did the same thing- it took them forever to accomplish tasks and what ended up happening was staff such as myself would get extra hits or an extra pts.....

I feel very torn because I don't want to feel like I have to spend extra time doing 'charting' or at a visit that isnt needed just because the agency is going to load me up with more patients if I don't work my full eight hours.

Also-- how do you all deal with time sheets- lets say if you have a doctors appt. in the middle of the day or if you have to stop to pick your child up from daycare?? Do you just leave that hour off the time sheet and notify your manager that have an obligation that day??

I was attracted to home health for flexibility (I have two small children) but my preceptor has me so scared that if I work a minute shy of eight hours hour EVERY single day that the field coordinators will give me as many visits as possible. Now I keep thinking if I ever have to take my kids to an appt. or something that I better just not do it because then it will appear as if I can take on more visits...

[dhyser96]

how do you all deal with time sheets- lets say if you have a doctors appt. in the middle of the day or if you have to stop to pick your child up from daycare?? Do you just leave that hour off the time sheet and notify your manager that have an obligation that day??

Yep - that's what I do. We do our timesheets on our laptops/software program. I just leave it blank...but I still end up with atleast 8 hours because of visits and charting before and after any appts- so know one really minds. Our VNA is pretty flexible too. I am salaried but the LPNs are hourly, so I am not sure how that works with them.

We don't have pressure on us to have a certain amt of visits a day. A full day is 6 patients with a possibility of a 7th if things are crazy. But there have been plenty of days where I only have 4 or 5 and know one says anything. We do case management and work with teams of RNs and LPNs. But if anything new pops up, our clinical manager does a pretty fair job of assigning them to the lightest scheduled nurse. So, if you are good at time management and see your patients efficiently and are done by 2:30 or so...you aren't penalized because there are slower moving nurses out there.

if your days seem to end before eight hours- they will go ahead and bump your visits up to 35 or 38 without compensation.

I think that would irritate me too!

[sherrytzu]

Are you talking about skilled nurse visits or the points system. My agency wants RN's to have 5 points daily (2 admits are 5 points), and SNV are 1 point each. The LVN's have to have 6 to 7 SNV a day to meet productivity. All RN's are salary to avoid overtime.

[nurseby07]

My preceptor likes to get out early and get done early. She said that there were days when she would finish early in the field, head back to the office and they would send her out again! So she (and everyone else) does their visits, charts most of it in the home and then goes home, not to the office. She uses and hour or two at home to chart and reports this on her time sheet for her hours. We are hourly and they do make a big deal of 8 hrs/day and 5 points/day.

[caliotter3]

I precepted with a nurse who did visits. She would fill up her day by stopping off at her home or doing errands in between visits. I would certainly recommend that one avoid going to the office if it means being given another visit for the day. Leave time off the sheet for time used for other things and make up your 8 hrs with charting time. Perhaps you might lengthen your visits by 5 or 10 minutes each. It doesn't hurt to spend a little extra time with the patient.