[Silverblitzen]

Hi CCMermaid and Cat,

I think the thing that made me want to look into HH is mostly my legs. The poor things just can't take standing on the concrete floors all the time. Our building has no carpeting and even though I wear "Anywears", plenty of rubber between my feet and the floor, I wake up at night in agony from the pain in my legs. Here, too, I'll be taking a cut in pay but I'm hoping the trade off will result in my legs being happier. Doing paper work at home after I've done the home visits is OK. I'll be home in the evenings - well, most of them.
I'll keep you all informed on my progress. I know I"ll have more questions!

Sue

[flrl0706]

Great Thread. I was just hired as a HHN with a pediatric agency. I have never worked HH only long term care. any tips for me? I will have only one client, a one yr old little girl.

[NurseRoRo]

I made the switch to HH after spending almost 10 years in the hospital. I started out in General Peds and then went to a free standing inpatient Peds Rehab facility. I then went to the Operating Room and stayed there for about 3.5 years. I found that I work well in a team but not as a supervisor of a team. In the OR the team has to be work in synch and I had to poke or prod those that were not working up to speed with the rest of what was going on.

As a case manager, I work in a team but am independent in my field. I work with other disciplines and maintain great communication with them but for the most part I am responsible for my part of the care and I facilitate more than supervise.

I love the independence. I love the lack of noise pollution so I can think in the car between visits. Long gone are the days of simultaneous phone ringing, people standing around talking while you're running around like a crazy person without them asking if they could do anything to help you, the call light going off, the unit rep telling you that family is on the other phone, and a resident following you around to ask you a question about how to arrange for discharge. I have crazy busy days, but I create my own chaos. I like to call it controlled chaos.

A typical day for me is: 5 patients, or maybe 3 or 4 regular visits and an admission. My patient load consists of PICC line/CADD pump patients, COPD/CHF patients, cancer patients still seeking last ditch effort treatment before deciding on hospice. I tell my patients I am great at playing Devil's advocate, I ask difficult questions to see where they are emotionally with their disease process and poor prognosis.

Sometimes I chart in the home. Sometimes I save it all up for home. I am never on the computer for more than 2 hours at home. And I start my day as late or early as I want to depending on what I have going on. One of my patients works and gets home at 5pm. Those days I start later...

[ranaazha]

Originally Posted by NurseRoRo

I made the switch to HH after spending almost 10 years in the hospital. I started out in General Peds and then went to a free standing inpatient Peds Rehab facility. I then went to the Operating Room and stayed there for about 3.5 years. I found that I work well in a team but not as a supervisor of a team. In the OR the team has to be work in synch and I had to poke or prod those that were not working up to speed with the rest of what was going on.

As a case manager, I work in a team but am independent in my field. I work with other disciplines and maintain great communication with them but for the most part I am responsible for my part of the care and I facilitate more than supervise.

I love the independence. I love the lack of noise pollution so I can think in the car between visits. Long gone are the days of simultaneous phone ringing, people standing around talking while you're running around like a crazy person without them asking if they could do anything to help you, the call light going off, the unit rep telling you that family is on the other phone, and a resident following you around to ask you a question about how to arrange for discharge. I have crazy busy days, but I create my own chaos. I like to call it controlled chaos.

A typical day for me is: 5 patients, or maybe 3 or 4 regular visits and an admission. My patient load consists of PICC line/CADD pump patients, COPD/CHF patients, cancer patients still seeking last ditch effort treatment before deciding on hospice. I tell my patients I am great at playing Devil's advocate, I ask difficult questions to see where they are emotionally with their disease process and poor prognosis.

Sometimes I chart in the home. Sometimes I save it all up for home. I am never on the computer for more than 2 hours at home. And I start my day as late or early as I want to depending on what I have going on. One of my patients works and gets home at 5pm. Those days I start later...

I'm so thankful to read this...

I'm a NG -- just over 2 months on my own (just over 4 total) on a med/tele floor. I have a per diem HH job lined up. Haven't started yet because the DON is trying to work around MY hospital schedule to pair me with a nurse mentor to teach me SOCs first. (Hopefully, one will fall on one or more of my days off this week.)

While I love the experience I'm getting in the hospital, I look forward to all of what you described! I actually look at doing HH per diem (a few visits a week) as a respite from the chaos of the hospital! Your days sound ideal to me, and I can't wait!

[shirlz]

I am an RN who is working Home Health for the first time and I hate it. It has only been 2 months and it keeps getting worse. I am the only RN and one LPN. I run around till 5 pm and then do charting until 11 pm every night. I am on call every other week (14 days a month). On my week end on call I always have a couple of admissions. Maybe I picked the wrong agency, but now I am afraid to try another one.

[Silverblitzen]

Originally Posted by shirlz

I am an RN who is working Home Health for the first time and I hate it. It has only been 2 months and it keeps getting worse. I am the only RN and one LPN. I run around till 5 pm and then do charting until 11 pm every night. I am on call every other week (14 days a month). On my week end on call I always have a couple of admissions. Maybe I picked the wrong agency, but now I am afraid to try another one.

Wow! I think I'd try another agency! They're not all like that; I mean, if you read through some of the postings in here, you'll see a big variety. Do you live in or near a bigger city that may have more to choose from?

Best of luck,
Sue

[proserose]

Hi everyone,
Just joined the forum. I'm a home health nurse for the past 12 years or so. I took a few years off when my last child was born but have been back for a couple years now. Anyway, I'm so tired from my typical day in home health nursing that I can't bring myself to describe it. It was a long exhausting day - - lots of driving and things didn't go smoothly. I had four admissions and a visit. At the end of the day we all had a VM message from our boss listing all the things we have failed to do in order to please Joint Commission. Trying to get it all right is like beating your head against the wall. Sheesh. It 's very discouraging somedays

[dhyser96]

I had four admissions and a visit

Yeeessshhh! I would quit or be calling in sick the next day if my agency asked me to do that! I personally think that is expecting to much of any one nurse. It does not enable you to perform your assessment thoroughly and is not fair to the patient. For us a full day is 6 or the equivalent of ( admissions being 2) but never more than 2 admissions a day. Occasionally 2 admits and 3 visits, but that is a rare day.

[proserose]

Hi,

I am an admissions nurse. I enjoy doing soc visits and I work 2- 12 hour days per week and am paid for 30 hours because I have a lot of paperwork. The problem is they don't take into account what's involved in each admit, or how much time I spend driving. I feel 3 admissions - - in order to do a good job - - is a good 12 hour day. I usually push more towards 14 hours by the time I'm done. I'm salaried so I get a certain number of units for everything. 'They' say the average admit only takes 45 minutes to an hour so we only get 2.5 units for an admission. That means in 12 hours it looks like we should be able to do 4. But all that is required at soc takes me longer than 45 mins or an hour unless it's just a 50 year old total knee with only a couple meds, and no complications. Trouble is most admissions are not like that. Someone upstairs just looks at numbers and forgets it's all about people - - at least that's how it feels somedays.

[dhyser96]

I am an admissions nurse

Well that makes a little more sense to me now! I work 8 hr days too, instead of 12. It's funny how nice the units add up on paper for the office staff...just doesn't work that way in the real world. If all my admits were therapy only...aahhh, I can only dream