HOME HEALTH...Positives and Negatives

TazziRN, RN · Jun 1, 2007

Positives:

Helping people stay at home

More time to teach

One pt at a time, vs the one in front of you and the three others on the call bell

Dixielee, BSN, RN · Jun 1, 2007

I've been out of home health for a while, but the positives were the autonomy over your schedule, the wonderful appreciation you got from your patients, being able to run errands while "at work", etc. I loved it.

The only con was the darn paperwork, and I understand it is even worse now.

If I ever decide to settle down and stop travel nursing where I only do ER, I will go back to home health.

Jo Dirt · Jun 1, 2007

Pros: *you can run errands and take care of other business while on the job

*alone time while you travel in your car

*fair amount of autonomy and schedule flexibility

Cons: *being expected to be "creative" and think of reasons why someone needs to continue HH services when there is really no need (most of the time, what we would call "BS" visits, such as medication teaching, monitoring cardiovascular status, diabetes teaching...I mean, if they haven't gotten the point after years of having these diseases I doubt there will be much to do to help them.)

*Running your car in the ground. If I would have stayed with the place a year (I was there 8 months) I would have racked up over 40,000 miles on my car.

*Some people do not like going into strangers houses all the time. I am one of them. I was under the impression when I signed on I would have pretty much the same patients and another nurse would be assigned to do admissions. That idea quickly went down the tubes, and the owner of "the company" wanted us to push to get as many admissions everyday as possible. So, like anywhere else, don't assume things won't change from the way they told you it would be.

*The way the agency was running when I finally ran away, you had a certain area (or more, depending on how staffing was at the time) and you were expected to be on call at all times. It got to where I was on the road seven days weekly...and I was salaried.

* You need to be very people oriented and comfortable doing a lot of talking. I like people but I'm not an outgoing people person. I'm too quiet and introverted, especially around strangers.

*You are all alone out there. You really need to develop your nursing skills, like IVs and blood draws, wound vacs and port-a-caths because you will find yourself out in someone's house all alone and no one to call for back-up.

*I was also under the impression Medicare would pay for the nurse to come in to teach the family how to, say, run an IV antibiotic and then we were to sign out of there. In most of these cases the families either do not want to do this or the patient lives alone and can't do it themselves...so we are expected to. The last patient I had, I had to drive 50 miles one way for a week to run IV antibiotics for an hour each time. And everytime you went she would find reasons to keep you there HOURS. The final straw was when the doctor extended the antibiotics ANOTHER WEEK. So every night for 14 days I was there, several hours on my salaried pay...I wanted to cry.

Cattitude · Jun 2, 2007

Positives: Flex schedule

No weekends, no nights, no holidays, no on call

Getting to really know my patients, most are like family to

me.

Autonomy.

Negatives: Lots of charting

Wear and tear on car

Social isolation-I miss chatting with my coworkers!

Neveranurseagain, RN · Jun 2, 2007

I did home health for several yrs through the county health dept. and loved it. More time with patients one on one, they learned more/retained more in the comfort of their home and it was rewarding to see them get better and not need you anymore. The flexibility with scheduling was great--I would see several pts, jot down VS and brief assessment, then go home to kids. That evening after bedtime I would do all my charting so I had more family time. The downside was the ENORMOUS amount of paper work--so much writing I developed a neuritis in my right hand/forearm and had difficulty writing for several mths.

allantiques4me · Jun 2, 2007

I did home care for a while.The plus,Autonomy over you schedule,one PT. at a time laid back atmosphere,decent money.The minus' it could be boring,sometimes theyd call you at the last minute to say they didnt need you.

Kristina_RN_student · Jun 3, 2007

I worked as a CNA for about a year and the negatives for me were the traveling.......one patient was about an hour drive from my house. I had another patient, who happened to be violent towards his family but family didn't bother to tell us, who grabbed me by the arm with one hand while going for my pants with the other....I was scared and I didn't treat that patient again. He really needed to be in a nursing home but family just didn't want to deal with him. Other negatives include: treating a really sweet patient whose home was infested with roaches....they were crawling everywhere including in my nursing bag and down my scrubs.....thankfully I had a change of clothes in my car and I complained to the health department because the landlord refused to spray; lots of wear and tear on your car; dangerous dogs; rude relatives.....

Despite of all the negatives....I truly loved my patients. I was treated like part of the family and one patient's husband baked me banana bread on a regular basis. The one-on-one time with the patients is priceless and the smiles make it worth while.

pagandeva2000, LPN · Jun 3, 2007

I am in a dilemma about leaving the home care case I have right now with a 5 year old pediatric patient with a trach. The mother is phenomenal, the child, cute as she is, is a brat. I am an LPN that also works in a hospital clinic full time. I work this case on Saturdays, 10 hours. I did get the child to become more accustomed to me, and we get along better than before; however, the mother wishes to take the child on many outings, now that the weather is breaking. Not a bad thing per se, because the child has a chronic illness, but, is not crippled, so to speak. She does have a high quality of life. She was enrolled in karate when I first got there. Now, the mother wants to get together with friends that also have children and take them to the movies, attend birthday parties and social events, while I am escorting the child. What I have worried about is if something even happens to one of the other children, and I AM a nurse, I feel that I can be held legally liable as a licensed person. At times, children innocently hurt each other, and I am constantly worried about them playing around with this girl's trach site.

Another incident; last Saturday, I went to the house, and the mother told me that one of the children at the school pulled up her daughter's dress and caressed her lady parts. The child mentions this to the night nurse while being bathed. The nurse tells the mother and day nurse. The mom goes to the school to report the incident, and she tells me because she didn't want me to get the news second hand. I check the child, there is no bruising in the genitalia, she is playful and didn't seem traumatized by the incident. I asked the mother if the agency knew and she wasn't sure. Since it was Memorial Day weekend, I had to wait until Tuesday to report it to the agency (but it was definitely placed in my notes). The agency calls me back, very grateful that I reported it because the other two nurses didn't say a word.

This is a very willful child that can cause more problems once she starts elementary school because by then, she will feel different from other children, and I already see that she will become more resistant to medical care. So, I think that I will leave there by the end of the summer. Not because I can't handle the case, but because it is not worth my license.

Otherwise, believe it or not, the home care is better for me. I do plan to continue to do it, but under different circumstances.