Is home health care for you?

  1. Have you considered homecare nursing? I am doing research for my BSN practicum project on recruiting and retaining nurses in homecare. Could you tell me if you have considered tying homecare? If so, what has stopped you from applying/interviewing? What do you think you would like about homecare, and what do you think the drawbacks may be?
    Or...if you have been a homecare nurse--why did you leave?
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  2. 17 Comments

  3. by   amy
    I recently switched from ER nursing to homecare. If you'd like to know more, pm me. I at first found it very frustrating; if you didn't bring it with you, you aren't going to find it . (fairly rural county) In ER, you have everything you need immediately or sooner, in homecare you improvise, sometimes ALOT! I went o homecare at the urging of another (family works in same office as LPN). I really feel like I am helping folks, took a while to get back the passion and adjust to the lack of adrenaline!
    Amy
  4. by   sjoe
    WAY too much paperwork. I walked out of the interview.
  5. by   deespoohbear
    Originally posted by sjoe
    WAY too much paperwork. I walked out of the interview.
    When my SIL who is a Home Health RN told me their admission paperwork was like over 40 pages, that stopped me in my tracks. She does work at home, off the clock. Me, I am not donating my time to my employer. I intend to be paid for work. I choose who I want to VOLUNTEER my time to....

    SIL loves Home Health. I don't think I could handle going into other peoples homes and walking into God knows what.....
  6. by   Jay-Jay
    I've been at it nearly 4 years now. If I walk away from it, it will be due to sometimes working 8 hours, and only being paid for 5. That can happen on a bad day, because we only get paid per visit, and our travel time isn't paid either (we do get mileage, though.)

    There's a lot of paperwork, and you spend a lot of time on the phone, talking to case managers, doctors, ordering supplies, etc., etc.

    The upside is I love being independent, and it's great to be able to develop a relationship with a patient, see them in their own environment, get to know who they really are. And, of course, see them get better. Or, in the case of palliative care, help them accomplish the final tasks of their life, and, if they desire it, help them to die in their own home.

    I find I generally have a better relationship with the doctors than hospital nurses do. You are their eyes and ears, and they have to listen to you. Most of them do, and it's really nice to have your opinion valued. I can think of only a few time in the past 3 years when I've encountered a doc. who was a real idiot. The worst was a GP whose pt. had had hip replacement surgery, fainted, and dislocated the hip. She was on total bed rest, and having really bad headaches. She was on Fragmin (Low molecular wt. heparin) which meant there was the possibility of an intracranial bleed, but she also had a history of migranes. SOOOO....I figured the GP was the best person to ask.

    His reaction? "What are you calling me for? I've never even heard of this medication (fragmin). You should be calling the surgeon..."

    "He's in surgery all day. I can't get ahold of him..."

    "Well, don't bother me just because I'm easier to get ahold of. I didn't even know she'd HAD surgery!"

    Sheesh. Wound up taking to the hematologist who'd seen her for all of 5 minutes before prescribing the Fragmin. He told me to send her to the ER.

    Patient refused to go. I agreed, it wasn't necessary, unless she started to have neuro symptoms.

    Then, I went home, and had guilt pangs all night, because I hadn't done what the doctor said, and WHAT IF???

    By the end of the week, the headaches were gone, and she had found herself a new G.P. (surprise,suprise!)

    That was one of the bad times. The good times are the times you know you've made a difference. I've saved a few lives over the years when I've found a few people lying on the floor, too weak to get up. One was a diabetic, who definitely wouldn't have lived much longer if I hadn't visited that day. Other times, the rewards come from simple stuff, like being able to offer reassurance, for instance, to say, "I've seen dozens of cases just like this (cellulitis) and most times, the infection is better in 3 days." Or..."The vast majority of people sail through chemo with maybe some mild nausea, fatigue and malaise. It's nothing to be scared of." And when things DO go wrong, community nursing allows a lot more opportunity to do some hand-holding and provide a shoulder to cry on than hospital nursing does.
  7. by   renerian
    I worked in home health and left after 11 years there. PM me if you need specifics.

    renerian
  8. by   NRSKarenRN
    Stillin homecare after 17 years. Seen the ups and seen the down times. Paperwork is the #1 reason staff leave home health. Those care plans DO mean something in home health.

    Lack of control over your envirnoment, clients/patients wanting things on their terms.....hanging IV bags or tubefedings from a nail on the wall..... cathing a patient in a recliner chair....doing wound care with flashlight between your teeth....seeing bedbound patient up walking again .....being able to attend children's school party, school concert, helping out in preschool as I scheduled my patients around kids events.... all priceless memories.
  9. by   CraftyLPN
    I worked as LPN in homecare w/ peds ..absolutely loved it...The only real drawback, is when the lil guys can no longer hang on....
    The only reason I am not in it now is the 2 co. I am "with" have no available clientele...so I am @ ltc for now
  10. by   dingofred
    I worked in home health for four years. The huge amount of paperwork was a factor in my leaving but probably the biggest factor was the medicare cuts and the inability to do what needed to be done to help the patient. Loved the independence and the
    necessity to improvise.
  11. by   nursecheryl
    I worked for 3 years in home health care and quit, went back to hospital for a few years in critical care and back again to home care, but this time one with a union. I've been a nurse now for 14 years. 6 years total in home health and the other 8 years doing critical care for neonates or pediatrics. Why did I quit the first time with home care. The hospital I was working for was trying to find a way to save money so they decided to hire LPN's to do the easy visits and let the RN's to the more difficult cases, addmittions and discharges. The paperwork for an addmittion and discharge is so time consuming that I'd have ended up getting payed a lower wage than an LPN whom I happened to be responsible for. We were payed per visit. LPN's made less money per visit but would be able to go in and do her visit in 30 minutes and it would take me 3 to 4 hours to do and addmittion and 1 to 2 hours to do a discharge, all at the same time taking responsiblity for anything that went wrong for the LPN during her visit, because she was instructed to call the RN if anything went wrong on her visit for the RN to deal with. We tryed to get a union in this homecare co. but were unsuccessful.
    I now work for a large metropolital home health care agency that gives me the time I need to finish my paperwork, make my phone calls and manage my cases as well as visit all my patients at least one time per week. My office is in my home. I get payed for overtime. They supply me with all needed supplies. I'm independent. My specialties are pediatrics and IV therapy. I only have to visit the big office 2x week. We have 3 to 5 patients that need to be seen per day. The rest of my time is spent in my office at home, dogs laying at my feet, coffee sitting next to me made by my own perculator. Meal cooking. Sometimes I work over 8 hours, but I'm very honest with myself. If it took my 20 minutes to start my meal etc... I add this to the end of my day and give it back. I never cheat them and I never let them cheat me. I'm almost always able to finish my work in 8 hours total time. I may be entering information into my computer from 8pm until 9pm for example, but if I am it is because I decided to do something else during my work hours and i now owe it to the agency and my patient. It all works out in the end. I don't know about anyone else but I love homecare. And, I love casemanagement at the agency I work for. Think Union!
  12. by   KP RN
    I've been in homecare for the last 6-7 years. I love it!!
    I chose to work for this agency because of their size, reputation, and the resources available to me.
    We are paid very, very well; have excellent benefits; a small geographical area to cover; and a generous sign on bonus.
    Some days I work very hard and endure long hours, but most of the time, I am home by 3:00 and all my work/paperwork is done.
    It really does work out in the long run.
    Would never consider going back to working in the hospital...
  13. by   renerian
    Karen you are so lucky. I loved home health but my pay was per visit in a 7 county service area, no pay for drive or office time. I made an hourly wage between 9 to 13 per hour. Was not worth it.

    Count your blesssings,

    renerian
  14. by   sphinx
    Been in homecare 2 years, love many, many aspects of it. However, I recently left the field and took an in-office RN position. Why? because I was tired of working all day, then coming home and finishing my paperwork, often taking till 9-10pm, interspered with a dinner break. Sure, it's partly because I'm pretty much a perfectionist......spent a lot of time with each patient, and even though I charted in the home, I always had charting to do at night too, as I am very particular about accurate chartng. Not to mention the case management, which is very time consuming and takes a good portion of your day. However, it was very rewarding, much more so than hospital work. But I got where I couldn't work the long hours, and no matter how I tried, I couldn't seem to scale back.Our caseloads kept growing, and as nurses leave, their positions are not filled (yes, the shortage is felt everywhere). Not to mention, only getting paid for 8 hours no matter how long I took to complete my day. Now I go in at a set time and leave at a set time. I miss the patient interaction, but am still working in a nursing capacity, and for now, it is what I need. I can't even imagine going back into the hospital setting, even now. No way.

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