10-11 snv a day. I'm going crazy

  1. I'm new to the board and just wanted to vent to some folks who might understand because my husband sure doesnt. does anyone else find themselves scheduled for 10 or 11 skilled nurse visits a day? I think our agency is going crazy. If there isnt enough nurses to go around then why are we still accepting referals? I know why, MONEY, MONEY, MONEY. No matter what kind of care you can provide to 11 patients in one day who happen to live 20 miles from one another. Just so they're seen and the visit is billed. Oh and make sure you charge for the bandaid you used on the 12th patient you had to pick up on a prn visit. Just wandering how many of the agencies still use case managment. We stopped about 2 months ago and thats when the schedule went crazy. I mean, daily wound care on a hangnail for a 30 year old man who can easily reach his toe. anyone else with something similar?
    just venting
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  2. 6 Comments

  3. by   KP RN
    WOW!! Since PPS began a couple years back, the name of the game is to reduce visits, costs, and be more efficient. My agency would NEVER tolerate us doing a qd wound on a pt with a hangnail!!
    Us RNs don't have to do more than 6 visits per day. Each admission or resumption counts as two. Certainly, if we want more, we can have more.
    Are you paid per hour, paid per case, or on salary?
    I bet I can guess!!
    I used to work for an agency which sounds a lot like yours. On weekends, I would be the only RN, and I could have 15-17 visits per day. The good thing was that I was making $33. per visit, and was able to make shytloads of money. Of course, I'd come home at night, shower, then immediately pass out until the next morning---but the money was good....
  4. by   CseMgr1
    Home Health (for what my opinion is worth), went to hell in a handbasket due to PPS. I was like you, doing between 8-15 visits per day, and when the emphasis is placed on quantity and not quality , something has to give. I quit Home Health, after they raised my productivity on the weekends to 12-15 visits, then proceeded to cut my salary by $1.60/hr. After 18 years, it just wasn't worth it, anymore
  5. by   renerian
    Yes I have done that many.....makes for a horrible day... i feel for you.......

    renerian
  6. by   Rustyhammer
    I've been doing 5-6 a day and over 100 miles each day. Today it was close to 200 miles.
    -Russell
  7. by   sphinx
    Wow, can't even imagine that much. Our RN's do between 5-6 a day. Maybe, VERY rarely will take a 7th in a pinch, but that is very rare, and overtime for sure. LPN's are expected to do 7 revisits a day.

    Our productivity for RN's is an average of, I believe 5.3 (?). If we do something like 3 days of 5 visits and 2 with 6, we make it. We don't have any kind of "weighted" productivity though, so in the numbers, and opening is worth no more than a revisit. When scheduling, if a nurse is doing an opening, it is ideal to do no more than 4 revisits and one opening. Occasionally it ends up 5 revisits and an opening, but we try to avoid that. I personally think that's a lot, esp in terms of paperwork. But the numbers see no difference between the 2 types of visit.

    We are always on a fine line between productivity and utilization. Get your productivity up, but don't have too many visits on a patient!!!!! Ugh.
  8. by   CseMgr1
    Originally posted by CseMgr1
    Home Health (for what my opinion is worth), went to hell in a handbasket due to PPS. I was like you, doing between 8-15 visits per day, and when the emphasis is placed on quantity and not quality , something has to give. I quit Home Health, after they raised my productivity on the weekends to 12-15 visits, then proceeded to cut my salary by $1.60/hr. After 18 years, it just wasn't worth it, anymore
    Just a footnote to the above: Shortly before I left this HHA, I was assigned to see a patient over the weekend, whose visit had been bumped from Friday to Sunday due to "scheduling concerns". I walked into the house and was immediately hit with the odor of gangrene (once you smell it, you will NEVER forget it). The patient's son told me that he had been sick since Friday, the day that the original visit had been scheduled. I sent him stat to the local E.R., where he wound up having his leg amputated the next day.

    I was really p-o'd about this, for this was clearly a sentinel event which could have been prevented, had the Powers That May Have Been left that schedule alone. But, no, it's all about money and politics, isn't it?

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