Calling all HH Nurses, roll call - page 34

Hi, as a newly appointed moderator, I want to live this forum up a bit. I just resigned my position as a HH supervisor, to go back to the field. I have been a nurse 20 years, 17 in critical care,... Read More

  1. by   loveAbabyNurse
    Well, I have completed my first week of orientation with my HHA. So far...I am overwhelmed. Pt care i have no problem with, the paperwork and PDA....STRESSFULL!! They may have me on my own next week because, according to them, I am doing a wonderful job. My DOA who has been with me this week says I am catching on very quickly and she has no doubt that I will do a wonderful job and will love HH. Even though I am working M-F instead of 3 days/week, with HH I feel I am home more but I have been more stressed which everyone tells me that is just at first. That is does get better and not to worry. Any tips from you who are experienced in HH would be wonderful and will definitely be read with anxious eyes.

    I love nursing and I have loved seeing these pt's in their home settings, more relaxed but I am terrified at times. It is totally different than the hospital and I think it will be better once I know what I am doing. LOL.

    Thanks!!
  2. by   annaedRN
    loveAbabyNurse - It WILL get better. When learning any new job, it is always stressful. The paperwork with HH is extensive, but I promise you that you will get better and quicker at it. There are still days that will be crazy and you will have more charting to do than usual...but in my book, those days are still better than any day at a facility for me!!! Just be up front with your supervisors - tell them how much you are enjoying your new job, but are getting very overwhelmed of frustrated. OASIS takes awhile to master. Let them know if you need more orientation on any procedures or paperwork. If they want you to succeed- they will help you out. Just b/c you are doing well doesn't mean you are quite ready to be independent with everything. There are still things after all these years I will call in to ask one of the managers about!

    Personally I find if I set up my timesheets and visits up the night before it helps my day to run more smoothly and efficiently. Good luck to you.
  3. by   lcc1080
    I've always found that working per diem suited me better as a HH RN. I tried working f/t at one point, and did not like feeling overwhelmed - as I was expected to case manage up to 30 pts. Good luck w/your orientation.
  4. by   YogaloverRN
    Hello Loveababy,
    well, lol if you read my posts from last few weeks, you know I just finished my "trial by fire", and I have been in HH since Feb. Gosh, did I almost freak out! And I had lots of hospital experience, but that only helped me with patient care, didn't help a darn bit with paperwork hee hee. But I did learn to speak up and tell them when I didn't feel comfortable, I had the advantage that I didn't HAVE to get paid per visit as soon as some of the others. Looking back now, I would say "be kind to yourself, be patient, and take small notebooks to make notes! Maybe you at least know the county you are in, I didn't even know the towns, LMAO. Best of luck! And the paperwork gets easier the more you do, you get quicker!:typing
  5. by   Stanthony624
    Checking in here--I have been in home almost all of my 20 years in nursing and the past 6 years as home health administrator. If I dont do my job, then my staff cant do theirs and my patients cant keep living at home. I think you can fall and lie on the floor just as long in your own urine at home as you can at many nursing homes so (juding how many patients looked during my 3 years hiatus to the ER when IPS started and converted to the early PPS days) so I just hope some day there will be someone looking out for me.
  6. by   SandBetweenMyToes
    Hi all...I am new to home health too...working in Ontario, after doing 8 years in hospitaln. It is really good to read the posts from the other newbies. The difference for me is that in Canada, we don't have all that OASIS and medicare stuff. Still have the paperwork, but seems simpler. The hard part is not the nursing so much as knowing who to contact about what, and which forms to fax to whom, and who has to be notified about different things. The coordination is overwhelming at times. I have been out on my own now for 1.5 weeks. Most clients are so nice (and helpful too), but boy did I have a doozy earlier this week. She is, I believe mentally unstable to say the least. She was literally yelling and swearing at me because she was angry her regular nurse wasn't there. Long story short, I muddled through. I did check her and tell her she didn't need to scream at me since I was there to help her. But I left quite unnerved, and have been wondering if HH is really for me. Another experienced nurse told me I should have verbally counted to three and left. I worry about patient abandonment though...like, could I have gotten in trouble for leaving? But on the other hand, we supposedly have a zero tolerance to workplace violence. What does everyone else do in weird situations like that?
  7. by   lamazeteacher
    "What does everyone else do in weird situations like that? "

    Anyone older than say 12, who is not a psychiatric patient and is verbally abusive (which yelling is), needs a reality test. Your idea of counting to 3 and leaving was excellent. However, I would have called my immediate supervisor while in the home, where the yelling could be heard, then going outside to discuss the situation.

    I received my Public Health Nursing degree from UofT (1962). It's good to hear of your experience in Ontario, Canada. I worked with "The Victorian Order of Nurses" in London, Ont. for my fieldwork. Does it still exist? Unstable people abound in the U.S., and since I have a proclivity toward that infantile field (but chose not to work in it full time).

    My greatest success was caring for a woman who had a colostomy for constipation! (After complaining to doctors in every major medical centrer in the country, she got someone to do that.)

    With the physician and patient (not out of control) involved, the Plan of Care then might entail a different Nurse visiting each week (for continuity of care), so dependence on any one Nurse could be avoided. If her care at home was for a short length of time, it may be every 2 days.

    For me, the yelling was a pivotal point in her psychological/psychiatric condition. In Canada, you possibly have more resources for that kind of care than we in the U.S. have........
  8. by   QueenAngie
    Hi, new friends!

    After being a hospital RN for almost 30 years, have just started this month as a HH RN.

    Totally different type of nursing and I love it!
    Ok, except for the paperwork....laptops are coming.

    Appreciate all your tips & tricks w/ my new career!
  9. by   eileenis1
    Question:

    Are you ladies required to continue visits at the homes of couples who have flees bouncing off their dogs regardless of all efforts from various agencies to remediate this problem?

    How about homes infested with cockroaches?

    I feel like vomitting when I have to go into homes like these.

    Thanks,

    Eileen
  10. by   nurse5448
    Laptops don't always make the job easier. The company I worked for required the same paperwork along with the work done on a laptop. This wasn't transitional and temporary, it was what they really wanted. In the end, I worked more hours and got paid less than I would elsewhere.

    I have been required to go into smokers' homes which about killed me. I have had verbally abusive patients and family members who were not only abusive but interferred with patient care. I have been sent out expected to ambulate (yes as a nurse) people who would have been no less than a two person assist in any hospital. Yes, I let my supervisors know? Yes. I also documented it and stated that the patient is and unsafe transfer for just one person. Did it do any good? NO. For my health and safety I left this particular company.

    The pay and compensation was also lacking. My cell phone bill went up and I wasn't reimrused, mileage was poorly reimbursed, the hours were long, sometimes into the wee hours of the morning just on paperwork. We often had 8 to 9 visits a day covering about 100 miles. I just got burnt out as did a lot of nurses in that place.
  11. by   Nannieme
    Hi Ladies;
    I'm starting back into HH Monday Sept 8 and I'm nervous but feel like I'm going home. I have a wide background in nursing from med-surg to hospice, nephrology, nursing home, mds, prison, and even 2 yrs in HH. I moved and had to quit. I'm told my company uses very little paper, just a lap top and we are paid per visit. Is the paid per visit common? They want 5 visits a day to maintain "production". I've heard this is a good company, I sure hope so. I'm doing everything I can think of to get ready. Any advice? I'm not a kid anymore and I want to stop and stay.
  12. by   AnnemRN
    Quote from Nannieme
    Hi Ladies;
    I'm starting back into HH Monday Sept 8 and I'm nervous but feel like I'm going home. I have a wide background in nursing from med-surg to hospice, nephrology, nursing home, mds, prison, and even 2 yrs in HH. I moved and had to quit. I'm told my company uses very little paper, just a lap top and we are paid per visit. Is the paid per visit common? They want 5 visits a day to maintain "production". I've heard this is a good company, I sure hope so. I'm doing everything I can think of to get ready. Any advice? I'm not a kid anymore and I want to stop and stay.
    Personally, I like being paid per hour vs per visit. If the visit is unusually long then, the compensation isn't very good if you're paid per visit. I think 5 visits per day is pretty standard. Hopefully, your company uses a good laptop program that is user friendly. I'm sure you'll do great - good luck!
  13. by   Meems
    Quote from Nannieme
    Hi Ladies;
    I'm starting back into HH Monday Sept 8 and I'm nervous but feel like I'm going home. I have a wide background in nursing from med-surg to hospice, nephrology, nursing home, mds, prison, and even 2 yrs in HH. I moved and had to quit. I'm told my company uses very little paper, just a lap top and we are paid per visit. Is the paid per visit common? They want 5 visits a day to maintain "production". I've heard this is a good company, I sure hope so. I'm doing everything I can think of to get ready. Any advice? I'm not a kid anymore and I want to stop and stay.
    I know the RNs @ the HH agency I work for are expected to have 25 visits or more per week if they work full time. Admits count for 2 visits, recerts are 1.5 visits. We have not done PPV for nursing due to a RN union, but are anticipating moving to that after the contract is up. PT,OT,ST,(and their assistants) went PPV about 3 months ago. Our company touts a"paperless system" but the software does not let us view the last notes so paper is needed. Advice: Give yourself time to adjust, and stay ORGANIZED.

    I am a LPN, and see about 6 patients on an avg day, but have seen as many as 8(our productivity is to be between 25-30 visits per week). All said, I love my job, and the company I work for is pretty good. But I am going back for my RN after 13 years

    Gotta have that RN, and probably go on for my BSN as well. Good Luck to you in your new job!

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