Calling all HH Nurses, roll call - page 39

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   lcc1080
    I've worked for more than one agency that has told me that I would be "so busy" with per diem visits once hired, only to have the same thing happen. But then when you take work on a p.t or f.t basis they really load you down with visits. Many RNs at my current hha complain about doing visits 11-12 hrs, when being paid only for 8 hrs, and also doing paperwork on the weekends, and late at night (without pay).
  2. by   lcc1080
    Also, I meant to mention that when working as a per diem in the past, I noticed that agencies would give me visits that were time consuming, or ones that required opening/oasis, and then discharge in 2 visits. I did not really have the experience with being passed the cases in dangerous areas as much.
  3. by   cwood88
    Hi everyone...I have been in hh for 5 years and I really love it, everything but the paperwork that is. And the director and clinical manager I work for could not begin to do the job that us field nurses do or put up with mess at times that we have to put up with. I wonder where they get these people anyway wow!!!! I love the rapport I have with my patients and family and it is very rewarding work. But it is true, I am one of those people who is salaried for 8 hrs day and work 12 a day and it really sucks. And then in recent weeks I have had 8 soc in 5 days and when the clinical manager said I haven't turned my paperwork in I told her how much she had given me and she said well that's the way it is sometimes WHATEVER!!! So now I have committed myself to only doing paperwork after 5pm 2 days a week. and btw we have 4 rn's and 1 lpn who work for our agency and only 1 of those nurses had 1 soc all week and the others had none, so how fair is that. I say take them out of their positions and put someone who has worked in the field before in that position, someone who actually knows how difficult it can be.
  4. by   lamazeteacher
    cwood88:

    Please be fair to the nurses with whom you work in your agency and all of us out here, and insist that your agency follow labor laws, which are quite specific about 40 hour weeks, overttime, breaks, etc.

    You're right about those iun the office being obtuse about the time it takes for paperwork. At this popinmt, it would be appropriate to tell the clinical Director and manager that you must be paid for doing paperwork (and get the other 3 nurses to back you up. They may already have set their boundaries regarding that, which may be why you're getting all the SOCs....... Being proactive inspires respect, and we HH nurses have been letting these agencies literally and figuratively get away with murder too long!

    I know that sticking one's neck out is extremely risky, but it's the only way you can save yourself and your colleagues. Look at the other HH thread called, "home health nursing - working all the time. HH agencies are profit making enterprises that consistently ignore labor laws, as nurses in the field aren't observed all the time, as those in facilities are. There is software for OASIS, but most agencies say its too expensive (sure, as long as nurses will work without poay to get it done.

    Remember that your agency needs you, more than you need them. They have contracts with insurance companies, other agencies, etc. to get the referred work done; and if you don't do it, who will?
  5. by   cwood88
    Quote from lamazeteacher
    cwood88:

    Please be fair to the nurses with whom you work in your agency and all of us out here, and insist that your agency follow labor laws, which are quite specific about 40 hour weeks, overttime, breaks, etc.

    You're right about those iun the office being obtuse about the time it takes for paperwork. At this popinmt, it would be appropriate to tell the clinical Director and manager that you must be paid for doing paperwork (and get the other 3 nurses to back you up. They may already have set their boundaries regarding that, which may be why you're getting all the SOCs....... Being proactive inspires respect, and we HH nurses have been letting these agencies literally and figuratively get away with murder too long!

    I know that sticking one's neck out is extremely risky, but it's the only way you can save yourself and your colleagues. Look at the other HH thread called, "home health nursing - working all the time. HH agencies are profit making enterprises that consistently ignore labor laws, as nurses in the field aren't observed all the time, as those in facilities are. There is software for OASIS, but most agencies say its too expensive (sure, as long as nurses will work without poay to get it done.

    Remember that your agency needs you, more than you need them. They have contracts with insurance companies, other agencies, etc. to get the referred work done; and if you don't do it, who will?
    You know you are right and I have stepped up and addressed the issue of working so much even above and beyond what I'm paid for and I get told that I am salaried and I have to do it. And we do have a oasis program but ours is not what they thought it was, with what we got we still have to fill out the paper oasis as well as the computer one, I refused to do it along with the other nurses so none of us use the computer version now. I am the bold one of all the other nurses and they will agree with me on stuff then back peddle first chance they get and they have been here longer than me. it ridiculous!!! when I have or one of the other nurses in particular approached the director about being paid for paperwork they tell us too that we are salaried and its part of the job however, she and I consistently see 6 pts a day and drive over 100 miles a day so when is there time and they just don't care.:angryfire
  6. by   lamazeteacher
    Quote from cwood88
    you know you are right and i have stepped up and addressed the issue of working so much even above and beyond what i'm paid for and i get told that i am salaried and i have to do it.

    there are labor laws prohibiting workers from being told that they must work more than 40 hours / week, without additional (punitive) compensation being given. a call to the board of labor in your state should promote an investigation of labor practices there.

    it would be best to do that soon, when you have the support (although it's been waffled) of the other nurses with whom you work. if you and they become polarized, it will seem as if you're the only unsatisfied employee there. having worked there longer, they've put up with unfair labor practices longer, and may be more wed to that situation.

    and we do have a oasis program but ours is not what they thought it was, with what we got we still have to fill out the paper oasis as well as the computer one, i refused to do it along with the other nurses so none of us use the computer version now.

    initially computer programs for oasis were less user friendly, and their product isn't required by the federal government (as is the written one). so agencies have taken the road of least resistence, as yours has. it's my hope that the drive for going paperless will pave the way for the software program to be made by those who require it; and that the smaller notebook will accompany nurses into the home, where they can complete the oasis with their assessment and not have to manually repeat the pages' headings,and other repetitive stuff.

    i am the bold one of all the other nurses and they will agree with me on stuff then back peddle first chance they get and they have been here longer than me. it ridiculous!!! when i have or one of the other nurses in particular approached the director about being paid for paperwork they tell us too that we are salaried and its part of the job however, she and i consistently see 6 pts a day and drive over 100 miles a day so when is there time and they just don't care.:angryfire
    that's when the job descriptioin you were given at hire comes in handy....... i'm sure that it doesn't state that records are done gratis!
  7. by   LuLu2008
    Quote from lamazeteacher
    that's when the job descriptioin you were given at hire comes in handy....... i'm sure that it doesn't state that records are done gratis!

    just so we are all clear on our discussion--what paperwork/records are hh nurses thinking should be reimbursable? it was my understanding that whatever paperwork related to the patients i care for (e.g. faxes to doctors, writing discharge summaries, spending time revising medication lists, contacting and documenting communication with therapists and hha's) is considered part and parcel of my pay. in my agency, we are paid per patient encounter. if that encounter generates paperwork it is considered part of the visit. any guidance i should know about here?
    Last edit by LuLu2008 on Dec 7, '09 : Reason: clarity
  8. by   lamazeteacher
    Quote from lulu2008
    just so we are all clear on our discussion--what paperwork/records are hh nurses thinking should be reimbursable? it was my understanding that whatever paperwork related to the patients i care for (e.g. faxes to doctors, writing discharge summaries, spending time revising medication lists, contacting and documenting communication with therapists and hha's) is considered part and parcel of my pay. in my agency, we are paid per patient encounter. if that encounter generates paperwork it is considered part of the visit. any guidance i should know about here?
    you're right! all documentation resulting from home visits (hvs) needs to be considered part of the hv, and nurses' time doing that requires compensation. any referrals and office work required to accomplish that, including telephone calls, faxes, etc. are included.

    you may contact the federal department of labor at dol.gov/compliance/topics/wages-other-breaks.htm
    there are guidelines there, and all the laws affecting all the states are there.

    congratulations on working for one of the only agencies that compensates their employees appropriately. :spin:

  9. by   LuLu2008
    Quote from lamazeteacher
    you're right! all documentation resulting from home visits (hvs) needs to be considered part of the hv, and nurses' time doing that requires compensation. any referrals and office work required to accomplish that, including telephone calls, faxes, etc. are included.

    you may contact the federal department of labor at dol.gov/compliance/topics/wages-other-breaks.htm
    there are guidelines there, and all the laws affecting all the states are there.

    congratulations on working for one of the only agencies that compensates their employees appropriately. :spin:
    sorry, i think i was unclear. my agency pays only for the patient encounter. if i do additional documentation this is not compensated separately. i don't know (1) if i will be laughed out of town for asking for $ to do this documentation for my clients and to provide appropriate nursing care or (2) if i will be fired for insubordination or (3) be the subject of office gossip for having a "pushy" attitude. i would love to know how other agencies compensate for this sort of documentation, and thus be able to make a case for being underpaid. but then again, even if i am underpaid, there are no real nursing jobs in our town so they can thumb their nose goodbye at me.
  10. by   lamazeteacher
    Quote from lulu2008
    sorry, i think i was unclear. my agency pays only for the patient encounter. if i do additional documentation this is not compensated separately. i don't know (1) if i will be laughed out of town for asking for $ to do this documentation for my clients and to provide appropriate nursing care or
    most hh nurses agree that hvs + documentation needs to be compensated together, not separately; and have the same misgivings you have listed below.

    (2) if i will be fired for insubordination or possibly, ask around to see if anyone had raised the question before, as long as you know whoever you ask, well enough to trust that your inquiry will be held confidentially.

    (3) be the subject of office gossip for having a "pushy" attitude. i would love to know how other agencies compensate for this sort of documentation, and thus be able to make a case for being underpaid. but then again, even if i am underpaid, there are no real nursing jobs in our town so they can thumb their nose goodbye at me.
    (3) only non nurses who don't get how long we work on extremely time consuming paperwork would do/think that, or if they had another nurse who tried to be fairly compensated.

    you need to get in touch with the new national nurses' union for assistance. this "slave" labor situation has gone
    on far too long, and should not be tolerated! you need support to do it, though. go to the thread about this new union, which is listed above, on the right, under "news".

    best wishes for your success getting your agency to adhere to the fair labor laws!
  11. by   LuLu2008
    Sorry, didn't see a link above entitled NEWS.
  12. by   MBARN
    Hi, I am a new nurse just off of orientation for the last few months working in a step down unit, a cross between med surg and icu. I am going to start to work as a HH nurse for children parttime. My question is, if I decide to go full time and not work in a hospital anymore will that hurt my chances for getting into a FNP program in the next 2 years? I was thinking of doing home health for children and then med sur for adults for the experience. I want to have a bit slower pace so that I can learn better and more efficiently and give patients the time and attention they deserve. Any info would be appreciated, I am very new to nursing and to HH.
  13. by   lamazeteacher
    Quote from lulu2008
    sorry, didn't see a link above entitled news.
    hi!

    it was hard to find, as the news had changed........ but here's what i think i wanted to share with you:

    news release
    whd news release: [11/19/2009]
    contact name: dolline hatchett or joseph de wolk
    phone number: (202) 693-4651 or x4681
    release number: 09-1452-nat

    statement by us secretary of labor hilda l. solis on wage and hour division's increased enforcement and outreach efforts

    washington-u.s. secretary of labor hilda l. solis today issued the following statement regarding the increased enforcement and outreach efforts of the department's wage and hour division:
    "there is no excuse for employers who disregard federal labor standards - especially those that are designed to protect the most vulnerable in the workplace. the failure to comply with these basic labor standards means that workers are not receiving the money they have earned. it is both an economic issue and a fairness issue. america's workers should rest assured that protecting worker rights is a top priority at the department of labor. to make good on that promise, i have hired an additional 250 new wage and hour investigators, a staff increase of more than one third, to ensure that we promptly respond to complaints and can undertake more targeted enforcement.
    "in the past three months alone, the department has had several significant enforcement cases, including collecting nearly $2 million in back wages for more than 500 workers.
    "in early 2010, the department will launch a national public awareness campaign titled "we can help" to inform workers about their rights. the department will work closely with advocacy groups and other stakeholders to ensure that the materials developed for the campaign reach the workers who need them. we will not rest until the law is followed by every employer, and each worker is treated and compensated fairly."

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