Calling all HH Nurses, roll call - page 41

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   meluhn
    Mijourney, I like what you said about HC being a spiritual experience. I feel the same way, I am new to HH and loving it. Although the pay is way lower than the hospital, I am finding it so much more rewarding. There is something about visiting pts in their homes that makes you see them as human so much more so than in the hospital. Combine that with the fact that you are not giving meds out to 6-7 other pts and running around like a chicken without a head, and it makes for a very nice nursing experience. I am finding myself really attached to and caring about my pts, not that I dont in the hospital setting, its just that now I have time to. Dont get me wrong, it is challenging, just in a different way. I can definitly see myself staying in HC for a while.
  2. by   lamazeteacher
    Quote from RyanSofie
    I willl be attending an inservice realllllly soon about Oasis C. The duplicity in documentation is what makes it so difficult. The agency I work with does not use a laptop software program for Oasis. I would venture a guess that with the healthcare reform happening in Washington the paper trail is going to increase with Oasis/Medicare and other insurance requirements.
    Why do you think the paperwork will increase? Those who have been appointed to the HHS department are interested in bringing more and better care to patinets' homes and diminish readmissions. Writing too much, too repetatively interferes with that goal. I think you'll see very positive things happening.

    It was the old guard that brought such useless documentation to HH agencies, who practically said, "Thank You". I believe the monitoring that will come about will be more oriented to discussion, rather than blanket acceptance no matter what is handed down. They'll be more interested in outcomes, than information confirming the need for HH care.
  3. by   Willow Moonsidhe
    Congratz on being moderator! I am a HH nurse in East TN. Not been doing it long. I have been a RN 25 years and worked mostly: Trauma, L&D, Psych, and ICU. Nice to meet you!

    ~Willow
  4. by   RyanSofie
    Quote from lamazeteacher
    Why do you think the paperwork will increase? Those who have been appointed to the HHS department are interested in bringing more and better care to patinets' homes and diminish readmissions. Writing too much, too repetatively interferes with that goal. I think you'll see very positive things happening.

    It was the old guard that brought such useless documentation to HH agencies, who practically said, "Thank You". I believe the monitoring that will come about will be more oriented to discussion, rather than blanket acceptance no matter what is handed down. They'll be more interested in outcomes, than information confirming the need for HH care.
    Since my post about Oasis C I have been doing quite well with it. I have found it is not as difficult as I assumed. Your correct the focus is on outcomes and teaching in HH. For myself ,I find empowering patients and families to take charge of their health is very rewarding. Patients see their progress in HH. I ask what their goals are at SOC and we work towards them together. It is nice to develop a care plan and see it to the goals patients and families set. I also interface with the discharge planners when my patients must be hospitalized and give the planner my assessment of the patient's needs . At times in HH the enviornment in the home may be unsafe or the patient may not have adequate support and resources as HH case managers we can assist with an MSW to put resources in place that will enable a patient to remain safely at home vs LTC. It is rewarding to see progress I normally would not see in acute care.
  5. by   CFitzRN
    Hello - I am an RN for 2 years, started out on L&D at hospital. Didn't love the hospital setting I have to say. But was learning the ropes pretty well. Went to nights and it all fell apart (couldn't sleep during the day). Left the hospital, started as a post-anesthesia nurse on the endo unit of a gastro practice and worked prn in family medicine. After more than a year of those things, I wasn't really sure what I was going to do with my life when I saw an acquaintance at a middle school orientation for our kids. She was in the car next to me when I parked. Stuck my head in and said hi. She looked harried so I asked what the problem was. She told me to get into her car (we had time before the orientation). I noticed she had mileage sheets and sup visit notes everywhere. She said she was trying to do 2 jobs and it was killing her. She explained that she is the ED of a local HHC agency but had lost her Clinical Sup several weeks earlier. So she was doing the ED job (huge job) AND the Cl. Sup job. Out of curiosity I asked what the clinical sup did. She explained the job to me and I knew it was MY job. I didn't say so though. Then she said "hey, you're an RN aren't you?" I said yes. She asked if I was looking for a job. I said "not really" but I would be interested in the terms. Long, long story short, she offered me the job on the spot and since it was exactly up my alley and paid quite a bit more than I was making, I took it.

    I didn't know this at the time, but I am a born supervisor. I don't say this because I think I'm better or superior either, really. It is just absolutely perfect for me. The job fell into my lap (I believe everything happens for a reason) and I have fallen into the job. I have HUGE frustrations with the patients that I know are totally abusing the system and living as human parasites on society, but thankfully those people are the exception and not the rule, so I am finding a balance and the ability to compartmentalize and refusing to allow myself to become jaded by those patients. I am the supervisor over all of our CNA cases. We also have skilled nursing cases but our DOPS is supervisor over those, and I have to say, that is A-OK with me! I do Sup visits and case management and just about anything else that comes up (my specialty is putting out fires wherever they flare up!) and I am really loving it. Today I did a job fair and was networking with the local schools and hospice and got to know people from the other local home health agencies, which was nice. I am of the mindset that we are all in this together and we should all support one another with mutual respect and kindness.

    I need a smaller, more fuel-efficient car, and I need a better GPS but other than those small details I am digging this job so much. Just today I was lamenting my lack of experience to my director and she said "you are so much more intelligent than I am - you will get this and probably be running this place some day." I totally disagreed with her, but it was a very nice thing to hear after 5 weeks on this job.
  6. by   lamazeteacher
    Well, congratulations on getting your job by being at the right place, at the right time. I'm a bit concerned about your lack of med-surg experience, since you were in OB most of the 2 years since you got your associate's degree.

    It would be a good idea to refresh your knowledge of med-surg, infection control regarding wound care, and expectations of nurses' aides. Whenever you can get to a conference, try to select med-surg ones, and do continuing ed online (Iris isn't bad). Best wishes for your continued success with HH.
  7. by   CFitzRN
    I've been doing tons of continuing ed (probably far more than I need) and I do tend to focus on med-surg topics for the precise reason that you mention (lack of experience there). I haven't had the opportunity to go to med-surg workshops yet but am always on the lookout for them. I have taken every class they are teaching in our office (vent-trach training etc) and plan to continue that. I am acutely aware of my lack of experience in many areas of nursing but am taking, and plan to continue taking, steps to improve my knowledge and experience. So far I have been okay and have actually schooled the others in my office on some pharm issues and disease processes. It helps that I read a lot.

    Anyway, thanks for the tips! They are always welcomed.
  8. by   lamazeteacher
    You'll always need more continuing ed, not just for CEUs, but because the face of medicine keeps changing. Think of it as clothing that protects you from the elements (protecting your license and from lawsuits), and at some times (like wintertime) you need more than others.

    This is the time you need more...... as you will whenever you change the focus of your work.
  9. by   MedSurgeMess
    I just left med surg after 7 1/2 years, and am totally new to the home health area. I'm totally excited, and think that I'll love HH. I'm glad to be out of the hospital setting, which to me doesn't promote autonomy. Hopefully, this time next year, I will still feel the same way
  10. by   jacrabbitrn
    Hello, I am new to home care and I love it. Still working the kinks out and learning something new everyday. I still work at the hospital as a casual. The Oasis and other paperwork is the worst part. Any advice or hints would be appreciated.
  11. by   RyanSofie
    HH the paperwork is all too time consuming and too much duplication of information. Being assigned one patient 45 miles east and another 60 miles north is plain insanity...especially when you must MAKE a daily productivity quota of 5-7 patients. It is not in the realm of consideration that driving 50 miles to see ONE pt and then 60 in another direction to see ONE patient then driving another 60 back back to see the remaining 5 ...is WORK. The time traveling is not considered at all. If it eats half a day then so be it...work another 8 hours to finish visits and then paperwork deep into the night. Insanity.
  12. by   sweetsugar
    That is why -- after five years in the home health industry -- I have decided to hang up my car keys. I could not keep up with that pace. I am beginning my RN to MSN this August. I did not want to go "back" to hospital nursing so my only other choice was to try to go forward. Insanity is doing the same thing over and over again.
  13. by   jacrabbitrn
    I am still learning the ropes of HH and so far it still beats the hospital, most days I dont' leave the house until 8am and am usually home by 5-6. What bugs me is the cancellations. I can't count on a certain amount of visits. I also don't have any benifits at this agency. The paperwork I can usually complete on my down time or at lunch. Today I am behind so I am up early to get a head start. One thing I don't like is I can't leave my job, I continuously feel responsible for my patients.

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