charting!!!! I am about to leave home health...

SeaH20RN, BSN · Nov 22, 2016

Your right! It IS the best job in the world but you do so much paperwork, your only making $5.00 hr. at the end of the day. I tried everything, taking paper work home to work on after dinner and get up earlier in the morning 5am to finish. It comes down to the workload / visits your company gives you per day and the miles you drive. You cant drive 100 miles a day and expect to see 4 return / routine visits, Admission and ROC and get home by dark. We had paper and laptops with McKesson and I worked for multiple companies, but still worked on my day off. It was a 24/7 job. and went I was off, no one would see my pt. uhh! I loved the pts but it was too much. After 4yrs I went back to the hospital and love my days off. Try working in a wound care clinic if you dont want to go back to the hospital. Good Luck.

Beldar_the_Cenobite, CNA · Nov 22, 2016

I'm currently in CNA school and we went to do clinical and we learned how to chart, specifically at the facility. Our instructor, who is a nurse, wanted us to not constantly remember how to do THEIR charting the way they do it but to chart the old school way on paper the way they used to do it. Their way is by Ipod touch with their own custom design system. If the system goes down, they switch to the paper way. The nursing station also uses digital form of charting. They used to have a bunch of papers EVERYWHERE posted on the cabinets but now they switched to digital.

If your charting is digital, at least it's digital where you can go back and correct an error and not have to worry about papers. The CNAs I got to shadow carry theirs everywhere patient they care for just in a little pocket sized device. I don't know what the nurses had and I didn't get to shadow them, nor did I need to but just a food for thought, that's what the facility I got to check out does.

I forgot who told me but at the facility, someone said that some clinics or hospitals or where ever there are RNs, the RNs take home their charts to do their charting. I kinda thought it was BS at first because we were told that leaving a paper chart on the floor with patients name and room number is a HIPPA violation so I kinda thought the same when it came to an RN bringing home charts to complete. Then again, if it's digital and the screen can lock, then it's not a HIPPA violation because no one can access the record. Who knows, you might have kids or nosey husband or wife who might take a picture of your screen while you're doing the charting or when you don't know it and might post it or send it to someone and get you in trouble. Unless the facility screens you for anyone in your household to gauge if trusting you with patient records is safe or not.

allnurses Guide · Nov 22, 2016

I left home health about nine months ago and haven't looked back.

I have returned to hospital work and am actually enjoying it; never

thought that I would. I work in a small community hospital for a

wonderful company, and I think that makes all the difference.

Anyway though... the charting in HH is brutal. My company went

from all paper charting, to computer charting, back in November of

last year. Some of us thought that going to the computer would make

things easier, but really it did not.

I will never ever go back to HH, except maybe PRN. A couple of visits

a week, maybe.

allnurses Guide · Nov 22, 2016

. . .If the system goes down, they switch to the paper way. . ..

The system our hospital uses (not the hospice system which is different) went down a couple of months ago for over two weeks. We used paper charting. We didn't have to go back in and chart on the computer for those two weeks but medical records had to scan everything in and they had to go back and charge for everything used on the patient. That took forever.

We keep a paper chart of all our patient contacts . . . just in case. So, we double chart.

Again, looking forward to retiring.

oceanblue52 · Nov 24, 2016

I'm a newish grad in home health (4 months) and the questions are a beast for sure. I have gotten my main OASIS for a new admit in the home down to about 90 minutes for all the main questions and the med reconciliation. I look a lot at how they are talking and move from the bottom up of question options to make sure I am capturing their needs. I think you can assess a lot about the patient by just talking with them and interjecting questions, and then if they are able get them up to the bathroom (ask them to show you) which allows you to pretty quickly assess safety measures...the written summary is time consuming but if you keep a *general* template that can help...important to be specific with verbiage though as state audits do not care for copy/paste í ½í¸¬ Do you use a computer? Track pads suck and an external mouse can also make things more expediant. Wish I had more advice, I love parts of this field but it's pretty daunting for a new grad.

mpathg747 · Nov 28, 2016

We use Kinnser and it is a real nightmare. Slow, crashes, always unavailable, so charting is always delayed. Everyone is complaining. Do you have one I can recommend?

mpathg747 · Nov 28, 2016

Many of you mention charting at the patient's home. I'm curious to know how many of you are provided with a device by your HHA. What is the norm? My agency does not supply laptops, tablets, or any other device to do charting. I do not like taking my home laptop out for security reasons.

Haddoa · Nov 29, 2016

Many of you mention charting at the patient's home. I'm curious to know how many of you are provided with a device by your HHA. What is the norm? My agency does not supply laptops, tablets, or any other device to do charting. I do not like taking my home laptop out for security reasons.

Ours supplies a tablet we use homecare homebase.

msteeleart · Nov 30, 2016

I feel the same way you do. We even had a pay cut and our documentation requirements have increased. I will be working in home health for 2 years in March and it just gets worse and worse. No raises ever. I try to do my charting in the car after the visit but I just don't have the time to do it all. I am thinking of going to the hospital and working in the ER, I hate working holidays and weekends but at least when I work in the hospital I have 4 days off and when I am off I am off and don't have a work phone that I have to answer. I have had enough. When I first started doing home health the paychecks were great but now they are basically the same as a hospital.

HHNursing · Apr 26, 2023

Nori.Giselle said:

What charting system are you using? Maybe you need to find a company with a better system. I've worked home health and there are some really great systems where I usually finish charting before I leave and there are some really sucky systems...

What kind of systems are good for charting?

Peachpit · May 27, 2023

Exactly why I, along with a lot of other nurses, leave home health. The points/productivity on top of the Oasis has changed HH a lot and not for the better. While SOME nurses can knock out a visit/SOC/ROC in less than 2 hours MOST nurse that I have worked with, even the most seasoned ones can't because of the patient case load. In my humble opinion, HH is best suited for nurses who are OASIS super stars or are able to work PRN/part time but for me, that pay balanced with the time outside of the work day was absolutely not worth it.

Vonda Soileau, LPN · Jul 6, 2023

Libby1987 said:

You should be able to chart at point of service and not be charting into the night. Is the issue really that too many visits are expected and/or the drive time is excessive?

Also, one year is not enough to become optimally efficient.

Have you ever done Home Health? If you have labs, wound care, or any other issues like having to call MD or get orders ? There is no way to get charting done at point of service. Especially not when you have 7-9 patients a day.