considering home health visits, input needed please

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Hello. I started as an LPN working in pediatric home health. While the flexibility and decreased presence of sipervisors was great, I found myself bored and unchallenged sitting in other peoples homes for ten to 12 hours at a time with patients who, the majority of which, were unable to communicate.even worse, it was horrible to lose money when I lost shifts to patients being in the hospital or families cancelling nursing for the day. upon becomming an RN I acquired a position in dialysis. The upside is I never work Sundays and at my clinic, never Saturdays. Also I only do three days a week...three long days, but I hate 5 day work Weeks. However its extremely stressful, overwhelming and the techs (cna's) that also care for my patients have a lot more autonomy than your typical CNA which is a concern. And worst of all is all the policies, direct supervision, and being couped up in one place for 12 to 15hrs. So ive been thinking of home health visits but im not very familiar with how the scheduling is, how much autonomy a visit nurse has, and Ive gained a little insigt on reimbursement. Any input? Im torn between the three days a week I really love vs. consistent hrs and the liberty to go from place to placenot feeling trapped for hrs. Thanks for your input!

Home health definitely has it's perks as far as flexibility. You can scheduled your patients whenever you want for the most part. If you have an admission or a resumption to do, you'll likely have a date given to you that it must be done on, but otherwise, you and your patients will arrange the times. If you're looking to do full-time, you're probably going to have to work five days a week unless you have patients that don't mind being seen late in the day. And, even if you do only see patients 3 days a week, keep in mind that if you have labs come back on a day you're not seeing patients, you're still responsible for making sure the labs were received by the MD and you got new orders. I tell everyone that even when I'm "not working"... I'm still working! Home health is basically a 24/7 kind of job. I have patients call me anytime they need anything, but most agencies don't require you give out your cell number if you don't want to. I just find it's easier then having them call the office and then the office calling me to call the patient back. There is minimal supervision in the field. We're supposed to have quarterly supervisory visits by the DON, but that rarely happens. You're pretty much left to do your thing unless there's a problem... Salary is going to vary quite a bit depending where you're located. I'm in Chicago, so we make a decent wage here. Typically per diem is $50 - $90 a visit depending on what you're doing. Some agencies reimburse some of your mileage and others don't reimburse at all. Some will give you a phone and others will pay part of your cell phone bill each month. To give you an idea of what to look for or ask about... for my full time job my benefits are: base $73,000 annually.... on call is $50 a day (so $100 a weekend). If I see a patient while I'm on call, a regular visit is $50 and an admission is $70. My full time status is 25 patients a week, up to 5 of which can be OASIS visits. If I have over 25 visits, additional regular visits are $50 and extra OASIS visits are $100 extra each. They pay $250 a month flat for mileage. They also pay $50 a month towards my cell phone bill. I have two weeks paid vacation a year, two personal days, five sick days, and my birthday paid off each year. Be sure to ask lots of questions when you get hired, because things like a $5 difference between per diem visits doesn't sound like much, but it adds up! Good luck!

I've never done anything but home health. it's challenging, stressful at times but you work independently. You are responsible for your own schedule. Nobody looks over your shoulder to make sure you are doing your job. You have to be responsible for your listed patients on any given day and schedule at your convenience/their convenience. I love making my own schedule. If I have time between patients I can catch the garage sale down the street. I can run to the store. I can shop. I make my own schedule. On the down side you have to be oncall. The worst part of home health. No way around it!!!! You work your regular schedule and on your rotation you take call. Weekend, night time anytime you can be called out to change that catheter, start that infusion, wound vac suction is messed up, start of cares for hospital discharges, resumption of cares for already signed up patients hospitalized. Whatever...be prepared for the unexpected then be prepared to work your regular shift/patients. It's better money than about anything though!!!! Every job has it's pros and cons. Depending on the company you may be doing your computer charting at home catching up. It's better money though...did I already say that??? go to the doctor, finish early one day...lots of flexibility in your schedule. Just know you ony get paid for what you do. Gotta be a go getter in home health. Wanna make money?? Be prepared to work!!!

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