Got Fired today

[nursynurseRN]

Hey guys, just wondering your opinions. I work Per Diem Home Health, today my boss informaed me I was fired because I made a short visit less than 20 minutes and the patient complained. So it was a follow up visit and we went over everthing I had to do, mostly with the caregiver. Aside from the fact the caregiver was extrememly rude to me and made it obvious she didn't want me there, I did my assessment, updated my meds, and taught them side effect of meds ect... So anyway, my boss said that the CG complained about my visit being short and that I showed up early to her house. Long story short, I have never got written up and I feel it was unfair. I am new to home health and thier policies but I think she could have talked to me about making a short visit before just firing me on the spot. thoughts?

[SuesquatchRN, BSN, RN]

Medicare does not reimburse for a visit

[paradiseboundRN]

Home healths nursing is really screwed up right now! Its all about profits! No, they shouldn't have fired you. I've made plenty of short visits when I've run out of things to teach about. But you have to document that you were there at least 30 minutes per medicare rules. I always end my visits with "Do you have any questions?" or "Is there anything else I can do for you", "Did we cover everything?" You don't want the patient to feel like your rushing or will they may complain. Are you sure that's the REAL reason that you got fired? Often times it has to do with documentation or not working weekends or something else but the company waits until someone complains and uses that excuse. In general, the companies do not like per Diem nurses because they can't abuse them like they can the full time salary nurses. We have the opposite problem in Metro Detroit. There is a shortage of home care nurses so terrible nurses NEVER get fired. Unless you're stealing drugs, you've good! Shrug if off. You probably won't have a problem finding another job in home health. Good Luck!

[nursynurseRN]

I guess you are right. I was usually late with my documentation, but why didn't she just say that? I mean I would have understood that more.

[iluvivt, BSN, RN]

That is real overkill in my opinion. They should have just reviewed with you the proper time guidelines an any other things that they they thought you may need improvement on. You could make an action plan with that employee and let them make the improvements and then reevaluate how they are doing. You could have stretched the visit to 30 min just by going on about the medications and side effects and doing a complete assessment and even doing a bit of charting in the home even though it may have been a bit uncomfortable as long as you did not fear for your safety.

But in terms of axing you for that.....someone is on a power trip. I cannot stand any manager that does not an IQ high enough to properly evaluate the situation and look at all sides of the story and situation. patients and families ARE NOT always right and can be very demanding and disrespectful to nurses and other health care providers and with this growing trend THEY think that they are always right . WE have all the responsibility but no power often to handle the situation less we will upset a patient or family even when we are correct. I have gotten to the point that I explain the situation ,meds,how to do things properly and document. They are adults..they either will do it or not...it is on them once I do my job....I do not coddle patient of sound mind,,no more of that crap.

You will be OK.They cannot take from you what you have worked for..you own that and you will take that and find a place that appreciates what you have to offer..then always do your best and make certain you follow every policy and always document very well...I cannot tell you how many times my documentation told the real story and save my behind!

[CrunchRN, ADN, RN]

No warning or anything? Doesn't seem right to me.

[cocot]

Is this an agency or hospital? Home care is full of angry and disturbed patients (and family). She should have spoken to you first. You must be in an area that is saturated with home care nurses. Where I live its hard to find and keep a HH nurse.

[tewdles, RN]

As said before...brush it off, seriously, you do not want to work for an agency that operates that way.

[RN40years]

"But you have to document that you were there at least 30 minutes per medicare rules" Sorry, you are wrong . There is NO Medicare regulation that states a visit must be 30 minutes long. I have been a State Surveyor for Medicare Home Health and Hospice.

[lovingtheunloved, ASN, RN]

I make short visits all the time. A daily wound care patient that you've had for 6 months, that you've taught everything, you're just there to do the wound care, is like a 20 minute visit. In almost 2 years I've never had an issue with short visits.

[paradiseboundRN]

"But you have to document that you were there at least 30 minutes per medicare rules" Sorry, you are wrong . There is NO Medicare regulation that states a visit must be 30 minutes long. I have been a State Surveyor for Medicare Home Health and Hospice.

Wow, I didn't know that. Thanks for the info. I've heard that so much that I assumed it to be true. I recently found out there is no such thing as a "medicare week" either. Please continue to share your knowledge!