HH Administrator Seeking Feedback About Productivity

Have these nurses ever worked for another home health agency before? Are they new grads? 'Cause frankly, I agree with Caliotter--they're spoiled.

Where are you? Can *I* come work for you? I'm putting an average of 75 miles on my car per day, no reimbursement for mileage because it's all "in town" (in the largest metro area in the country), and everything except gloves and lab supplies comes out of my own pocket. I even had to buy a pill planner box for one patient! Send your nurses to this forum, let them see how good they've got it.

You could easily find replacements for your spoiled workforce from members of this site. We would be grateful to work for such a good employer. I know I would.

i agree, sounds great to me!!!! where are you located!!!???? i travel, on average 100 miles/day and see 8-10 pts. , we do our own soc's etc, can only give to PRN nurse the easy visits, no oasis pts.,,,so your nurses do have it good.!!!!

Have you conducted exit interviews with the nurses who've left? I can understand why hospital nurses might go back to the hospital. HH can get lonely for those who are used to the cameraderie of the hospital and the adrenaline rush from an emergency. But I'm at a loss why a seasoned HH nurse would cut bait from such a sweet (to us, anyway) deal. Personality conflicts? A bad office manager or scheduler? Another long-term nurse with issues? For seasoned HH nurses to go to other agencies for lower pay and fewer benefits, that's a huge red flag and sounds like you might want to investigate with those nurses. Let them know that you're trying to make things better and improve staff retention, that their answers are absolutely confidential and they won't be penalized at all. Or even hire an outside firm to conduct the interviews for the sake of confidentiality. I think there's more to it than what we're reading here.

Based on the bolded statement only, I would suggest that you look into your own communcation style. You may be coming across in a way that you don't intend. Also because of this, I would suggest an independent firm conduct your exit interviews, maintaining the confidentiality of the former employees. Nurses may have a hard time telling you that *you* are the issue. Are you friendly and approachable or do the nurses sit across the desk from you when they come to your office to speak with you? Do you take time to chat with the nurses or do they only come to you when there's an issue? As I said before, if you have seasoned HH nurses leaving your agency for what appear to be poorer working conditions, there's probably a good reason.

Another possible move for you, just off the top of my head. Consult with the nurses that you still have. Any of them long-timers? Ask *them* what's working, what's not, and what could be tweaked. The more invested your nurses are with the daily operations, the more satisfaction they'll have. Are they micromanaged? Do they have freedom and flexibility within their assignments? Are they able to take a mental-health day if they need one? Is there good communication between the nurses and the higher-ups (including you)? Is there good communication between the nurses themselves?

I would look at the "working too long" statement. Sometimes four visits is a lot, considering the driving time and the type of visit. If I have to drive 75 miles between each patient, have an hour-and-a-half long visit for each one, that's a twelve hour day. Too much. (And I've done that, sadly.) Add in that one of them may be a SOC, and it's too much.

Consider the loneliness factor, also. You say they're only required to come into the office two days a week. That may put an unreasonable amount of distance between field and office staff. Technically, I only have to go to my office to turn in OASIS admits within 48 hours, and have my regular notes turned in by 3pm on the pay-period cut off. Theoretically, I could only show up once a week if I wanted to. But I want to get face-time with the staff in my office, my Nursing Director, the clinic nurse (we do infusion therapy), the pharmacist, the office manager, the receptionist (especially!), other nurses, etc. There's always something going on with the office staff--they frequently order out for lunch, get cakes for birthdays, have pot-lucks, etc. The loneliness factor cannot be underestimated for field staff, especially when you're working in rural areas (I did HH in rural MO many years ago). Anyway, that distance may be contributing to a wider gap between office and field staff than there needs to be and can lead to a feeling of underappreciation for some nurses.

Those are some ideas off the top of my head. Off to take DH out for Father's Day brunch.