Home Health-The good, The bad, and I'm getting out. - page 4

I've been working in home health now for almost 3 years as a RN case manager in southern California. I'm posting this so those of you that are thinking about home health know what to expect and I'm basically just venting why I... Read More

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    I work in hospice and also have a love/hate relationship with it. I absolutely love love love the relationships that I build with patients and their families. This is the main thing that keeps me hanging in there. However, I do have to admit that the time requirements are difficult. I oftentimes end up working 50-60 hours a week with all the on call requirements which makes it difficult to have a life outside of work. I turn my phone off when I am off the clock. I used to answer, but I now turn it off and don't even have my work phone with me on days off or after work. I have a difficult time with the comments about wear and tear on your car being covered by mileage. I'm lucky if my mileage reimbursement covers my gas costs let alone increased frequency of maintenance on my car. It especially doesn't come close to making up for the fact that I am going to have to trade my vehicle in 2 years earlier than I had planned. That is 2 years I would have had without a car payment which is substantial. I'm still hanging in there but I have to say I don't know that I will be able to finish my career out in hospice because the time requirements are just too much.

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    I totally understand what you mean I have been doing Hospice now for 6 months. never time to yourself unless you tell them you are going out of town. I have almost decided to go back to the ICU, at least after my week is done I have my days off to myself.
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    Quote from anna hoffman
    I totally understand what you mean I have been doing Hospice now for 6 months. never time to yourself unless you tell them you are going out of town. I have almost decided to go back to the ICU, at least after my week is done I have my days off to myself.

    I've noticed a good amount of us former ICU's went hospice. I actually did apply back in my old ICU. I can only do per diem shift work. I was so sure I would get hired back, I'm still friends with everyone who works there and they are trying to pull strings for me. I may have to break out the big guns and contact a doc I know.

    My sentiments exactly, do my shifts and carry no work over until the next. Endorse to the next shift and go home and check out.

    Yup, I just finally put down the charting after doing it since I got home from work. I told my poor 5 year old I couldn't play a game with her " momma's got to work".
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    I am also a former ICU nurse that has turned to hospice nursing! I have only been working in hospice about 6 weeks so I haven't had time to fully evaluate the pros/cons. I am in a triage position and work 7 days on and 7 days off. Some disadvantages that have bothered me so far:

    1 - Why does management think they can automatically get in touch with me on my 7 days off?
    2 - No, I don't want to "pick up" this Saturday and Sunday for no extra pay. I am salaried, remember?
    3- Forced to work short because they constantly float someone to inpatient.
    4- Forced to work 24 hour shift recently with NO SLEEP due to floating.

    Love the work, might hate the policies.
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    Guess What! Original poster here. I was offered 6-8 dollars less per hour to go work at the new job in the hospital/clinic setting. Forget it!! SO I did not leave home health. It drives me crazy some days but at least I dont have to punch a clock and make less money. I am per visit and very productive in my area so I'm sticking with it. For now....
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    Quote from lsvalliant
    Guess What! Original poster here. I was offered 6-8 dollars less per hour to go work at the new job in the hospital/clinic setting. Forget it!! SO I did not leave home health. It drives me crazy some days but at least I dont have to punch a clock and make less money. I am per visit and very productive in my area so I'm sticking with it. For now....
    I Know what you mean!!! Ughhhh....that's why I second guess myself. I still make about 6-8$ more than most hospitals in the area. I would have to cope with the loss of freedom we get out and about...I'm torn between what evil is better.
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    Those of you who ventured to hospice after ICU.... May I ask what about Hospice made it more appealing to you than ICU at the time? Very curious because the company I work for just hired two nurses coming from ICU. I don't hate my job or the company/policies, I'm nervous wanting to leave for the "icu experience" and others are running from it. Would greatly appreciate a different frame of mind than mine.
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    Quote from luckyshamrock22
    Those of you who ventured to hospice after ICU.... May I ask what about Hospice made it more appealing to you than ICU at the time? Very curious because the company I work for just hired two nurses coming from ICU. I don't hate my job or the company/policies, I'm nervous wanting to leave for the "icu experience" and others are running from it. Would greatly appreciate a different frame of mind than mine.
    It is difficult to explain but I will try. It becomes an exercise in futility to keep a person alive who is never going to get better, or death is in the immediate future. It is disheartening and feels like you are a torturer at some points.

    For example, keeping a 65YO on an oscillator that has terminal advanced lung CA. Intubating 80YO ARDS pts that are not going to get better and face a sure death. Repositioning Q2HR when it obviously causes more pain than relief and you don't have enough pain meds ordered, nor are you likely to get them. Doing CPR on a frail 90 YO and YOU are the one who has to crack the pt's ribs. Explaining to loved ones and family that everyone has to die and watching them sob over beds.

    I find it much more pleasant to give patients a good quality of life until they do die a pain-free death in hospice. In other words, death in ICUs are rarely good and are mostly horrible and traumatic for all involved.
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    Quote from Hoozdo
    It is difficult to explain but I will try. It becomes an exercise in futility to keep a person alive who is never going to get better, or death is in the immediate future. It is disheartening and feels like you are a torturer at some points.

    For example, keeping a 65YO on an oscillator that has terminal advanced lung CA. Intubating 80YO ARDS pts that are not going to get better and face a sure death. Repositioning Q2HR when it obviously causes more pain than relief and you don't have enough pain meds ordered, nor are you likely to get them. Doing CPR on a frail 90 YO and YOU are the one who has to crack the pt's ribs. Explaining to loved ones and family that everyone has to die and watching them sob over beds.



    I find it much more pleasant to give patients a good quality of life until they do die a pain-free death in hospice. In other words, death in ICUs are rarely good and are mostly horrible and traumatic for all involved.

    Is is exactly why I went from ICU to hospice.
    Hoozdo likes this.
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    Thanks to both on your insight. I liked that both agreed to the same thing and that the "things" were not related to: how hard, stressful, unrealistic job demands, the long shifts, the nights, the weekends. I can see how that bothered both of you. I get aggravated when a patient begins to decline, (which is expected on hospice) and the family panics and wishes to change to "aggressive measures" and they transfer to ER. I can get through to most but the few would end up like those patients you guys described and it is a horrible way to die. Invasive treatments are not always life saving for everybody. I also like about hospice that it is not going anywhere. The demand for it will grow as home care becomes more important and more people understand the importance in changing intensity of care as we age or have a debilitating disease with poor prognosis.


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