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 have a love/hate relationship with this job.
First why I love it: I love autonomy and independence and not having my boss look over my shoulder at all times. I feel like no one is really watching me most of the time unless there are random chart audits or I accidentally miss a recert oasis. I get to drive around beautiful So cal all day, which most days is absolutely stunning. If I'm having a bad day, my car is my refuge and I can blast that radio really loud. I see about 5-7 patients a day and love that my current agency does not have me drive over 100 miles per day like my old one. I drive about 60 a day on average now. My patients for the most part are really appreciative and I develop a rapport with them and their families. I still use most of my med surg skills. I do alot of PICC lines, wound care, phlebotomy, gtube, and teaching, a few trachs here and there. Mostly it's teaching which I love.
The bad: Every agency I've worked for is a disorganized mess. My supervisor does not remember her own name half the time. She will call me at all hours, text me at 630am for report on a patient I did not see, and call me on the weekends. Calls from co-workers and patients on my days off constantly gets on my nerves. I had last Thursday off and my phone rang every 15 minutes and I did have to take some of those calls. All agencies try to milk medicare patients to the fullest extent they can. I feel like I am a part of the problem and not the solution as far as medicare overspending. I was pulling into my driveway one day last week at 445pm (I work 8-5) and I get a call from my boss.."OH I forgot to tell you that admission for tomorrow actually needs an IV dose today at 5pm oops!." So that ruined my plans for the evening and that is typical. Typical example of disorganized non-sense that I have experienced with all 3 of the agencies I have worked for. 2 of these agencies are top 500 national agencies. I feel like I am a money machine for these agencies and they do not value me as a person who has a life outside of work. Last gripe, If i refuse to admit a patient because they do not meet medicare guidelines its a huge deal and I get interrogated by multiple managers as to what my rationale is, with the constant reminder that each patient they don't admit is a $4000 loss. Its all about money.
So I'm out of home health starting next month by miraculous devine intervention. One of my dear friends who I worked with in HH, got out about a year ago and started working in an infusion room in a local outpatient clinic associated with a big hospital here. Her manager wanted to hire a HH RN as an assistant to two specialty doctors in a clinic/hospital setting, so she recommended me and I got the job. I had about 24 hours to think about it, happened so fast. This position would require that I become wound certified and I still will be doing infusion and teaching patients. I get to round with the doctors and work closely with them in developing a POC for the patients. Sounds like a great job and I get to use my HH skills and independence to my advantage. We will see, they always say grass is greener on the other side. Good luck in home health. I may be back some day.
the problem with home care, whether its hospice or home health, that field attracts ***** in the management position. sorry, just no other way to put that.
Last edit by JustBeachyNurse on Mar 26, '13
: Reason: edit out veiled profanity