in the dark w home health

homehealth43130 · Aug 18, 2007

edyrn,

The answers to your questions depend on the type of agency you work for, the part of the country you live in and how the agency is set up. Lifting depends alot upon the type of patient you have and if you are doing intermittent skilled care versus long-term care. Not so much lifiting and tuning with intermittent, but the possibility is always there.

There are weekend and holiday visits, in our agency, we have weekend nurses, but prior to hiring them, all nurses did weekend visits, a supervisior takes triage call, and an RN takes visit call. Yes, they do get called out, but not much. There is a holiday rotation and in our agency, one RN is on call for the day, the rest of the visits are split among the rest of the staff so that everyone gets a little time at home on the holidays. Care doesn't stop because its a holiday especially with dressing changes, IV infusions etc. The goal of most skilled medicare agencies now is to keep people out of the hospital and emergency room, so in our agency, the culture is to make that call visit, not just automatically send to the ER.

Salary depends upon your agency - you can be on salary, paid per visit or paid hourly, the rate depends upon the part of the country you live in and the salary rates there. Some agencies pay mileage between patients, some don't, we do a trip charge.

The risk of going into other peoples homes also depends upon where you live, I live rural and it is relatively safe - of course we have had nurses attached by the chickens, but I have been in home care for 27 years off and on, and we have not had one issue with the nurses, aides, or therapists safety. We have had people feel uncomfortable with a situation and have had visits where there have been two people sent, but that is a rare exeption, not the rule.

Your best bet would be to contact an agency around where you live and ask to shadow a nurse for a day or two to see if you will like home care. You will either love it or hate it, it is a different kind of nursing and it is not truely suited for everyone.

Good luck, and I hope I answered some of your quesitons.

cookie102 · Aug 18, 2007

i will try and answer your question from the way i see HH

i do skilled visits vs shifts, so there are on occasions times when i must turn a patient (bedbound and i need to do wound care), lots of driving, so in/out of the car, people that may live on the second or third floor of apt buildings, (to me the home health aides have the more physical part of the job) weekend/holiday: depends, some agencies have an oncall staff, where i work we rotate one weekend a month, (the more nurses you have the less frequent the rotation), on call means you do the admission, resumptions anything that requires a RN, we have a LPN on also and she does the scheduled visits,,,call is 24hrs, but very infreq do you have to do out at night,,,,going into peoples home: you learn always leave nothing between you and the door, if you feel unsafe you don't go in, you can call the police for escort, go in with a buddy etc,,i have done HH for 20 years and can count on less than one hand the times i felt unsafe, salary: i think is comparable to the hospitals

hope this helps!!!!

rxrn · Aug 20, 2007

edyrn,
The answers to your questions depend on the type of agency you work for, the part of the country you live in and how the agency is set up. Lifting depends alot upon the type of patient you have and if you are doing intermittent skilled care versus long-term care. Not so much lifiting and tuning with intermittent, but the possibility is always there.
There are weekend and holiday visits, in our agency, we have weekend nurses, but prior to hiring them, all nurses did weekend visits, a supervisior takes triage call, and an RN takes visit call. Yes, they do get called out, but not much. There is a holiday rotation and in our agency, one RN is on call for the day, the rest of the visits are split among the rest of the staff so that everyone gets a little time at home on the holidays. Care doesn't stop because its a holiday especially with dressing changes, IV infusions etc. The goal of most skilled medicare agencies now is to keep people out of the hospital and emergency room, so in our agency, the culture is to make that call visit, not just automatically send to the ER.
Salary depends upon your agency - you can be on salary, paid per visit or paid hourly, the rate depends upon the part of the country you live in and the salary rates there. Some agencies pay mileage between patients, some don't, we do a trip charge.
The risk of going into other peoples homes also depends upon where you live, I live rural and it is relatively safe - of course we have had nurses attached by the chickens, but I have been in home care for 27 years off and on, and we have not had one issue with the nurses, aides, or therapists safety. We have had people feel uncomfortable with a situation and have had visits where there have been two people sent, but that is a rare exeption, not the rule.
Your best bet would be to contact an agency around where you live and ask to shadow a nurse for a day or two to see if you will like home care. You will either love it or hate it, it is a different kind of nursing and it is not truely suited for everyone.
Good luck, and I hope I answered some of your quesitons.

thanks a lot for all these informations...ive worked for 10 yrs now as a hospital based nurse so its kinds gets into me now...i want to have a change of scenery..im still actually looking around and hhc is one of the spot that i have my eyes on..

i might try shadowing a nurse for a day or two and see if my heart ison it....what qualities should a home health nurse possess to survive?

rxrn · Aug 20, 2007

i will try and answer your question from the way i see HH
i do skilled visits vs shifts, so there are on occasions times when i must turn a patient (bedbound and i need to do wound care), lots of driving, so in/out of the car, people that may live on the second or third floor of apt buildings, (to me the home health aides have the more physical part of the job) weekend/holiday: depends, some agencies have an oncall staff, where i work we rotate one weekend a month, (the more nurses you have the less frequent the rotation), on call means you do the admission, resumptions anything that requires a RN, we have a LPN on also and she does the scheduled visits,,,call is 24hrs, but very infreq do you have to do out at night,,,,going into peoples home: you learn always leave nothing between you and the door, if you feel unsafe you don't go in, you can call the police for escort, go in with a buddy etc,,i have done HH for 20 years and can count on less than one hand the times i felt unsafe, salary: i think is comparable to the hospitals
hope this helps!!!!

hello..thanks for the reply..

im thinking of trying it for now but still keeping my weekend duties in the hospital in case i wont be able to do it.

more questions :

can i choose a case ,like i only take wound dressing changes, or diabetes, no spinal cord,etc?

whats the difference bet skilled visits and shifts?

is working full time means you have to do 5 days?

i just hope i have a pamphlet or an article about hhc ,with glossary of terms :)

wonderbee, BSN, RN · Aug 25, 2007

Hi edyrn. My perspective on HH is that of a newbie, although I did hospice which is a specialty of HH but really a different animal.

We have a weekend nurse and a supervisor who takes triage and overflow. Emergent situations are not handled by HH. We tell our patients on admission to call 911 or go to te ER. Basically, no nights or weekends but we do work holidays which is handled as a regular work day. Of course we rotate.

There's a lot of windshield time. You really have to at least be comfortable with driving. There is an element of risk taking involved. There are bad neighborhoods, bad weather, unsanitary homes, aggressive dogs, aggressive people, etc. You will get lost on occasion and need to find your way out of that. I have a GPS navigation device (Garmin) which takes those headaches away. One less problem to deal with.

I don't know that you will get to choose what kind of patient you will take. I doubt that a company will hire anyone who doesn't possess the skills required to take care of a variety of illnesses. You can however find a company that won't take certain kinds of patients. For instance, my company does not take ventilator dependent patients which is great because I HATE dealing with secretions and doing mouth care.

Visits vs. shifts means you get paid by the visit rather than being paid a salary or hourly. I'm salary. I get paid for 8 hours whether I work 8 or 12. I think most companies are structured that way but then again, I'm new.

HH is great for someone who likes autonomy and is comfortable with their skills. There is enough variety in my day to keep me interested. I get to see people where they are most comfortable. The care is based on patient needs and is patient driven rather than a facility calling the shots. There's a focused goal, you're in and you're out. I love it.

I purchased a book which I'm finding quite helpful as a resource called Handbook of Home Health Orientation by Tina Marrelli. It offers a nuts and bolts approach that is understandable and reliable.