Is it possible . . .

. . . to find a decent home health job? I ask this after the umpteenth time of getting home after 8pm and being so burnt out that I just typed up my letter of resignation. I absolutely *love* home care but the situations I find myself in have been ridiculous. In the last 20 years, I've worked for two agencies that have been indicted for Medicare fraud, one that is currently on its way, and this last one has just driven me into the ground. Is it too much to ask for:

*Not more than 5 visits a day (and admits and ROCs count as 2 visits)?
*A decent per visit or hourly wage that takes into account all the paperwork, not just the amount of time spent in the home?
*A director who understands that I have a life outside of work and would like to participate in it?
*A travel area that doesn't add 3+ hours to my work day?
*A decent wage for all the administrative stuff that has to be done, or someone else to do all that administrative stuff?
*A decent benefits package that provides me with a level of care that supports and maintains my overall health?
*Training and the opportunity to advance my skills or go to conferences to improve my knowledge base?

What's been going on lately: I came into this small agency with the understanding that it was a small travel area, but they neglected to tell me that we also cover 2-3 surrounding counties, as well as the largest county in the country. I could stay within the city limits and still drive 100 miles between visits. We were supposed to have 2 RNs, 2 LPNs, a Psych RN, and a couple of PRN folks who could pick up overflow. Well, now there's me (RN) and an LPN and the Psych RN is on her way out the door. The MSW quit as of this week, so I was just told that I have to be a social worker, too. Yesterday, after spending 2 1/2 hours on administrative stuff, my schedule was 2 regular visits, 1 IV visit with labs and sterile dressing change (and this was on the far north end of the city with the blood needing to be transported back downtown to the lab), an admit, and a ROC/recert on the far southside. Too much.

My husband was hopping mad and upset because he had to put MIL in a nursing home yesterday and I wasn't there to help answer the questions or give him any kind of support. My toddler hasn't had anything to eat but fishsticks and ramen in weeks because that's all his 16 year old sister can make. I manage a sandwich in the afternoons and an apple if I'm lucky but rarely eat dinner during the week. I think I've lost about 10 pounds in the last 6 weeks.

I am expected to do all the sup visits, all the admits, ROCs, recerts, as well as case manage 40+ patients (wonder what I'll do with the psych cases when the psych RN leaves?), obtain DME for them all, follow up with all their physicians, call the ones that were sent to ER or emergent doctor's appointments, and never forget anything. Plus travel up to 100 miles a day. Oh, and I'm supposed to call all my patients the day before to make an "appointment" for the visit. Oh, and I still have hours and hours of computer-based training modules to do or they'll shut off my computer. When am I supposed to do all of this?