Lurk, Lurk....................

live4today, RN · Jan 24, 2006

hi jnette

i used to do home health nursing, and loved every minute of it! matter of fact, i'd like to return to it once i get my nursing license here in this state (that's going to happen within the next couple of weeks hopefully).

everything you described about home health nursing is all that and then some. the only negative is in being careful about going to homes and neighborhoods that are not "familiar territory" to what you are accustomed to being around. when working home health in california there were cases on the news about home health nurses being raped or robbed as they left their clients homes. those cases of robbery and/or rape all happened in broad daylight, too. so, never go into an area or home that you feel unsafe entering. always watch your back, lock your car, stay out of totally dark areas....stay safe and pray a lot!

tbinghamlpn · Jan 24, 2006

I am now a Home Health nurse. But, I work in the office. Yes, I love it. I started out in the field with this company and then moved into the office. I liked both ends. I especially like the ours, I get to be with my kids more. I am only on call one week a month. There are some bad points about it. It is not as "easy" as everyone thinks. There are strict Medicare guidelines as far as Start of Care assessments that have to meet certain qualifications. They are about 15 pages long. They have to be done, turned in, typed, and printed within a certain amount of days. But all in all it is great.

jnette, ASN, EMT-I · Jan 24, 2006

everything you described about home health nursing is all that and then some. the only negative is in being careful about going to homes and neighborhoods that are not "familiar territory" to what you are accustomed to being around. when working home health in california there were cases on the news about home health nurses being raped or robbed as they left their clients homes. those cases of robbery and/or rape all happened in broad daylight, too. so, never go into an area or home that you feel unsafe entering. always watch your back, lock your car, stay out of totally dark areas....stay safe and pray a lot!

thanx, cheer, but you are talking to the wrrrroooooooooooong person here about that stuff !!! :rotfl:

that is the last thing on my mind. i am so not worried about that in the least.. i don't even have it in me to be concerned with such ! :chuckle

and in this area? forget it ! no need for such concerns, believe me ! we are a far cry from calif., or northeren states, or "urban" living. (no offense to any of those, either!)

remember... ppl here still stop and help when they see your car off on the side of the road. ppl here still wave hello as you drive by, clerks and cashiers still smile and speak and inquire as to your wellbeing.... and mean it!:rotfl:

so that is the least of my worries, dear friend, although i do appreciate the thought. if i lived anywhere else but here, i would give those concerns more weight, but not here. and i do know that freak incidents can happen anywhere, but that can happen anytime outside of nursing as well, so i don't waste precious time or energy on looking over my shoulder.

i think you'd make a great hh nurse, renee, and i agree this is something you should persue once again ! and you already know the ropes, so it would be a breeze for you !

tbinghamlpn... thanx for you input. :)

i'm aware of all the paperwork involved, but eager to hear from my colleaugue just how much and/or how bad it really is. i know there will be some downsides as well, and just why i am waiting to find out more before i make any rash decisions.

will continue lurking now, and learn all i can.. from here on this forum, as welll as from acquaintaces here locally who are in the field.

SWRN84 · Jan 24, 2006

Hi Jnette,

I've been in home care for 19 years. I left briefly (6 months) to try something else, but it is my calling as a nurse. I've done case management, supervisory, QI, and now am content doing prn home care. I work 4 days per week, seeing overflow patients for a rural home care agency.

You are correct ( as far as my opinion goes)....this is everything a nurse should be. You will be loved by most of your patients. They consider you their angel and many times their only contact with a caring human heart. Of course, there are negatives....the homes you cannot sit down in because of filth, or the sad cases of elderly patients with no one to care for them, or those you have to hotline because of neglect, etc. But....I have learned so much. And I don't mean just about nursing. You do learn new skills, and learn to be autonomous, but I have discovered so many things about myself through the years. I've grown so much personally and have been enriched by my patients. It's such a different aspect of nursing to be seeing patients on their own turf, their own environment. Such a great place to make a real difference.

Yes, the schedules are great, too. For the most part you work days, with the exception of an occasional evening when you are on call.....and an IV comes in or you have to go out and teach a Lovenox injection, things like that. Pay is pretty good....weekends are minimal, as well as holidays. Yes, there are negatives, mostly concerning paperwork issues as far as the daily job goes. You do get those chronic patients that you may not be too fond of, but you still make a difference in their lives.

I do know what you mean about being terrified out there on your own. I was a supervisor in a home care agency for about 8 years. It had been quite awhile since I was out doing direct patient care. I took this prn job and told myself..."I've done all this before.....just need brushing up." I take a deep breath, ask questions when I need to, and go for it. It didn't take long before those things I hadn't seen before all came streaming back one by one. I don't stumble too often any longer, but occasionally still have some things I may not be super comfortable with.I've been out doing direct patient care again for 4 years, and love it. The great thing about home care is, you get to see just about everything. It does make your assessment skills sharp. I think the best thing about it is being able to teach these patients/families/caregivers how to manage illness, how to get better if they can, and how to cope if they can't.

I hope you do go for it and I think you don't give yourself enough credit in your med/surg skills. I really think you'd love it. It's a breath of fresh air....really!

Shelley

jnette, ASN, EMT-I · Jan 26, 2006

Hi Jnette,
I've been in home care for 19 years. I left briefly (6 months) to try something else, but it is my calling as a nurse. I've done case management, supervisory, QI, and now am content doing prn home care. I work 4 days per week, seeing overflow patients for a rural home care agency.
You are correct ( as far as my opinion goes)....this is everything a nurse should be. You will be loved by most of your patients. They consider you their angel and many times their only contact with a caring human heart. Of course, there are negatives....the homes you cannot sit down in because of filth, or the sad cases of elderly patients with no one to care for them, or those you have to hotline because of neglect, etc. But....I have learned so much. And I don't mean just about nursing. You do learn new skills, and learn to be autonomous, but I have discovered so many things about myself through the years. I've grown so much personally and have been enriched by my patients. It's such a different aspect of nursing to be seeing patients on their own turf, their own environment. Such a great place to make a real difference.
Yes, the schedules are great, too. For the most part you work days, with the exception of an occasional evening when you are on call.....and an IV comes in or you have to go out and teach a Lovenox injection, things like that. Pay is pretty good....weekends are minimal, as well as holidays. Yes, there are negatives, mostly concerning paperwork issues as far as the daily job goes. You do get those chronic patients that you may not be too fond of, but you still make a difference in their lives.
I do know what you mean about being terrified out there on your own. I was a supervisor in a home care agency for about 8 years. It had been quite awhile since I was out doing direct patient care. I took this prn job and told myself..."I've done all this before.....just need brushing up." I take a deep breath, ask questions when I need to, and go for it. It didn't take long before those things I hadn't seen before all came streaming back one by one. I don't stumble too often any longer, but occasionally still have some things I may not be super comfortable with.I've been out doing direct patient care again for 4 years, and love it. The great thing about home care is, you get to see just about everything. It does make your assessment skills sharp. I think the best thing about it is being able to teach these patients/families/caregivers how to manage illness, how to get better if they can, and how to cope if they can't.
I hope you do go for it and I think you don't give yourself enough credit in your med/surg skills. I really think you'd love it. It's a breath of fresh air....really!
Shelley

Thank you, Shelley, for your kind response. I am very seriously considering the transition. Our folks here in the surrounding counties are ever so sweet, and truly appreciate the care given them.

Occasional weekends/holidays wouldn't bother me in the least, I'm more than used to that. I've worked weekends and holidays nearly all my life, so it doesn't make a bit of difference either way. And I see our chronic patients daily now, so nothing new there, either.

I will continue to read and learn all I can here, as well as communicate with my former colleague to get the full scoop on this agency and see how she still likes it 6 mos. down the road.. after she has some experience under her belt. If all is well by that time, I may just go drop off my resume and take the plunge.

Thanx again ! :)

luvmy2angels · Jan 26, 2006

I am sort of in a similar situation. I have been a CNA in nursing homes for 18 years, will be graduating from LPN school next month. I am SOOOOO comfortable in the LTC environment that i just assumed that is where i would end up. I applied for and have been offered a job at a hopsital in their sub-acute care unit.A far cry from the work i am accustomed to in LTC. It has driven me crazy trying to weigh the pros and cons of taking the new job, but the experience i will be getting at the hospital will be far better than working in the nursing home. So, I am frightened to death:eek: but i'am ready for a change.

My advice.....

weetziebat · Jan 29, 2006

Then our beloved Weetziebat (I hate her!) :rotfl: just started in homehealth as well, and I can't stand to sit by and read all this stuff I've daydreamed about and longed for, while others are actually out there DOING IT !!!
ARRRGH !!! Living MY dream ! http://www.millan.net/minimations/smileys/gaah.gif

Hi Netters,

Only been in orientation for a week now, but so far I love Home Health. The patients are soo sweet, and being able to spend time with them (imagine!!), helping and supporting them in their health choices is very satisfying. Been going out with another nurse, and yesterday one of the patients told me I was the only one who really listened to him, and understood how he felt.:w00t: - made me feel like a million bucks! Also like the autonomy and the freedom to not be in one place all day. It is exactly what nursing should be, IMHO.

Everyone warns me about the paperwork, and can see that there is an outrageous amount of it, but don't think that will really bother me. One thing I never thought about is needing to plot where I can find public restrooms along the way. :uhoh21:

Like you, the area I live in is not the type of place one need worry about in terms of crime (thank goodness). Of course, its possible - but so is getting hit by a car crossing the street.

It has been a long time since I've done med/surg, and am finding out how much knowledge you need in every area. Kind of scary for me, so I forked out $$$ to buy a 'Manual of Home Health Nursing Procedures' by Robyn Rice. Also the office has a lot of reference books that I've been looking through. Another thing that concerns me is the blood draws - haven't done that in ages - but should be a piece of cake for you.

Though I haven't spent enough time in it to tell how it will be when I'm on my own, think it is an area you should seriously consider changing to - I know you'd make an awesome HH nurse! :icon_hug:

jnette, ASN, EMT-I · Jan 29, 2006

Hi Netters,
Only been in orientation for a week now, but so far I love Home Health. The patients are soo sweet, and being able to spend time with them (imagine!!), helping and supporting them in their health choices is very satisfying. Been going out with another nurse, and yesterday one of the patients told me I was the only one who really listened to him, and understood how he felt.:w00t: - made me feel like a million bucks! Also like the autonomy and the freedom to not be in one place all day. It is exactly what nursing should be, IMHO.
Everyone warns me about the paperwork, and can see that there is an outrageous amount of it, but don't think that will really bother me. One thing I never thought about is needing to plot where I can find public restrooms along the way. :uhoh21:
Like you, the area I live in is not the type of place one need worry about in terms of crime (thank goodness). Of course, its possible - but so is getting hit by a car crossing the street.
It has been a long time since I've done med/surg, and am finding out how much knowledge you need in every area. Kind of scary for me, so I forked out $$$ to buy a 'Manual of Home Health Nursing Procedures' by Robyn Rice. Also the office has a lot of reference books that I've been looking through. Another thing that concerns me is the blood draws - haven't done that in ages - but should be a piece of cake for you.
Though I haven't spent enough time in it to tell how it will be when I'm on my own, think it is an area you should seriously consider changing to - I know you'd make an awesome HH nurse! :icon_hug:

OMG.. Weetz.. I can hardly stand it anymore. Truly, I have been obsessing about it all week. :uhoh3: Today, my former colleague is going to give me a call, and we are going to discuss everything.. every little iota of it!

Here's what I know so far:

This agency is supposed to be the best in our area. Currently has 138 patients and growing.

They give you a service area in the area in which you reside. (still need to find out approx. how many miles an area that would be, approximately)

RNs make $25.00 per visit. They average 6-10 visits per day, usually 8, sometimes more if they want and have the time.

Mileage is reimbursed at $0.36 per mile, in a tax free check.

BC/BS health insurance after 3 mos.

Two weeks vacation after 6 mos. and three personal days per year.

Don't know yet about pension plan/401k/profit sharing, but will find out today.

Every 4th or 5th weekend you take call and wear a beeper, and are paid for time on the beeper. Don't know the details of that yet, either, but will ask today.

Other than that, it's M-F, show up at the office at 0730 and are considered "on the clock" until 1630, even if you have completed all your visits. Not sure exactly what that means, either, or how that works, but intend to find out today as well. No holidays, unless on call, but usually not a problem.

My colleague (LPN) tells me she usually finishes her day between one and two o'clock, sometimes earlier, depending on the length of the visits. Says her visits don't last more than a half hour.. but I'm assuming the RN visits will be more involved. (admissions, discharges, thorough initial assessments, etc.) Will discuss that with the agency when I go see them this week to inquire about things.

Sha absolutely LOVES the autonomy, not being tied to a unit. Loves the variety, and finally having time to TEACH, as you mentioned yourself. This is something I cherish, and anymore, at work, I'm feeling more and more like a robot.. totally mechanical.

No time for real teaching.. our dietician does all that and our social worker, so basically we just reinforce that while "on the run". :rolleyes:

I hunger for the "rest" of nursing. I really want to learn and grow, and use other skills. I want to do more "hands on" skills than what we do at dialysis.

Don't get me wrong, I do love this specialty, but I'm now yearning for more.

It's getting too "routine" and I wish to broaden my horizons... utilize more critical thinking skills, excercise and perfect my assessment skills in ALL areas, not just those which relate to our needs in dialysis. Perform more of the many nursing skills I have not really had the opportunity to employ.

Like you, I know I will have to really brush up on these, as there are so MANY I have not even used in "forever". I will feel like a brand new GN in many ways, needing someone to hold my hand for awhile until I'm exposed to all the different things out there I'll be needing to learn and do. Very scary, but exciting. :)

I intend to get the book you mentioned above, and any other little items which would be helpful out in the field that you can thing of.. quick references, not too big or heavy to lug around with me.

I believe the RNs will have more of the paperwork load as well, but will still inquire as to all that. But my friend says that she jots down notes at the visit, and then does most of the editing and perfecting of her paperwork at home, and that she does not feel overwhelmed by it at all. Says that she can actually do it simultaneously with the visit, but likes to review it at home anyway. Says it does not consume her time in the least.

And she says that many days she'll be done at noon, but then go out again to do a few afternoon dressing changes.. she really likes the way it breaks up the day. She can go home, throw in some laundry, have a good lunch, stop at the supermarket or post office.. and go back out to check in on her patients later in the day.

DANG, that sounds good !

So........ let me know if there's anything else I should inquire about, OK?

I printed off Karen's sticky, or "list" of things to ask of hte agency, and I have answers to most of those already. But I'm sure there are things I still need to know, so help me out here, ok?

I'm soooooooooooooooo glad you're loving it ! :balloons:

Can't wait to hear more ! Keep me posted !

Editorial Team / Admin · Jan 29, 2006

Jnette, I'm butting in here, not with any HH knowledge but with a question for the HH nurses: would having a PDA help, rather than lugging books around?

Example: when I downloaded Epocrates, there was a whole section I didn't choose to download, that NPs would use: which meds are in which HMOs formulary, etc. I wonder if there's a program/programs on codes, etc, or book/books on HH Nursing that are available for PDAs? They are easily updated as well.

Just, well, it's actually my one cent, not even two cents, here! Good luck with your decision (but it sounds like you've already made up your mind, lol!)! It sounds like "your" kind of area! ----------- D:)

jnette, ASN, EMT-I · Jan 29, 2006

jnette, i'm butting in here, not with any hh knowledge but with a question for the hh nurses: would having a pda help, rather than lugging books around?
example: when i downloaded epocrates, there was a whole section i didn't choose to download, that nps would use: which meds are in which hmos formulary, etc. i wonder if there's a program/programs on codes, etc, or book/books on hh nursing that are available for pdas? they are easily updated as well.
just, well, it's actually my one cent, not even two cents, here! good luck with your decision (but it sounds like you've already made up your mind, lol!)! it sounds like "your" kind of area! ----------- d:)

you know, dianah.. i really have thought of purchasing a pda for this. but that is one thing i know nada about, and if i end up doing that, i would really have to beg for assistance in getting to know how to use and program it. i feel it would be exceedingly helpful, though!

and just another excuse to buy another geek toy, too !

well.. i just got off the phone with my friend, and got the whole scoop, and i'm so excited now, i can hardly sit still! she has never been so happy in her entire nursing career, and she's been a nurse for nearly 15 years.

so guess who's going up to the agency tuesday afternoon when i get off my "short day" ? you got it !

not going to commit myself that day, but will certainly put in my application, and talk with the owner (who is supposedly fabulous!) and awesome to work with and for. and if they satisfy any remaining questions i might still have, and are willing to have, me, then i will be taking this new position before you know it ! wow.

scary, in a way, and yet, i just can't stop !!!

woohooooooooooo !!!

oh ! one quick question for you hh nurses.. my idols...heh...

where might i find a portable pulse oxometer at a decent price ? they don't supply them but will order one for you if you want one, but they're pretty pricey. thought you all might have some good resources or links where i could get on at a reasonable price. any suggestions?

thanx ! :)

weetziebat · Jan 29, 2006

RNs make $25.00 per visit. They average 6-10 visits per day, usually 8, sometimes more if they want and have the time.
Every 4th or 5th weekend you take call and wear a beeper, and are paid for time on the beeper.
My colleague (LPN) tells me she usually finishes her day between one and two o'clock, sometimes earlier, depending on the length of the visits. Says her visits don't last more than a half hour.. but I'm assuming the RN visits will be more involved. (admissions, discharges, thorough initial assessments, etc.)
I intend to get the book you mentioned above, and any other little items which would be helpful out in the field that you can thing of.. quick references, not too big or heavy to lug around with me.
I believe the RNs will have more of the paperwork load as well, but will still inquire as to all that. But my friend says that she jots down notes at the visit, and then does most of the editing and perfecting of her paperwork at home, and that she does not feel overwhelmed by it at all. Says that she can actually do it simultaneously with the visit, but likes to review it at home anyway. Says it does not consume her time in the least.
And she says that many days she'll be done at noon, but then go out again to do a few afternoon dressing changes.. she really likes the way it breaks up the day. She can go home, throw in some laundry, have a good lunch, stop at the supermarket or post office.. and go back out to check in on her patients later in the day.

Jnette,

With my VAST expertise in HH nursing, I think it sounds like LPN's must have a LOT less to do. Seeing that many patients daily sounds undoable from what I've seen. We saw 5 and that kept us busy all day.Our visits lasted at least an hour each, not counting the paperwork. And the drive time. We started at 9 and called it a day at 5, with a half hour lunch break. We can do the paperwork at home, but make sure you won't be spending more time doing that than the pay for each visit. Does that make sense??

The book I mentioned is wonderful, but also cost $130. and is in a huge 3 ring binder book. Trying to look through it now, so as to lessen the chances of being caught with less knowledge of what to do than I'd like.