New nurse / new to HH / tons of questions - page 3

by tinyRN72 7,822 Views | 37 Comments

Hi all, I just graduated and got my license. My first job is home health. My first week is over and I have found that I have a ton of questions if anyone doesn't mind taking the time to give me some input. 1) Where do you... Read More


  1. 0
    You are in a very dangerous situation & I would get outta there YESTERDAY!
  2. 0
    Don't risk your license for a sub-standard company.
  3. 0
    Hi Missy. It sounds as if you work for a very small home health agency as I do from the things that you have posted. I am the DON and we do go through what you are describing at times. My company does not have a large supply closet filled with all the supplies you can imagine. Actually we have basic supplies such as gauze, abd pads, kling, tape, tegaderm, duoderm, NS, wound cleaner; the BASICS like I said. If we do not have the supplies that are needed to provide care to a patient in the office, we will ask the nurse who has accepted the case if they can obtain those supplies and we reimburse them once they send the receipt in. Did your agency mention reimbursement? Items like picc line dressing should have been arranged by the insurance company to deliver to the patients home. Were you administering iv infusions. When the patient is in the hospital they send a referral to the patients insurance Co. The insurance is then responsible for making sure all special equipment and necessary supplies like picc dressings are sent to the patients home.

    In regard to drawing blood we do not go into a lab and obtain supplies. We use lab in a box and all the necessary equipment are in the boxes. Lab in a box is specifically geared for home care so your agency should know about it. If not, inform your supervisor about this and let them know it is free.

    Now in regard to pay, my agency does not pay for mileage either. We pay per visit and how we think of it is as an hourly rate. 98% of the time a visit does not take more than an hour to complete so that per visit rate if you think of it as an hourly rate is not too bad. Again we do not pay mileage and that its because we ask our nurses how far they are willing to travel and staff them when we have cases within those areas. If they accept a case farther than they have agreed upon we will increase power visit fee to accommodate gas cost.

    I am not here to defend your agency because they may be as bad as they sound but I just wanted to explain from the agencies stand point. Hope this has cleared some things up for you.
  4. 2
    IMHO (and experience), a visit including the documentation takes about 45 minutes. That leaves about 15 minutes for travel both ways. So, if I worked for your agency, I would never accept a case that was more that 7 1/2 minutes (5 miles) away from my home. The mileage pay is to cover the wear and tear on your car. The IRS standard deductible mileage rate for January 2013 is 56.5 cents per mile. Most agencies pay about .50 cents per mile. You are really screwing your nurses!
    SE_BSN_RN and LaRN like this.
  5. 1
    Also- if they aren't paying your mileage, get a log ad write your miles down so you can deduct them.
    KelRN215 likes this.
  6. 2
    I would leave like YESTERDAY.. You are a new grad with no experience. You need training and the lack of it will not protect you if/when something goes wrong because A.. you did not receive the proper training and B.. you are not given the proper supplies needed for the job at hand ie: the PICC dressing. A central line dressing is a sterile dressing change and CVS does not have the needed supplies. You are responsible for your own actions regardless. That agency is putting you at risk.

    I wish you the best and hope you find something with better supplies, training and support.
    SE_BSN_RN and KelRN215 like this.
  7. 2
    Quote from mother1strn2nd
    If we do not have the supplies that are needed to provide care to a patient in the office, we will ask the nurse who has accepted the case if they can obtain those supplies and we reimburse them once they send the receipt in.
    that seems so unprofessional to me. whether it is a small agency or a big agency, they should be able to obtain the supplies a patient needs without making the nurse "shop" on her own time. I would resent being asked to do this.
    SE_BSN_RN and KelRN215 like this.
  8. 0
    Quote from LaRN

    that seems so unprofessional to me. whether it is a small agency or a big agency, they should be able to obtain the supplies a patient needs without making the nurse "shop" on her own time. I would resent being asked to do this.
    Many of our nurses live on average an hour away from the office. Many times they do not want to drive to the office to pick up supplies and may be inconvenient for them, especially if they have accepted a
    Case and Soc is the next day.
  9. 0
    Does anyone have viewpoints on whether home health nursing is better than possibly seeking employment in the hospital?? Thanks...
  10. 2
    I absolutely love HH nursing. The flexibility, being able to work with a team to take care of ALL of the patients needs (not just what I can get done in my 12 hr shift), being able to make my own schedule. I also enjoy the independence I have to make my own decisions. HH nurses have so much independence. Often times the docs send a patient our way asking for our opinions. I like being able to admit a patient, see them recover (mostly) and then discharging them and actually seeing the fruits of our labor.
    KelRN215 and paradiseboundRN like this.


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