new to home health-do you like it?

HHnurse · Jul 24, 2000

I love home care and fell we get paid pretty well, 25$ per visit. 36 for an admit. I work parttime and find it's prefect to allow me to have time with my family. our full time productivity is 32 visit a week.

admits count the same a a revisit but I don't think they'd ever dared to try to give a nurse more than 1 admit in a day but they will give you 1 admit, a oasis recert and a discharge along with 4 revisits

Beth RN

nightstar41 · Jul 26, 2000

Hi JAY JAY from Ontario.

To answer your question, I work in B.C. Canada for the ministry of health under a region . I work as part of a continuing care division where the funding comes from the provincial government. All nurses belong to the same union and the wages are comparable to hospital nurses. As all health care dollars come under our region to manage all aspects of health care which means that hospitals and home care work closely together to privide the best possible care possible in the most appropriate manner. There is a great focus on keeping patients home or discharging them early from hospital as it is much more cost effective to treat them at home. I work independently, make my own scheduled based on my caseload and have the resources to be an advocate for my patients. Liason, telephone calls , travel time are all included in my hours worked for that day.I also get mileage. If you want more specific info, feel free to e-mail me. I love what I do and I feel valued by all health care profesionals I encounter. I though that it was like this all over Canada... I would like to correspond more with you if you wish to compare notes. Yours truly, Nightstar

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nightstar

Mae May · Aug 4, 2000

Hello , after reading all your replies, wow! I've been doing homehealth nursing now for 8 years. I love the hours and the independence of this kind of work. We are paid by the hour, but are stretched very thin with the demands from the acuity of caseloads, and growing aging population. It's very challenging and demanding, as here we are not only a nurse, but sometimes an accountant,social worker, dietician,diplomat and the list goes on, in short very resourceful people with great problem solving skills. We do an interdisciplinary homehealth care and are privileged to have liason nurses in hospitals that are very good at weeding out our referrals. We carry our own caseloads and plan them accordingly for the visits. Although some days I will say that I long for the shift elswhere that you know when the day ends you're done with that client. That doesn't happen with home health nursing here, we tend to have caseloads of about 50-55 at present, and know that when we leave at the end of the day, there is no one managing that client's case until you go back in the next day unless a crisis occurs. Crisises seem to be occuring with more and more frequency these days in the home. Enough about that. One of the things I love about home health nursing is that the clients I see, we provide them with the teaching, and educating necessary for their health, but we allow them the independence to choose how they wish to proceed, and this allows them the choice whether it be right or wrong, and we just have to bite our tongues sometimes and stand back. When they take that information and use it, you get that warm glow that you've done something valuable to assist them. Sometimes it takes a lot of work just to get past the first step, but in the long run its worth it. I also like that with a lot of these clients you develop a long term relationship that usually facilitates decision making on both parties. Improvisation, well that says it all, you never know what you're going to find when you step through those doors, sometimes pleasant, sometimes not.We are paid mileage as well, and it is taxable so that we are able to claim this on the yearly taxes. The staff I work with are very supportive, although our system at the moment is going through a lot of change(Change has always been the byword in our workplace). I don't always like the communication systems with some of the Drs, some are very, very good, and others well......We work with a lot of the GPs, and a lot of times they do respect us enough that they listen to our suggestions and carry them out.Our visits are planned by the individual, and depending on the complexity of the case we may have 2 visits that day or as many as 11.Somedays it is an effort to get up in the morning to go to work, but most days its looking forward to the challenges, you know for sure you'll get a least one.

Sandy W · Sep 10, 2000

I enjoyed reading all the replies. I've been doing Home Health most of my nursing career. I enjoy it very much. I like the one or one relationship one gets with the clients. I also enjoy seeing people in their own environment and interacting with their families. My speciality is Dementia/Alzheimer Care. Currently I have five clients in different stages of Dementia. Never a dull moment that is for sure. I work for an Agency and they take care of all the insurance, taxes etc. I get paid .25/mile when I transport the client anywhere. I do not get compensated for coming and going to each patient.

All and all, I'm quite happy with the position. Before HH I worked in a SNF and found it to be very depressing as so many of the pts. had lost their dignity.

Sandy

BETA · Apr 25, 2001

I no longer work in Home Health but was a case manager and a nursing supervisor for many years in Home Health. I would be very concerned for a new grad with only a few months experience to be in Home Health. They just don't have the assessment skills that are required in this position. In CA, we have a law that mandates that nurses have a year of experience before they can work in Home Health. Even those come with skills lacking in assessment. A Home Health nurse has to be versed in IV, wounds, social issues, and dx processes that relate to that patient. There is no back up in the field for another eye on opinion and calling the office and MD office can help but not if you need help with a foley, IV or something else immediately. The other problem with Home Health and one of the reasons I left, was because the acuity is so much higher now. Esp. here in So. CA where the managed care market has shortened hosp/SNF stays. Nurses are being asked to do more for sicker patients with a lot more paperwork in less time. I wish you luck with your new career choice but would caution you to get more experience before you go into Home Health.

Jeanbean · Apr 26, 2001

Beta, I agree with you 100%. I was in home health for about 7 months, then left when I had a baby and am now a stay-home-mom. I would have left home health sooner had I not been pregnant and knowing that I was quitting soon. My employers had great confidence in my abilities, though I didn't. I would now not recommend home health to anyone without several years of experience. I was in way over my head. Luckily my employers understood if I or another nurse turned down an assignment if we did not feel we had the skills or knowledge.

Sylvia · Apr 26, 2001

Hi. I work in home health and I do like it for the most part. With one patient at a time, you actually have an opportunity to do nursing the "way it is supposed to be" - at least some of the time.

The downside is that sometimes it gets a little boring - at least for someone like me who became accustomed to having 30-40 patients a shift.

And while home health is probably "easier" than other areas of nursing, when you work in the home you do tend to get involved in all kinds of situations you never would otherwise, just because you are there. For example, one of my duties is to drive patients to doctor's visits. When I learned how to monitor vent-dependent patients, I never dreamed I would one day have to do it while driving a van on a crowded interstate!

I work for an agency, so my pay is a little bit higher than it would be if I was a "regular" employee. I usually give several weeks notice before I take a day off, and my company is very accomodating about it.

Good luck.