Per diem questionRegister Today!
- by xoNurseRNxo Jun 19, '12I work for a home health agency where most of the nurses are per diem, but we typically work 5-6 days a week. We are paid per visit. One day I had a personal appt that was made a week in advance. I made the appt at the latest time possible and for a day I knew I would be done early. Well that day towards the end of my day I was asked to see a pt for SOC and I politely said I had an appt at certain time and was unable to do it. I was then told that I had to see an X amount of pts a day and that i was to not make personal appt on days I'm scheduled to work. First off, can someone pls explain how per diem works in HH when getting paid per pt. Second, I'm not on shift hrs or pay so is it not reasonable to make an appt in late afternoon when you assume you'll be done with work? Any advise or reason is welcome!
- Jun 19, '12 by Ashley, PICU RNI'd say it depends on how you're scheduled. When you get called in, do you get called in for the whole day or only for the cases on the schedule?
If you're called in for the whole day ("We need you to work this Wednesday." and your shift is scheduled from 9-5 then you're committed to being at work for that entire time, even if you usually get out early on a certain day. Since you're called in for the whole shift, you wouldn't be able to make other plans, as you need to be available for work if needed.
But if you're called in on a case by case basis ("We need you to see Mrs. X from 9a-10a, Mr. J from 11a-1p, and Mrs. K from 2p-3p), then I see no reason why you shouldn't see be able to make your own plans when you aren't scheduled to see patients.
In the future, though, it would probably be best to let your work know in advance that you have an appointment and are only available until X time on that day.
- Jun 19, '12 by intelligentnewnurseDo you have a union? I'm in NY and we have a union. I have never been asked to do a SOC late in the day only in emergency and then that would be a revisit and someone would do the SOC the next day.
- Jun 19, '12 by xoNurseRNxoLike I said we are all per diem but have full time schedules. I have IV pts that have to be seen daily (I work 5-6 days/wk). I get my schedule weekly with my pts for the day. SOC pts are usually given a day before, sometimes the day of. I was never told that I had to be available from 9-5 for example. Since we get paid per visit, every nurse starts their day at different times.
- Jun 19, '12 by intelligentnewnurseI would look into the policy. I am per diem but I can go to the union representative for clarification. Did you meet your quota for the day in question or did you move cases around? We are allowed to leave the field once we have seen our cases. Is it a per week quota or daily? We have to see a minimum of 35, 7 per day, but you may see 4 today and 10 tomorrow.but it shouldn't matter if you saw your planned cases. I just know they value SOC and don't want you to say no to new cases. What I have done when I have an appointment is to say I'm leaving the field early next Tuesday and all my cases are covered. I would really look into the policy to cover yourself.
- Jun 19, '12 by 84RNI'm per diem, and when we are busy I can basically be fulltime if I want to take that many patients.
The way my agency does per diem is that they are not obligated to give me any certain amount of visits (also paid per visit), but I'm also not obligated to take a certain amount. I can work as much (if we have the census) or as little as I want to work. In times of low census, I have very few visits because they have to fill the schedules of the fulltime employees first.
I routinely schedule my visits so that I can pick up my kids from school and be here when they are home. I've said "no thanks" at times to a Start of Care patient or extra visit when I've had an appointment or just can't do it for whatever reason. I do try if possible to do all visits requested, but don't feel an obligation because I'm not fulltime.
- Jun 20, '12 by caliotter3First of all I would look into the policy so that you are well aware of it for the future. And if you need to make personal appointments, then give them this information well in advance, in writing, if necessary. They should have given the SOC to another nurse, but then, you could have mentioned the appointment ahead of time.