So overwhelmed..any advice?

My agency is currently "asking politely" that nurses see 6-7 pt minimum in a day, no matter what. And SOCs, recerts, or ROCs are NOT considered more than one visit. You have an agency-wide meeting that runs two hours? too bad, you still need to see at least 6 patients. 6-7 is fine, but there's NO top cap, so heaven forbid your area explodes and you get 3 admissions a day for a week, because you're SOL. We have people stuck seeing 10-12 patients on occasion with no relief. If I was per diem I'm be loving the hell out of the situation, but I'm staff and my company is NOT paying overtime right now. I'm going to be hitting up job fairs pretty soon.

Well, my thoughts on that are:: What about your mental health? You work like that, then you will burn out--eventually. It always happens. Will they be there for your "mental health days" then? "No!" Then they will move on to the other poor soul that is willing to do it. AND if they are not paying you more $, why stay?

But mostly, I'm sorry, seeing that many patients day in and day out, with RCTS, ADMITS, SOC, etc, mistakes are bound to happen. Labs getting missed, Someone not seen, etc. Patient safety FIRST.

Bottom line, if you are willing to do that, then they will continue to abuse you. I know it's a tight economy, but for the most part, I think you can find something else. Believe me, I'm not judging. I was there too. It's just that there are people out there that really do care and would NEVER ask that of you. And why stop at 7 or 8? I mean, that's easy to do---just do the paperwork at home then you can do 9 or 10.

Just my two cents....

My Central Intake Depts been processing 90-100 + day Mon-Fri for new starts of care...

The volume + itch to go visit patients rather than sitting behind a desk had me out admiting a patient on Saturday (old patient of mine from 2002). Monday took me 3 1/2 hrs complete paperwork as never oriented to OASIS or 485 computer entry.....call to IT manager required to activate my access to care managment software seciton; called on-call RN who happened to be Coder/UR for one of the branches who walked me through specifics pulling up library text to complete 485. All for $70.00 WE admit fee. Wonder what messages MC UR will have for me upon return from vacation this week.

Learning to say NO is just hard for some of us folks....

Per Home Health Line, 6-7 pts per day is national average.

I managed 32 pt caseload comfortably; 37-40 do able with LPN assist for followups. If patients all in one geographic area or city zip code and simple CHF, BP, med prefills averaging 20-30 min with 5 minute travel, could do 10 in a day, especially when had Senior high rise to case manage..... Doing Infusion nursing I sometimes only managed 2-4 day as was driving 125+ miles and had lab drop offs along the way.

Sometimes admissions just needs to say NOOOOOOOOO when staff stressed to the max and new hires not on the horizon. I have had on occaison to tell VP patient services and CFO along with referral sources we cannot accept patients as know everyone full and 1wk delay for therapy so unsafe to accept patient if we can not meet needs.

I agree that 6-7 pt's a day is doable. In fact 10 is too. BUT when you add admits, RCTS, PH, etc, that takes a huge chunck out of your time. As you realized after your admit this weekend. And if you were told one thing, then asked to do more with no pay, that's just wrong.

I agree it's hard to say "no" If it weren't for the psycho DON that came in and 5 people quit in the four weeks she was there, I'd most likely be doing call q every week, and 10 pt's a day. My point is, there are people out there that will NOT abuse you, and really do care!!

I'm reading these posts and thinking....why would a nurse stay at an agency that treats them like this? I don't know about other areas of the country but in Metro Detroit they are begging for home care nurses. When I left my last job, I had 3 solid offers (full time) in 1 week. Is the market for home care nurses that bad or is it low self-esteem??? or fear of change?????

Well said Paradisebound, but here in so cal I have had difficulty finding fulltime HH work I have only found per diem. I have been out of school for 3 years, and I went into the OR right out of school and was there for 2.5 yrs before I wanted HH.

I feel better now that I see I am not lost in the whirlwind of letting this job kick my butt. I feel the same way you do. I CARE about the kind of care that I give my patients. I also care about my family and I get frustrated sitting on the sofa while my family watch TV and see me night after night lost in a pile of papers filling out one OASIS after another until my eyes won't stay open. I too feel like I am working 168 hours a week and only get paid for 40. By the way, are you having to handwrite all of your paperwork ?? I am and it sucks

If I take the per diem job I was offered last week I will be doing the SOC in writing. The visits are on computer and are one page