So overwhelmed..any advice?

I normally don't post on forums, I usually just read and learn but today I felt like I needed someone who "has been there" to listen. Then I come here, and read other posts that sound just like me. We work, work, work from 8-5, then come home, work more...STOP!!! dinner must be prepared! so I pull out a Sam's frozen dinner, pop it in the microwave for 15 minutes and yell "Dinner is ready" I grab my plate and go back to hiding in my room to continue charting, of course I'm stepping all over dirty laundry on my way to my room, because guess what??? No time for that either!!! Went away for Easter weekend and, of course, my charts and laptop went with me... Why am I doing this to myself??? Because, like others I am afraid I won't be able to find another job... even more afraid that the next one will be worse... This is the second HHA I worked for in the past 10 months and, also like others, considering going back to the hospital where you can leave your work behind you at the end of the shift...

Thanks for letting me vent!

roxyo,
I am starting per diem at a HH agency this Mon. I left the OR after 2.5yrs and will continue to look for OR, but the job market is so bad. I have excellent experience in the OR (Level I trauma), but it is difficult to get a job.
Why did you leave your first HH job? Don't quit until you have something really solid in a hospital. I'm not familiar with the paperwork, but it seems to take a lot of peoples time. Are you knew to it, or is it just a lot.

I think that if you work for a bad company and couple that with really bad management, you get a job like the ones listed in some of the above posts.

Their jobs and mine are like night and day. It's 2pm, I just got home and have about two hours of calls and charting to do. Then I'm done. Night and day differences.

nurseby07

Do you have any advice for me just starting out in HH.

Do you get paid by the visit or the hour? Your hours sound perfect. Do you think that they are taking too many visits or what is the difference.

muffin7,

The first company I left, because they were doing things that seemed "fishy" to me. At least 80% of the census were patients that had been on service for years. One episode would be billed for DM as main dx, next episode for HTN, third episode back to DM, fourth on HTN, fifth... you get the point. I was taught that only the last 2 episodes are kept in the chart and that if audited, those 2 episodes were the only ones the state would see. On top of that, many patients were not homebound, they were driving on a daily basis and management knew it well. The last thing that did it for me was when our manager asked a nurse to make up a recert OASIS because the recert window had been missed, it was billed as a "recert visit". I ran out of there fast!!!

I still have much to learn about HH, but common sense told me that was fraud. I do not want to mess with the feds in order to keep my manager happy.

The company I currently work with does not have any of those issues, the problem we have is that they keep accepting referrals even though we don't have the staff to care for the patients and even accept patients as far as 2 hour away drive!!! How in the world are we supposed to provide adequate care to pts who live so far away??? As a result nurses seem to only have time for a quick assessment and then on to the next patient... at the end of the day, you try to put everything together but often don't have time to finish and you start falling behind. You fall behind one, two, three days, then a week, then 2 weeks, then a month!!! You ask management for office time and you are told we can't right now, next week we'll try... Next week comes along and then the same story. Oh, this is where it gets interesting because at this point you have fallen so far behind the billing department is on your tail asking you to finish this and the other so they can get paid, LVNs are out there working without orders because the RNs have not been able to finish the 485s.

Like someone else mentioned earlier in the thread, when you finally burn out and have a mental break down is there anyone there for you??? NO!!! In fact, when I called in sick my phone kept ringing all day... You then realize you don't matter as nurse to them, much less as a person... Morale is way down around here guys... Can you tell? ;-)

YUCK! Does anyone else have any "good" stories? This is just ridiculous and sounds just like Amedisys to me. I had a case load of 30-40 and an LPN. I had no idea who needed what or what was going on. God shined down and I got this job and I can't fathom the difference. The schedulers know their stuff! I know my patients! Things do go wrong, but not often.
Maybe it's because it's a big hospital system?

NURSEBY07,

I am glad that we have this place to share. There are horror stories, but then there are the stories like yours that give some of us hope that there are companies out there that do care about their patients and their nurses. In all honesty I have been so down about my current job situation that I've been thinking about taking a break, not only from HH, but from nursing all together.

I can tell you that NOT every agency is like the ones mentioned above....and I know. I've worked for both types. I currently work for one as a prn employee, but can do as many or as little as I want. I have my insurance through my spouse, so I don't have to worry about that. The company gave me my own cell phone, and I get paid well over what I was making. Now, we are currently on "paper" but hopefully, that will change in the next moth or so. I also work with a great bunch of LVN's that also know there stuff especially about the Medicare guidelines and keep me informed on my cases.

Let me tell you what has happened to me: I went to admit a DM pt that needs QID insulin injections and wound care. When I went, I asked how long the pt has been a DM, to which he said 7-8 years. I then asked, well, how have you been getting your injections. He said, I give them to myself. I have a chart that I can fill out, and even know when I need to take a snack, etc. Well, guess what? He doesn't meet Medicare guidelines! When I called the office, I was told, "no way can we admit him!" Now, when I worked for Amedisys, we did NOT do QID injections, but we once did a BID injection patient. And after telling my director, SEVERAL times, the patient is capable of giving her own injections, it's been documented that she has been wittnessed as doing so, and she just doesn't WANT to, I was told "No, you have to do it"

It is NOT worth my hard earned license to try and meet some "quota" for them. And this was the same company that had me on call every other weekend---driving all over God's great country!

Now, my new place repeatedly told me how sorry they were, and assured me I would be paid for a "non-admit". I will bend over backwards for someone one that respects me, my license, and treats me fairly!! I will NOT go back to someone who works me like a dog, doesn't care about my license, and doesn't care if it's my day off. NO ONE SHOULD!!!!

People will only abuse you if you allow them too. First time, shame on them, second time, shame on you.....

I've had similar things happen to me with the same responses from both employers.
There really have to be limits drawn. I think in general nurses want to support one another, even when
they become supervisors. I too was on call constantly at the above mentioned company. I'm sure I told the story of coming home from my 8 hour day and at 5:02 pm my phone rang. It was the on-call service. A pt's cath had come out that morning and when they called the office the supervisor told them to call back that evening for the on call nurse.
I was highly perturbed.

My current job has after hours nurses. Nobody does call. It is glorious.

What about this situation, I would like some advice..... when you work for an agency that has questionable practices and does not support you as a nurse, but you do not want to quit for various reasons, can you somehow write "notes for the record" about the situations you encounter, what you did, and what the response was?