Typical day for a Home Health nurse... - page 15

Not a bad day today... started back per diem today. 6 cases, all in the same township. Not my usual zip codes though, so I did waste some time and scheduled visits akimbo, instead of in a line like... Read More

  1. Visit  NurseRoRo profile page
    1
    I made the switch to HH after spending almost 10 years in the hospital. I started out in General Peds and then went to a free standing inpatient Peds Rehab facility. I then went to the Operating Room and stayed there for about 3.5 years. I found that I work well in a team but not as a supervisor of a team. In the OR the team has to be work in synch and I had to poke or prod those that were not working up to speed with the rest of what was going on.

    As a case manager, I work in a team but am independent in my field. I work with other disciplines and maintain great communication with them but for the most part I am responsible for my part of the care and I facilitate more than supervise.

    I love the independence. I love the lack of noise pollution so I can think in the car between visits. Long gone are the days of simultaneous phone ringing, people standing around talking while you're running around like a crazy person without them asking if they could do anything to help you, the call light going off, the unit rep telling you that family is on the other phone, and a resident following you around to ask you a question about how to arrange for discharge. I have crazy busy days, but I create my own chaos. I like to call it controlled chaos.

    A typical day for me is: 5 patients, or maybe 3 or 4 regular visits and an admission. My patient load consists of PICC line/CADD pump patients, COPD/CHF patients, cancer patients still seeking last ditch effort treatment before deciding on hospice. I tell my patients I am great at playing Devil's advocate, I ask difficult questions to see where they are emotionally with their disease process and poor prognosis.

    Sometimes I chart in the home. Sometimes I save it all up for home. I am never on the computer for more than 2 hours at home. And I start my day as late or early as I want to depending on what I have going on. One of my patients works and gets home at 5pm. Those days I start later...
    Candimk2 likes this.
  2. Visit  imanedrn profile page
    0
    Quote from NurseRoRo
    I made the switch to HH after spending almost 10 years in the hospital. I started out in General Peds and then went to a free standing inpatient Peds Rehab facility. I then went to the Operating Room and stayed there for about 3.5 years. I found that I work well in a team but not as a supervisor of a team. In the OR the team has to be work in synch and I had to poke or prod those that were not working up to speed with the rest of what was going on.

    As a case manager, I work in a team but am independent in my field. I work with other disciplines and maintain great communication with them but for the most part I am responsible for my part of the care and I facilitate more than supervise.

    I love the independence. I love the lack of noise pollution so I can think in the car between visits. Long gone are the days of simultaneous phone ringing, people standing around talking while you're running around like a crazy person without them asking if they could do anything to help you, the call light going off, the unit rep telling you that family is on the other phone, and a resident following you around to ask you a question about how to arrange for discharge. I have crazy busy days, but I create my own chaos. I like to call it controlled chaos.

    A typical day for me is: 5 patients, or maybe 3 or 4 regular visits and an admission. My patient load consists of PICC line/CADD pump patients, COPD/CHF patients, cancer patients still seeking last ditch effort treatment before deciding on hospice. I tell my patients I am great at playing Devil's advocate, I ask difficult questions to see where they are emotionally with their disease process and poor prognosis.

    Sometimes I chart in the home. Sometimes I save it all up for home. I am never on the computer for more than 2 hours at home. And I start my day as late or early as I want to depending on what I have going on. One of my patients works and gets home at 5pm. Those days I start later...
    I'm so thankful to read this...

    I'm a NG -- just over 2 months on my own (just over 4 total) on a med/tele floor. I have a per diem HH job lined up. Haven't started yet because the DON is trying to work around MY hospital schedule to pair me with a nurse mentor to teach me SOCs first. (Hopefully, one will fall on one or more of my days off this week.)

    While I love the experience I'm getting in the hospital, I look forward to all of what you described! I actually look at doing HH per diem (a few visits a week) as a respite from the chaos of the hospital! Your days sound ideal to me, and I can't wait!
  3. Visit  shirlz profile page
    0
    I am an RN who is working Home Health for the first time and I hate it. It has only been 2 months and it keeps getting worse. I am the only RN and one LPN. I run around till 5 pm and then do charting until 11 pm every night. I am on call every other week (14 days a month). On my week end on call I always have a couple of admissions. Maybe I picked the wrong agency, but now I am afraid to try another one.
  4. Visit  Silverblitzen profile page
    0
    Quote from shirlz
    I am an RN who is working Home Health for the first time and I hate it. It has only been 2 months and it keeps getting worse. I am the only RN and one LPN. I run around till 5 pm and then do charting until 11 pm every night. I am on call every other week (14 days a month). On my week end on call I always have a couple of admissions. Maybe I picked the wrong agency, but now I am afraid to try another one.
    Wow! I think I'd try another agency! They're not all like that; I mean, if you read through some of the postings in here, you'll see a big variety. Do you live in or near a bigger city that may have more to choose from?

    Best of luck,
    Sue
  5. Visit  proserose profile page
    0
    Hi everyone,
    Just joined the forum. I'm a home health nurse for the past 12 years or so. I took a few years off when my last child was born but have been back for a couple years now. Anyway, I'm so tired from my typical day in home health nursing that I can't bring myself to describe it. It was a long exhausting day - - lots of driving and things didn't go smoothly. I had four admissions and a visit. At the end of the day we all had a VM message from our boss listing all the things we have failed to do in order to please Joint Commission. Trying to get it all right is like beating your head against the wall. Sheesh. It 's very discouraging somedays
  6. Visit  annaedRN profile page
    0
    I had four admissions and a visit
    Yeeessshhh! I would quit or be calling in sick the next day if my agency asked me to do that! I personally think that is expecting to much of any one nurse. It does not enable you to perform your assessment thoroughly and is not fair to the patient. For us a full day is 6 or the equivalent of ( admissions being 2) but never more than 2 admissions a day. Occasionally 2 admits and 3 visits, but that is a rare day.
  7. Visit  proserose profile page
    0
    Hi,

    I am an admissions nurse. I enjoy doing soc visits and I work 2- 12 hour days per week and am paid for 30 hours because I have a lot of paperwork. The problem is they don't take into account what's involved in each admit, or how much time I spend driving. I feel 3 admissions - - in order to do a good job - - is a good 12 hour day. I usually push more towards 14 hours by the time I'm done. I'm salaried so I get a certain number of units for everything. 'They' say the average admit only takes 45 minutes to an hour so we only get 2.5 units for an admission. That means in 12 hours it looks like we should be able to do 4. But all that is required at soc takes me longer than 45 mins or an hour unless it's just a 50 year old total knee with only a couple meds, and no complications. Trouble is most admissions are not like that. Someone upstairs just looks at numbers and forgets it's all about people - - at least that's how it feels somedays.
  8. Visit  annaedRN profile page
    0
    I am an admissions nurse
    Well that makes a little more sense to me now! I work 8 hr days too, instead of 12. It's funny how nice the units add up on paper for the office staff...just doesn't work that way in the real world. If all my admits were therapy only...aahhh, I can only dream
  9. Visit  Silverblitzen profile page
    0
    Hi all,

    I've been in HH for 4 months, started full time and am now part time. Even at only 3 days a week it's burning me out more than anything else ever has and the kicker is that I love this kind of nursing! I took an $11 an hour pay cut to do this, but my main complaint is that it takes over my life! The day off before I work, I'm doing admission paperwork, schedule adjustments, faxes, phone calls to schedule appointments and the list goes on. We have no benefits, no paid days off, no paid vacation time and we're all afraid to call in sick because our team members would have to pick up the slack. All my team members are physically sick and I don't know how much longer they'll last, but I can only change MY situation, right?

    What to do? Hospitals are crazy. LTC, unless you get into a supervisory position are extended med passes and kill my legs. I have an ADN degree (AAS nursing) and I'm 58. I wish I could retire, but that's not an option. Any suggestions out there?

    Sorry this is such a whine, but it's good to vent now and then. I hope with all the accumulated wisdom out there, someone may have an idea of where else I could turn.....

    Many thanks,
    Sue
  10. Visit  Nursecathy123ca profile page
    1
    Quote from Silverblitzen
    Hi all,

    I've been in HH for 4 months, started full time and am now part time. Even at only 3 days a week it's burning me out more than anything else ever has and the kicker is that I love this kind of nursing! I took an $11 an hour pay cut to do this, but my main complaint is that it takes over my life! The day off before I work, I'm doing admission paperwork, schedule adjustments, faxes, phone calls to schedule appointments and the list goes on. We have no benefits, no paid days off, no paid vacation time and we're all afraid to call in sick because our team members would have to pick up the slack. All my team members are physically sick and I don't know how much longer they'll last, but I can only change MY situation, right?

    What to do? Hospitals are crazy. LTC, unless you get into a supervisory position are extended med passes and kill my legs. I have an ADN degree (AAS nursing) and I'm 58. I wish I could retire, but that's not an option. Any suggestions out there?

    Sorry this is such a whine, but it's good to vent now and then. I hope with all the accumulated wisdom out there, someone may have an idea of where else I could turn.....

    Many thanks,
    Sue

    I sympathize. 3 suggestions: It sounds like you are working PRN, since you say you have no paid vacation, etc. Could you cut down one your visits by one a day? I have signed a contract with my agency to work at least a 32-hour week (20 points a week, a point being a standard visit, 2 points per Start of Care). Then I can work more than that if I choose to, and get paid more. I get 0.6 hours paid time off per month (instead of the standard 8 hours PTO for full timers). Those visits are spread over an entire 5-day week.

    Second, there are agencies that do electronic charting. It is a steep learning curve, but once you learn it, it cuts the paperwork load dramatically. My agency doesn't have it yet, but they assure us it's coming. Former colleagues who have gone to the one agency in town that does this charting like it, even though it isn't perfect.

    Third, it took me several months before I became used to the paperwork. It is a monstrous mountain, but eventually it becomes more automatic. Do as much charting as possible during and right after the visit. Eliminates the burden at home.

    Good luck.
    Silverblitzen likes this.
  11. Visit  Silverblitzen profile page
    0
    Hi Os,

    Nope, not prn. Regular part time. Our company doesn't offer benefits. We were promised a new contract by July 1 that offered 8 hour shifts, comparable pay to hospital nurses and paid benefits. Guess what. We got a 3% raise. Nuff said. I can start off the day with 6 patients and end up with those and 2 admissions thrown at me at midday. It's 2230 and I just got home and now have to do my calls and faxes. I have a nice glass of Cab sauv in front of me however, and the paper stuff may have to wait till the AM. Thank you for the kind suggestions. I need to think some more about all of this.

    Sue
  12. Visit  irishnoreenRN profile page
    0
    Hi Hoolahan:
    Love the name...Also loved your comments regarding home health. LOL Every bit of it.
    I will hopefully be working in home health soon. I've passed the initial interview and will do what is called a trail run on Monday.

    I was a critical care nurse for many years and home care for one. I've not worked in ten years. I hope I do okay. Starting to get a bit nervous. I know it's the rhythm of things that one has to get down. I hope I don't have that Major Hot Flash that I get when I'm under stress.

    So much for a former CCRN. Start over I guess.

    Siamese4me ps, I'm still laughing with your tongue and cheek remarks. Gotta have a sense of humor to survive this world let alone this vocation.
  13. Visit  nurseby07 profile page
    0
    Quote from Silverblitzen
    Hi all,

    I've been in HH for 4 months, started full time and am now part time. Even at only 3 days a week it's burning me out more than anything else ever has and the kicker is that I love this kind of nursing! I took an $11 an hour pay cut to do this, but my main complaint is that it takes over my life! The day off before I work, I'm doing admission paperwork, schedule adjustments, faxes, phone calls to schedule appointments and the list goes on. We have no benefits, no paid days off, no paid vacation time and we're all afraid to call in sick because our team members would have to pick up the slack. All my team members are physically sick and I don't know how much longer they'll last, but I can only change MY situation, right?

    What to do? Hospitals are crazy. LTC, unless you get into a supervisory position are extended med passes and kill my legs. I have an ADN degree (AAS nursing) and I'm 58. I wish I could retire, but that's not an option. Any suggestions out there?

    Sorry this is such a whine, but it's good to vent now and then. I hope with all the accumulated wisdom out there, someone may have an idea of where else I could turn.....

    Many thanks,
    Sue
    Sue
    That sounds awful!! You don't have to stand for that! Aren't you in Canada? Not ok..I wish I could help..

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