Typical day for a Home Health nurse... Typical day for a Home Health nurse... - pg.5 | allnurses

Typical day for a Home Health nurse... - page 5

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  hoolahan profile page
    #52 0
    I wouldn't worry too much about the IV skills. Many agencies subcontract with an IV homecare agency, or have a team of IV nurses. And, even if they don't, they have to ensure your competency, so they will train you.

    You will have to be able to draw labs. Though if you are going to do well mom-baby type visits, there may not be too much call for labs, but I am not an OB nurse so I really can't say. Just be upfront in your interview, I am sure they will be able to train you in lab draws as well. You could go in for a day into your hospital lab or outpt dept to learn this. I am fairly good at labs, and rarely miss with a butterfly needle. The worst thing that could happen is you stick the pt and aren't able to get the lab, and they send another nurse out the next day or same day if not too late. Or, they just tell the pt to go to the lab or doc's office. For those who are truly homebound, the mobile lab can be arranged to come out, but that takes a few days to set up, so we usually do the first round of labs.

    I am sure the agency would work with you b/c maternal child homecare nurses are in demand.
  2. Visit  nursegeorge profile page
    #53 0
    Thanks for posting so much about your days as HHN. I am interviewing for a HHN position. I have 20 years of Med/Surg hospital experience, 4 years of OR, 1 year of private duty in the home and for some reason considering going in to HHN scares the wee out of me! I think reading through your posts has been a wonderful education and humbling experience for me. You all sound so dedicated and right on the ball with all of your patients. Your humor has really touched my heart too!

    Someone said they needed to get out of the hospital atmosphere....I agree with that. I've been there for 20 years and the pace is killer!! I can still run circles around the girls half my age, but for how much longer. After reading through what all of you do...ya'all aint no slackers, that's for sure!! I'm not afraid of hard work, nor long days. I guess, just the learning curve!

    As far as pay goes, I'm being offered $42/visit and $60/admission plus mileage if I do the per diem. They are trying to match my hospital salary of $30/hr basepay plus premium on weekends. (I can only work weekends...2 small daughters and a workweek husband.)

    I really can't affor to drop my pay much from the hospital, but if I don't do something, I'll drop from the stress at the hospital, (as well as the 18 hour shifts without a wee-wee break or food!)

    God Bless all of you here. You are truly an inspiration to me and I love reading your posts in this thread!! Your honesty, devotion and professionalism really shines through your words, and as I think Hoolahan said a doctor said: "Your patients are really lucky to have you for nurses!"

    Thanks, Nurse G.
  3. Visit  NRSKarenRN profile page
    #54 0
    Welcome Nursegeorge!

    Go the perdiem visit route for weekends. Be mindful that all paperwork willl be required in the office Monday 8AM so keep sunday evening open for hours of paperwork until you become proficient--3 to 6 months to master.

    Your level of experience should be a plus to this agency. I'd request a ride along with an agency nurse to fin out more this agency's clientelle.

    Good Luck and welcome to HH and allnurses.
  4. Visit  nursegeorge profile page
    #55 0
    I am currently negotiating with the HHAgency which is affiliated with the local catholic hospital. They (the hospital) has consistantly been rated in the top 100 places to work for working mothers.

    They are trying to match my hospital salary and I was told by the HHDirector that they really, really want me, so we shall see...

    Thanks again for your welcome. I hope it works out.

    G
  5. Visit  lioneliz profile page
    #56 0
    This was not really a typical event in a typical day in HH, but I just had to vent a little. A man came by the office the other day and asked about hiring someone to help bathe his mother. He told me his brother and he had been assisting mom to bathe because she couldn't do it by herself since she had recently had a stroke and had just come home from the hospital. I thought hey this lady sounds like she needs a home health eval and proceeded to discribe what services we offer. But, the man quickly held up his hands and said we don't need home health services we already have that through *****HH agency. They are sending out a PT and a ST all we need is someone to bathe mom. I encouraged him to talk to mom's HHA and ask for aide assistance. He told me the agency couldn't send out an aide due to the distance from ***** town where the agency is located. At this point I saw red, but explained that if an agency accepts someone as a patient the agency is obligated to provide for that patient's care. I gave him the number of some sitters in the community and the DHS number to look into provider assist. We are a small rural hosp based agency hanging on by the skin of our teeth and *****agency is a large hosp based agency at a regional medical center in a town approx 75 miles away. They have a branch office in a neighboring town approx 30 miles away and in numerous communities in this part of the state. *****agency is not known for being overly ethical in their business dealings or in the way they obtain patient's. Many small rural towns send patient's into this regional medical center for care that can not be provided in the smaller hospital's. I have heard from countless other rural HHA similar stories. I really wanted to tell this poor man he should call the state and report *****agency but since I didn't know all the details about how mom was functioning I really couldn't. I felt sorry for this guy and his brother having to try to bathe mom just cause ******agency worships money and doesn't care a whit about their patients.
  6. Visit  luzababy profile page
    #57 0
    Hi!

    Please help! I'm thinking about entering HH and have hospital experience only. I have an interview tomorrow with a local HHA and don't know what to ask. Any advise?

    thank you!
  7. Visit  lioneliz profile page
    #58 0
    Funny thing happened today...I was just wrapping up a visit (pt assessment caregive teaching wound care & dressing for a patient with a tunneling abdominal wound) when she told me that her husband couldn't understand why the HH staff always checked her bp and temp. She seemed rather amused by her husbands lack of knowledge about what we do and proudly said "I told him you all are sort of like nurses only you're not in a or hospital." Now it was my turn to be amused. I let her ramble on for a moment and the said you are right we are nurses that work outside of a hospital. I'm sure that little bit of information was like water running off of a ducks back.
  8. Visit  CardioTrans profile page
    #59 1
    Another shower thing...lol One of my home care aides came in the other day and we were talking about a pt who has recently passed away. He was a precious man, but a man of few words. He was always the quiet type, would answer your direct questions, but nothing more, he would never "cut up" with the nurses or HCAs. He was a serious man. She was telling me one day that she had put him in the shower and was standing in the shower behind him, his wife came in the bathroom to leave a towel for him, the wife leaves the room, and the patient out of the blue with the most serious tone said "well, its official" The aide was curious and asked what was.... he said "we've been caught by the missus" She started laughing and said "well, what do we do now?" In his serious manner again, he said "not much now, she knows our secret"
  9. Visit  prisca profile page
    #60 0
    that was a really cute story. someone should make a book with all thes cute stories
  10. Visit  Hairstylingnurse profile page
    #61 0
    Hi everyone, I was hoping to hear and share some suggestions to avoid weight gain like I did when I first started in homehealth. When I first started in HH, it was soooooooo easy to pull through Macky D's or KFC, and get a delicious, quick lunch while on the way to a pts. house. All those wonderful large coca-cola's to get a quick, refreshing caffine fix. I went from running around like a mad woman at the hosp. and LTC centers to riding around in the car and not sweating too much(physically anyway). My metabolism went into shock. I have hypothyroidism, so that didn't help. I have since lost all the extra weight by packing tuna fish sandwiches, carrot or celery sticks and a large thermos cup of ice H2o. My problem with drinking all that h2o is that I get sooooooo tired of stopping at convient stores that look new and/or very clean and having to go to those nasty restrooms. I once had to use the restroom at a pts. home out of sheer, desperation(THIS OFCOURSE IS A MAJOR NO-NO AT OUR AGENGY ). So it would be great to hear what some other nurses do for lunch, snack, and bathroom breaks and anything else you do between visits. I rarely see pts. close to my home( I stop at home when I'm in the neighborhood.) Also it would be awesome to hear from some more HH nurses about thier typical day. I LOVE reading some of the challenges that we go through and learn alot from the posts. Thanx and have a great day
  11. Visit  hoolahan profile page
    #62 0
    Your agency actually has a policy about not using the patient's bathrooms???

    I don't know about anyone else, but we don't have any policy like that, it's just that I would choose to not use anyone's bathroom most of the time. Sometimes the old timers don't make it and have a bit of a mess, and I certaily don't want to sit on their raised seats! lol

    Anyway, I have used many a bathroom in nice homes. I don't see what the problem is, you're a nurse, and a human being, not a servant too lowly to use the gentry loo!

    About the food. It is tough on the road. I am lucky in that I am in one county, so I used to come home for lunch, do a few charts, then same 2 or 3 visits for the afternoon.

    I am on the road now, driving really long distances, and I am sick of McD's. I picked up a nice thermos from walmart, and I keep decaf iced tea, it stays cold all day. I also just make up a sandwich, chicken salad from leftover chicken, or eggsald, ot turkey meat, of course it can't be hot, and use an insulated lunch box and one of those frozen block things. I may also put in a small cup of fresh fruit cut up inside of a rubbermaid container and put it on top of the ice.

    However, on cold days, I may stop into a supermarket and get a cup of soup and eat it in the car, or find a restaurant or pizza place that also has soups and eat insode, I always take in a chart or two to do while I break, making sure I don't let anyone see names or anything, I pick a table far away and keep only what I am working on face up.

    In summer, I may go to a nice air conditioned library, and do a few charts, use the bathroom, whatever. Can't eat in there, though I confess to sneaking in a sandwich and sitting in the back, sneaking bites as I worked. And a water bottle. Also in summer, I freeze water bottles. I have an insulated bottle carrier, which doesn't allow it to melt too fast, so I may leave it on the seat in the sun for a visit, so I can get a bit more to drink, then slip it back into the carrier.

    So, what does your agency expect you to do? They should perhaps compile a list of restaurants in every county, gas stations, and places you can use the bathroom and give it to you on orientation. But frankly, that is the stupidest rule I have ever heard. I have never in all these years had anyone act like it was a burden to them for me to use their bathroom! In fact many people offer me food, coffee, I always refuse that, but I am not even shy about asking to use the bathroom. Everybody pees!
  12. Visit  Hairstylingnurse profile page
    #63 0
    Quote from hoolahan
    Your agency actually has a policy about not using the patient's bathrooms???

    I don't know about anyone else, but we don't have any policy like that, it's just that I would choose to not use anyone's bathroom most of the time. Sometimes the old timers don't make it and have a bit of a mess, and I certaily don't want to sit on their raised seats! lol

    Anyway, I have used many a bathroom in nice homes. I don't see what the problem is, you're a nurse, and a human being, not a servant too lowly to use the gentry loo!

    About the food. It is tough on the road. I am lucky in that I am in one county, so I used to come home for lunch, do a few charts, then same 2 or 3 visits for the afternoon.

    I am on the road now, driving really long distances, and I am sick of McD's. I picked up a nice thermos from walmart, and I keep decaf iced tea, it stays cold all day. I also just make up a sandwich, chicken salad from leftover chicken, or eggsald, ot turkey meat, of course it can't be hot, and use an insulated lunch box and one of those frozen block things. I may also put in a small cup of fresh fruit cut up inside of a rubbermaid container and put it on top of the ice.

    However, on cold days, I may stop into a supermarket and get a cup of soup and eat it in the car, or find a restaurant or pizza place that also has soups and eat insode, I always take in a chart or two to do while I break, making sure I don't let anyone see names or anything, I pick a table far away and keep only what I am working on face up.

    In summer, I may go to a nice air conditioned library, and do a few charts, use the bathroom, whatever. Can't eat in there, though I confess to sneaking in a sandwich and sitting in the back, sneaking bites as I worked. And a water bottle. Also in summer, I freeze water bottles. I have an insulated bottle carrier, which doesn't allow it to melt too fast, so I may leave it on the seat in the sun for a visit, so I can get a bit more to drink, then slip it back into the carrier.

    So, what does your agency expect you to do? They should perhaps compile a list of restaurants in every county, gas stations, and places you can use the bathroom and give it to you on orientation. But frankly, that is the stupidest rule I have ever heard. I have never in all these years had anyone act like it was a burden to them for me to use their bathroom! In fact many people offer me food, coffee, I always refuse that, but I am not even shy about asking to use the bathroom. Everybody pees!
    Hi Hoolahan, I thought thier policy regarding bathrooms was standard. My agency wants us to make sure you use the bathroom on the way to and from the pts. house. We also shouldn't use the pts. phone unless it is an absolute emergency. Ofcourse they provide us with cell phones so that isn't usually a problem. We do call 911 from the pts. phone if necessary. Our goal is not to inconvience the pt. in any way, shape, or form in their home so I'm told. I'm really shocked that that is not the norm. I will defiantly bring this up at our next meeting. Sometimes, there just isn't a restroom available, and I hate to lose that extra 5 min. several times a day when I could (in the words of Nike)"just do it" while at the pts. house. Do you do this several times a day or once at best. But on the other hand some of the pts. homes look way worse than a nasty old gas station. We have some pts. that we won't even sit while we are in the house . But I'm sure that just goes with the field of nursing we are in(I absolutely love this field). I don't know if you've seen a new little gadget that you plug into your ciggarete lighter and it warms your lunch in about 30 minutes. It is pretty popular among truck drivers.
  13. Visit  hoolahan profile page
    #64 0
    How often?? Well, in all honesty, I don't drink much after I leave the office, or my house wherever I am starting from, so hardly ever really. I don't drink much specifically so I won't have to pee much! lol I am usually parched by the end of the day! I guzzle water once I am home.

    Plus, I am usually in one county, and can usually plan to get home for those kind of stops. There are 5 senior building within 5 miles of my home, so if many of my visits are there, I just drive home for a pitstop, and let the dog have one too!

    If I have to drive far, like I do now, dunkin donuts, little restaurants, or librabries.

    BUT, we have even had a few patients who are on and off service and they tell us to stop in if we ever need a bathroom break! Some of the nurses have regular stops like that.

    As far as the phone, of course we wouldn't use theirs, however, since our agencies cell phone bill was soooo high, we were told to make calls from the home whenever possible, if not a toll call, like to the pt's doctors, pharmacy, etc... Of course not personal use, but we also call the office from their phones sometimes, if it isn't long distance or a toll call. I prefer to use my cell phone in many cases, have you seen how gross some of those phone peices look sometimes? One phone had little roaches in it, after that,unless it is a very clean place, I use the cell, I don't care how high the bill is. At one point our agency was threatening to bill us if we used over 100 min a month. That's <4 min a day! And how many times have you been on hold at a doc's office? Sometimes the automated systems are 2 minutes long!!

    I hoonestly don'y see that you reliveing yourself, if there is no other option close by, or using the phone to call their doctor, is inconveniencing the pt!!

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