Typical day for a HH nurse... - page 10

by hoolahan

173,144 Unique Views | 249 Comments

Hi guys, I thought it would be nice to start an ongoing thread to just post/vent about your usual day. With a lot of entries, it can sort of serve to show nurses who are thinking about getting into HH what it is really like on... Read More


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    Hoolahan,

    A jersey girl myself I wanted to thank you for posting this. It was very helpful for me since i am considering going into HHC from the NICU. IF you see this or anyone else does and has advice for an interview I have Monday with a Peds home health care I would greatly appreciate it!
    Thank You!
  2. 0
    Yeah, this is a great thread and thanks for starting it, Hoolihan.

    I was supposed to go in for orientation to paperwork/forms today, but it was moved to tomorrow. Hopefully, I'll buddy up with a former colleague the day after tomorrow, THEN hopefully I'll be set to go and actually leap back in to HHC after 5 years away from the field. I already had an agency orientation last week.

    This thread has been instrumental in my decision to return to HHC, because really -- it sounds like things haven't changed that much since I left, and I always loved it. Hopefully, it will pay the bills! I left NOT because of paperwork, but because I did not care to work for hourly pay at a hospital-based agency and those were the only ones that had a steady stream of referrals after OASIS came in. I'm returning to the field per diem, to maintain a comfort level of control over my scheduling, but I am hoping to work full-time visits for the most part.

    Again, thanks for this thread!
  3. 1
    Wow--when I started visiting this site, I was still a "daysleeper"--working night shift on the Oncology Floor. Part of my decision to transfer to Home Health was because of the posts here! Anyway . . . about my day today.

    9:30 Called my first patient (who is a long time friend of my in-laws) and she agreed to me visiting at 10 today.
    10:00 Saw first patient, drew Protime/INR, then ended up sitting and chatting with her and her (very talkative) husband for a half an hour about "the good old days." (Good thing I'm not busy today!!)
    11:00 On to patient #2. I love this little fella. Since I opened him for care back in November, he has had an MI, has been diagnosed with CHF and now has a MRSA+ wound on his leg. Took photos and measurements of wound today, wound care, etc.
    12:00 To the office. The hospital my agency is through treated everyone to pizza today for lunch. I was happy--I was starving and didn't want to take a break to go out for lunch.
    1:00-4:00 Charting, phone calls, etc. Also reviewed charts for every patient in my caseload (10). (Guess what happens next week? JCAHO survey! Woo hoo!)
    4:30 Home at last. A few more phone calls and I am done for the day. I like "easy" days like today! I love this job and have never been able to say that about any job before!
    AnnZan likes this.
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    Quote from curleysue
    I thought I would give you my typical day as a home health aide. Which I think is quite interesting.

    7am-8:30am
    -Get up, shower, drink my hot cocoa, look at my schedule and out the door I go

    8:30-2pm
    -First client, 27 years old, 3 years ago involved in a DUII MVA. Resulting in fractured back, crushed pelvis and closed head injury. Was in a coma for 2 months. Currently is ambulatory, can do many things on her own however cannot stand or sit for long periods of time. So she cannot hold a job. She is in the process of getting SSDI.
    -I get her up in the morning, shower, help her dress, medications, cook breakfast. Then I start cleaning. THe house is trashed everytime I come there. THe day before I am there I leave the house spotless but the next day it is trashed. Her husband is the laziest person in the world. Will not even do a dish, take the trash out, pick up his clothes, I could go on and on. They also have a child so that adds to the mess. I just take a deep breath and begin my 4 hour cleaning routine. Make beds, do dishes, wash clothes, scrub bathroom and kitchen floors, vacuum, pick up toys (client cannot bend over to pick things up), scrub toilet and so on. I love cleaning, its something I have always like to do I guess I am weird like that. So I really don't mind cleaning. What bugs me is how incredibly lazy her husband is. He NEVER does anything! I was told I was only supposed to do my clients laundry, dishes and pick up after her, no one else. WEll, I cannot really do that easily. I guess if it gets really bad I can go on strike and make him do something. He is really immature and spends what little money they have on video games. Lovely, huh? In fact I had to buy my own cleaning supplies.
    -And besides cleaning I have to make sure my client has everything she needs, assist her with her shoes and socks and other things. WHen I first started working there their house was awful, black mold everywhere, just terrible. Now with me there we are starting to organize things so its not so bad.

    2pm-6pm
    -My second client, 50 some year old lady with COPD, Fibromyalgia, diabetes, and on oxygen. I do the same for her as I do with my other client except she is more of a hoarder, stuff everywhere. She has a problem with sugar, eats a lot of junk. Sometimes she has me make a cake or a batch of cookies and eats all or most of it! WOW. THe one thing that really scares me is that she smokes while she is on oxygen.

    Anyways, I cannot emphasize how much I love my job. Although its not really reliable, your never really guarenteed hours or would if someone dies or gets their hours reduced. I get health insurance through them which I really need so I hope I don't have a problem with that.

    Anyways, that is my typical day. I hope I didn't break any confidentiality rules, I didn't name any names and I didn't say the town or state so hopefully I am okay.

    Thanks for listening. CS
    Curlysue, please don't think me rude but your post sounds like it should be on a "merry maids" website. I'm sorry but I refuse to bake cakes, wash toilets, and most of the other things you do. I guess maybe your a housekeeper on a cna salary. As long as your happy that is all that matters. I really don't mean to seem rude,so please don't take it that way.
    AnnZan likes this.
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    Curleysue is provding a different type of home health aide care for clients who are longterm disabled, most likely under a medical asistance wavier program.
    Wavier program is designed as "nursing home diverson program" to provide skilled and custodial care aide services to help a client live at home rather than be placed in a nursing home. They ususally receive several hours per day of mix of home health aide and homemaker services to maintain a client in their own home. HHA hours range from 2 to 8/hrs per day, 5-7 times a week.

    Clients care plan includes personal care, meal preperation and daily kitchen cleaning of sink/table/meal prep area, sometimes weekly food shopping, weekly cleaning of bathroom, laundry 2-3x week along with time for "Companionship" i.e. socilaizing with client to keep them stimulted. Weekly vacumming and straghtening-up of living room and bedroom along with monthy refrigerator cleaning is included. Some programs even have social workers/business staff that mange patients bills.

    These programs are cost effective and improve longevity of client IF adequate HHA supervision provided, often every two weeks or at least monthly HHA while HHA present in the home. Monthly skilled SN visit may be provided for home safety assessment, VS, instruction in diease managment along with evaluating med compliance and possibly prefilling mediplanners.

    Not all home health aides are cut out for this work. I managed 200+ clients on this type program (had staff that made SN visits). After much education, our aides called me immediately if they found their client sick or went to the hospital cause they wanted them back PRONTO upon discharge as they were so concerned for their welfare and it was steady work in the same homes daily.
    mVSd and annaedRN like this.
  6. 0
    Daysleeper:

    WOOT that you had an easy day...treasure those moments. Good luck on JCAHO. KNOW inside our patient safety goals for your agency and what your Quality improvement plan is.

    Wont bore everybody with my day except to say CORPORATE COMPLIANCE OFFICER is visiting on 3/14 to pull 10 staff charts and 10 physicians to see if sanction check was performed. For two days I've asked our IT department for current doctor list just for my company (we manage 4 agency's Intakes) and still without list at end of day so IT director got an email--last list i had was from 2002 when we installed new computer and loaded doctors so outdated. I know we have several thousand doctors and at least 500 don't have sanction check cause I wasn't in charge back then. Up at 8AM on laptop at home workinng on docs while washer humming and left office at 9:30 PM.

    Hope everyone's day was better.
  7. 0
    Quote from NRSKarenRN
    Curleysue is provding a different type of home health aide care for clients who are longterm disabled, most likely under a medical asistance wavier program.
    Wavier program is designed as "nursing home diverson program" to provide skilled and custodial care aide services to help a client live at home rather than be placed in a nursing home. They ususally receive several hours per day of mix of home health aide and homemaker services to maintain a client in their own home. HHA hours range from 2 to 8/hrs per day, 5-7 times a week.

    Clients care plan includes personal care, meal preperation and daily kitchen cleaning of sink/table/meal prep area, sometimes weekly food shopping, weekly cleaning of bathroom, laundry 2-3x week along with time for "Companionship" i.e. socilaizing with client to keep them stimulted. Weekly vacumming and straghtening-up of living room and bedroom along with monthy refrigerator cleaning is included. Some programs even have social workers/business staff that mange patients bills.

    These programs are cost effective and improve longevity of client IF adequate HHA supervision provided, often every two weeks or at least monthly HHA while HHA present in the home. Monthly skilled SN visit may be provided for home safety assessment, VS, instruction in diease managment along with evaluating med compliance and possibly prefilling mediplanners.

    Not all home health aides are cut out for this work. I managed 200+ clients on this type program (had staff that made SN visits). After much education, our aides called me immediately if they found their client sick or went to the hospital cause they wanted them back PRONTO upon discharge as they were so concerned for their welfare and it was steady work in the same homes daily.
    Thanks Karen for that info, I had no idea that hha or cna's could be responsible for all that. I understand how some pts. would defiantly need the custodial care, I just don't understand it being delivered by cna or hha instead of a housekeeper. But like I said as long as the person providing the custodial care is happy, that is all that matters. I wish I could get some custodial care . Thanks again, I had no idea that home health provided all that. I guess different agecies go to different depths of homecare.
  8. 0
    Hairstylingnurse-

    Sometimes I do feel like I am doing way too much housework and not enough nursing care! Both of my clients manipulate me, and I take it cause I cannot afford to loose my job. Today I got into an arguement with my client cause she wanted me to pick up cat poop. I said its not in my job description but I would happily give some gloves to her non-disabled husband. Oh no she said, its you job plus cause he has a huge gag reflex and would throw up. Excuse me?! THis is like the 4th time she has had me pick up cat ****. I suggested she get cat litter box so her cats would stop pooping on the carpet, but oh no, she said she already trained her cats to go outside and that it might confuse them. I was like Oh my gosh, are you stupid! The cat is going to go in the house when it needs to go and I am always the ONE to have to pick up the sh*t! I am so mad. I said its not in my job description and that I can give her husband (who was home) a pair of gloves to pick it up and she said, Oh no you cannot make him do it, he will throw up at the smell. Well, excuse me, I hate the smell too, but I have to pick it up?!

    I go out of my way in a lot of things to help her out. I take her daughter to school everyday and I don't get paid for it, plus I bought her sheets and cleaning supplies when I first started working there cause she was so poor. I have about had it. However I cannot quit with her yet until I get another job lined up. And full time caregiver jobs are hard to find in my small town. So I AM STUCK! AHHH! I am so mad. SHe manipulates me into doing everything. Her and her husband trash the house everyday and it takes me hours to clean up. However according to my job description I am only supposed to pick up after her! But that never happens. Do you see what kind of predictimate I am in? I called my boss and said I am up for a new job as soon as one comes in. So I cannot wait until one comes.

    Sorry to vent but I had a very bad bad day. CS
  9. 0
    Curleysue:
    PLEASE report this to your supervisor (before it gets worse). They are responsible for the care plan in the home and telling you your duties.
    Cat excrement inside a home is an INFECTION CONTROL issue and a litterbox definately is in order here.
  10. 0
    I can't report all the stuff I do cause she already told me that they are not paying me for all those extra stuff that is not on my job description list. I know I will lose my job cause my supervisor is going out for a visit to her house to actually determine is she needs all the hours that I am working. I feel like if I let her know of all the things I am doing out of my way she will dock hours off from her and I will be punished by not getting enough hours. See my point? I am stuck. I don't have another job lined up to work if hours are taken away from her. I am trying to raise money to finish nursing school, I only have one year left. So do you understand now?

    I wish there was a job opening so I could say, "See ya" but there isn't. CS


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