Where does the job end? - page 2

by MomRN0913

4,902 Views | 17 Comments

Still trying to figure out if this gig is for me on month 6. I thank you for all the help in advance for answering my questions.I do home health and hospice. More home health than hospice. Supposed to be mon8:30- 4;30, but it... Read More


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    One of my reasons for leaving my last job was because I could never leave my problems at work. Totally different setting than hh but same issue. Not worth it to me.
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    I do home infusion about 20-40 hrs per pay period and the rest on an IV/PICC team for a different healthcare organization. I put in all my time for HH and they pay me for what I actually do. I get time for patient calls and prep time as well. If something takes me longer than expected such ad a drug reaction or heavy traffic I list that on my DAR and they pay me. In return the company and the patients get a very intelligent and knowledgeable nurse that really has quite a love for the profession.
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    As nurses we do not want to volunteer our clinical or professional time to our employers.
    This creates terrible situations for the nurses who will follow you into that work...the expectation is then alive and well.

    Nurses are professionals in my honest opinion. We should not bill in less than 15 minute intervals, in my opinion, and we should not offer to work off the clock out of the goodness of our hearts.
    KelRN215 and OldPhatMC like this.
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    I really like some of the comments to this post. I couldn't believe the amount of hrs I was putting in daily, as you described. I too am a mom (single) with a <1yr old at the time. I couldn't do it. It's ok everything isn't for everyone. Perhaps you could explore not case managing and just doing visits, or going part time if possible.
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    I feel the same way. I am putting in too many afterwork hours,i am burning out. I feel like work is always on my mind because there is always something to do: call pt,call MD,send in reports,schedules etc..then they always call to ask if I can work more. I love the work but hate having to come home and not be able to enjoy just being off.
    unreal likes this.
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    Same thing. Work all day, try to get all charting done in home and handle issues there but it can put you in a time crunch if you're carrying a full or overfull load. I myself would work 24/7 if I didn't have other responsibilities. Love the job. Sometimes complain about not having enough downtime when it gets really crazy and I've done 5 admissions and 30 visits that week (which for a long busy period that was every week). What's interesting to me though is the "not being paid for time worked." No, I'm not management, but my thought process here is this...are you being paid by the hour is the #1 question. If so, all the hours you spend seeing patients and documenting or working should be compensated.

    If you are being paid per visit, that payment is for seeing the client and doing the documentation that goes along with that visit. I can't wrap my brain around how that can be against labor regulations when you agree to that method of compensation. I know nurses who do visits then go home and have to do their charting but think that's wrong and they don't want to spend the time doing the paperwork. If you didn't document it you didn't do it, right?

    Documentation is how your agency gets paid which in turn provides you your income. In the hospital you wouldn't assess a patient and then not chart it.

    I am paid per visit. The rate I am paid per visit when broken down covers the time it takes to see the patient and the time it takes to document on it. Of course there are those visits that take extra time (multiple wounds, or PICC dressing changes plus labs plus G tube care plus catheter) but then there are those where you go in, assess, teach, and you're looking for something else to do because you feel guilty about not spending at least half an hour with that person. My biggest pet peeve is sitting in traffic (if the wheels aren't turning I'm not making money.)

    I guess my point is if you're working for a per visit rate, keep track of your actual time working then divide that down into a per hour rate. If it's less than what you feel you should be making, assess the situation and figure out why. Be honest with yourself too. Are you taking time chatting with patients and spending too much time in the home? (I do that, that's why I say that) Are you efficient at the documentation or do you struggle through taking more time than should be on each chart? Do you have a difficult case load where everyone needs a lot of care? (time suck, been there too) or is your visit rate just too low that it doesn't cover the average time needed to complete the work? (I have heard other agencies per visit rate in my area and I cringe at some of them, but a couple of them are a little higher than mine). I have done the breakdown on mine multiple times for comparison. I have estimated I make between $30 and $50 an hour including travel time and time spent documenting. When I have a ton of admissions I can make $60 or more an hour. That is excellent pay based on my location, experience, etc.

    No matter what we make we always want more. Just a fact of life. More you make the more you spend and then you want to make more. I live it too, but when I look at the whole picture sometimes I think wow I'm overpaid for once in my life.

    I have those days when I hate myself because I did 4 revisits and 3 SOC's and I'm getting home after 6 and thinking I've got dinner to make, laundry to do, and a mound of paperwork ahead of me. And I'm on call and the phone is ringing (factor in that on call pay too) and it feels like no amount of money is enough to tackle all that tonight because someone sitting in an office believes I've got no life and they want everything turned in within 24-48 hours. Still, voice of reason prevails and I have to remind myself when it's all said and done I made $15 more an hour than I'd make on my feet running back and forth on a busy med surg floor with call lights going off every 15 seconds because everyone needs pain meds, from the pixis, which was moved to another unit because they're remodeling the med room, and that traffic jam I sat in today where I was thinking those wheels aren't turning, I'm not even making mileage here, doesn't seem so bad.
    davianrt66 likes this.
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    I make a crappy per hour rate. So I am not being compensated for my off hours work. Not to mention the fact in the cuter math of hurricane sandy I worked the day after and went down to my gaslight and couldn't work the rest of the week because I didn't have enough gas to even get to the gas station, not to mention find one that had gas with a 3 hour wait. They made me use vacation days, yet managed to call and text me and have me phone sup aides. I wouldn't be doing that on " vacation". Not to mention I had to power for 11 days.I'm done. Not the field for me. They want my blood, and I want my life back.
    unreal likes this.
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    Quote from MomRN0913
    I make a crappy per hour rate. So I am not being compensated for my off hours work. Not to mention the fact in the cuter math of hurricane sandy I worked the day after and went down to my gaslight and couldn't work the rest of the week because I didn't have enough gas to even get to the gas station, not to mention find one that had gas with a 3 hour wait. They made me use vacation days, yet managed to call and text me and have me phone sup aides. I wouldn't be doing that on " vacation". Not to mention I had to power for 11 days.I'm done. Not the field for me. They want my blood, and I want my life back.
    That's a terrible shame the experience you had. I'm sorry for that. Not all agencies are like that. Good luck to you.


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