Why HH nurses quit

Specialties Home Health

Published

I have decided the biggest reason home health nurses quit is no time off. You work non stop all day 8 am to 5 pm then get home and still have 2 to 3 hours of charting. It is nuts.

Blessings

~Golanv

Specializes in Functional Medicine, Holistic Nutrition.
That's a HHABN that the patient signs to acknowledge they will not receive services. Totally not needed for a non-admit, which is why you don't need the consent form singed to do the admission assessment.

I don't think I agree about the consent form not being signed prior to the admission assessment. Perhaps it depends on a technicality of how the consent forms are set up and how the nurse is conducting their assessment. However, it does indicate in several places in the COPs that patients must be advised BEFORE care is initiated, orally and in writing, of their right to be informed and to participate in planning care, of patient liability for payment, existence of a home health hotline, etc. These are typically items that are part of the usual consent form. The point to be argued would be if an "assessment" is considered treatment or care. I know that I conduct assessments with time efficiency in mind; in other words, I try to make my assessment flow and combine items if at all possible. So, if my patient is diabetic and I'm assessing diet and appetite, I would assess their knowledge of the prescribed diabetic diet-- which may then lead me to do some diabetic diet education. Perhaps the assessment of diet is not "treatment", but the diabetic diet teaching would be. Also, for the purposes of answering some OASIS items (I'm thinking of M1350 in particular), assessment is considered treatment or intervention. For these reasons, I think it is best to err on the side of caution and obtain consent prior to touching the patient at all. As an educator in home health, I taught my nurses to assess homebound status and ensure that they are eligible for services as one of the first things they should do after introducing themselves and entering the home. And then they should obtain consent before moving forward with the assessment. In my opinion, too many issues can arise while you are assessing the patient that moves it from assessment to treatment. And then, if for some reason the patient refuses to sign the consent or agree to services, you have delivered care without the written consent of the patient.

I don't agree that home health attracts loner type nurses with authority issues. It took a lot of adjustment for me to finally get used to being alone most of the time. Previously, I had worked very busy hospital floors that literally made my head spin with all the activity going on at once. I actually missed the hectic pace, but when I tried to go back to the hospital they wanted me to take a pay cut that I couldn't afford so, I stuck it out in homecare.

Unfortunately, I have seen many very good nurses who were not given the time to fully orient to home health which in the end led to their failure. I've also seen many supervisors on a superiority trip create a very hostile work environment for the nurses they didn't like.

***this is EXACTLY why I'm leaving HH***

The Hospital case managers are not doing a good job with this. They should be the ones that KNOW and can TELL the patients what HH is and what HH is not.

I applied for several hospital jobs after being in HH for 8 years. I thought the same as you. I kept getting responses that I "don't have the qualifications for the position"

I've been in HH for a few months and I'm looking for another job. I started out in SNF and I'd prefer not to go back to it, but I will out of desperation if I can't find something better.

The company I work at is really bad. Everyone was incredibly nice and helpful at first, then the complaints started. Every day I would hear complaints about my quota. Everyone at the office is always upset about something and they micromanage everything I do. I spend a large portion of time just driving back and forth between long distances because CMs argue whose patient has priority and demand that I go there. I'm required to see a minimum of 7-8 patients per day regardless of the type of visit. I rarely get to that number, and it typically means I'm making visits up until late at night. Most days I only get about 4 or 5, which isn't even my fault because people are in the hospital or simply don't even pick up the phone.

Anyway...the point of this rant was that the owners now plan on docking my pay because I'm not meeting the required amount of visits.

I wanted to know if anybody here has experience with this. I'm salary and my understanding is that my pay can be docked as long as they offer overtime. However, I do not receive overtime on my workdays despite that I put in about 60-80 hours per week. They do offer overtime on my days off though if I choose to pick up patients.

I'm just trying to survive until I get a new job. Most home health people seem to really enjoy the field. I wish my experience wasn't so bad and all I wanna do is get out.

I work as a case manager for a private duty nursing company. We provide home health nursing services (and in-home therapy services) to medically fragile children.

In my experience of 11 months working in home health, I've worked with the same family (mostly 12 hour shifts) for a family who qualifies for 24/7 PDN (Private Duty Nursing) through Medicaid. I've worked PRN with a few other families as well. The nurses on my case have quit because the mother (separated parents) is consistently negative, a micro-manager and passionate. She's often quick to speak, judge, jump to conclusions and become heated. Thank yous are few and far between. Fault finding (not putting shoes in closet after a hectic day with the child, etc.) much more regular than thanks. She pushes boundaries, some said demanding, some said hypocritical. Most of the nurses that left the case left due to the mother. The work environment was not friendly. The mother never did anything you could outright say was inappropriate in terms of client/company relationship, she was just "not nice." She was frustrating. For example, at one point when her child was a candidate for trach decannulation, she was upset because she did not want to lose nursing hours qualification. Nurses felt she should be glad because decannulation was a positive step. With counseling and time, she saw the positive side, but it frustrated a nurse who was trying, but unsuccessful in her own pursuit of child-bearing. It frustrated other to listen to her complain about decannulation for 15 minutes when they were trying to give report and go home. It frustrated others just due to the negativity.

My reason for quitting... I have not quit yet. I'm finishing up a Bachelor's degree and then hope to transition from home health to the hospital. My reason for quitting will be is that professionally (and personally) it's hard, excruciatingly hard to work 36-40 hours with the same child for months (3 12's or 4 10's). Over the 11 months that I provide PDN services to the same child, I saw him grow from a ventilator, barely mobile, weak, developmentally delayed baby on GB feeds to a terrible two year old, no longer on a vent, walking, talking, strong, eating by mouth and developmentally appropriate. We had our special things. We did the rollercoaster (where I throw him in the air) and then he'd say more. He was happy to see me when he woke up in the morning and he gave me hugs and I 'BOOOPed' his nose. I feel I taught him many things and saw many 'firsts.' I got too close. On my last day, after giving report and having sentimental conversations with the mother, one last roller coaster with the patient, I ran out crying and cried on my drive home. That is why I will quit home health nursing. I could do it indefinitely because I am a professional, but I don't want to.

Specializes in NICU, PICU, Transport, L&D, Hospice.
I've been in HH for a few months and I'm looking for another job. I started out in SNF and I'd prefer not to go back to it, but I will out of desperation if I can't find something better.

The company I work at is really bad. Everyone was incredibly nice and helpful at first, then the complaints started. Every day I would hear complaints about my quota. Everyone at the office is always upset about something and they micromanage everything I do. I spend a large portion of time just driving back and forth between long distances because CMs argue whose patient has priority and demand that I go there. I'm required to see a minimum of 7-8 patients per day regardless of the type of visit. I rarely get to that number, and it typically means I'm making visits up until late at night. Most days I only get about 4 or 5, which isn't even my fault because people are in the hospital or simply don't even pick up the phone.

Anyway...the point of this rant was that the owners now plan on docking my pay because I'm not meeting the required amount of visits.

I wanted to know if anybody here has experience with this. I'm salary and my understanding is that my pay can be docked as long as they offer overtime. However, I do not receive overtime on my workdays despite that I put in about 60-80 hours per week. They do offer overtime on my days off though if I choose to pick up patients.

I'm just trying to survive until I get a new job. Most home health people seem to really enjoy the field. I wish my experience wasn't so bad and all I wanna do is get out.

If I were in your shoes I would contact a labor lawyer after I asked my employer to provide for me, in writing, exactly how they were going to "dock my pay", for what reasons, and by how much.

That's what I was thinking too. I'll wait until it happens because nobody has mentioned it again. I'll go to our finance department to ask for a rationale and see if I can have it written out for me so I can bring it to the dept of labor

+ Add a Comment