Confused and scared...I need advice... - page 2

Hi, I am currently an on call RN for a large nation wide for profit company. I have experienced burnout and have taken one LOA earlier this year. At that time I was a case manager for the same hospice company. After returning... Read More

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    I hate to say it, but you are getting screwed!!!! I am an on call nurse and there is no in H@ll I would to that schedule. Not to mention at 150 pt's you should have at least 2 on call nurses at all times, possibly 3.

    It is usual protocol to go to deaths even in nursing homes, we have to stay until the funeral home picks up the body even if the family is there or not. but going out for every call, no way.. Our policy if they call twice for the same thing, we need to go out. We have to go out for falls, (but if its the middle of the night, no injury and they are back in bed, I usually go out in the morning. regs are it must be within 24hours)

    It is my understanding that Medicare pays one flat rate per month regarless of how many visits you make, what meds they get or equipment, someone correct me if I am wrong. the only time they would get more money is if they are on crisis care or GIP, then it is a higher rate.

    I work Friday 5p until Monday 8a. We have a little over 100 pt's and I have a case manager backup. I have to do admissions, deaths and visits. Somedays even with both of us, I still end up working anywhere from 14-16h straight, no breaks except what I eat in my car on the way to next visit.

    What happenes if you get fired? If that would break the contract, I would do what I felt like and if I didn't think they needed a visit, so be it.

    It sounds like a very toxic work environment. Possibly hostile, and if it is hostile, maybe you have something there to work with. You need to document, document, document and if possible, have somelse attend any meetings they have with you. I have known people to lie about that they say, or get a tape recorder and and record it every time you talk to them. CYA.

    Sorry this is such a mess, our work is stressful enough, without that kind of BS.

    Good luck.
    NurseMikki, gswifty, Marshall1, and 3 others like this.

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  2. 2
    OK, there is definitely a problem where you are, you have a bad feeling about what is going on at your place of work, they treatinh you like trash, and all of this is stressing you out and you are going to get sick, depressed, leave nursing or make mistakes, is this all worth it to you? Go to someone that can give you some financial advice of how you could pay this money back. This job is not worth what you are going through. If they really are committing fraud or you even think there is fraud you need to report it to Medicare or you can be considered just as guilty for not reporting and you do not want to lose your license, acrue fines and possible jail time. Seriously, start looking for a new job and get out of there and file your report with the Medicare Fraud Hotline, it turns out it is fraud, you may recieve a reward for reporting it and I have heard that it can be a pretty sum. You can do this anomonis (ok, can't spell), but you need to protect yourself, no one else will do it for you. Best of luck, I hope you come to a decision soon. Life is way too short to be this miserable.
    Bubbles and echoRNC711 like this.
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    Sounds like the hospice I worked at for just about a month before I was outta there. Yours sounds the same. Lots of HH and hospice are fraud. It gets dirty. I am an older second degree nurse - I saw it right off so I gave notice and left.

    Thing is I would support heavy crack down on HH/hospice by medicare. Many are just fraud these days with more new start-ups each year.

    I left fearing for my license and my ability to work being taken from me.

    Get out what ever you do.
    gswifty likes this.
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    look into what's called I believe forgiveness loans for health professionals. I was recently told about this by a friend. She went for her BSN and from what I understand as long as you work for 4 or 5 years as an RN your covered. like I said I am not sure of all the details yet. Good luck and God bless.
  5. 0
    Thank you all so much for your support! In response to bubbles...and all...I have been an RN over 5 yrs...experience in acute rehab, management, LTC, and hospice...I have decided to take some time for myself and really THINK about how to proceed...I am seeking legal advice and doing research on the Internet...whistle blowing is scary to say the least. Seeing your replies is such a HUGE comfort and I thank you all again...I was talking about my take home pay after taxes etc it's about $3000/mo which is great But if I lose that I'm hangin by a thread...I can sew though! Lol (trying to stay positive) I took FMLA?..
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    I think you are on the right track by doing your research. I am an oncology nurse and part of my previous job included some case management functions (navigator role) and sometimes when I was trying to get patients hooked up with home care I had to do what may be considered "creative writing." I did not lie, but medicare has very specific wording they need to cover certain health care needs. I would often have to ask the physician to add an addendum to his note to include why the patient needed enteral feedings etc. Many of the home health and hospice facilities would tell me how things needed to worded. I never lied about anything, and when we could not state things the way they wanted the patient could not get the care, so I think it's very important to complete your research before whistleblowing.

    Of course if you find it is fraud, then you should report them; however I know it's easier said than done. I have worked with so many people that have been unhappy about their jobs and were always saying "I can't quit because I have kids, mortgage, and bills." That is true of all of us, but what I can tell you is that I too worked at a horrible place (not as a nurse), and the manager was awful and swore and yelled all the time. I was just a temp so I may have been treated a bit better, but I saw how the other staff was treated and they all complained. That day I swore to myself that I would never stay at a job that made me unhappy. I have lived up to that promise, and I have had many jobs, but I have gained great experience and I feel confident to stand my ground when things don't seem right in my nursing career. I am also lucky because I work in oncology and have had great experinces. I won't say I aways worked exactly where I wanted to, and I did do travel nursing for a few years, but I am confident in my nursing skills and strongly advocate for myself and my patients.

    It goes back to the old saying, "you need to take care of yourself before you can take care of others." I encourage you to get in a good place first. Make that your focus and put all your energy into you and then you may see things differently and have the strength you need to do whatever it is you need to do. It's clear that your job is a huge stress for you right now so I would suggest doing whatever it takes to get out of there. I too have student loans, I'm a single mom, and have many bills, but I gladly pay those bills each month because I am happy and no amount of money is worth losing your happiness.

    I know it's difficult to make and accept change but I hope you find your happiness. Good luck to you.
    SENSUALBLISSINFL and Bubbles like this.
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    What an awesome post hav2nurse!
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    I don't have the answers, but wanted to wish you well.
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    Be EXTREMELY careful whistleblowing. A medical office employee in this state reported medicare fraud (in the millions) which was found to be true, and while there were no OVERT repercussions, she was unable to find a job for over 5 years. (In other words, all medical professionals talk to each other, and she was "blackballed".) What she did was the right thing, but it came back to "bite her in the hiney." Not saying don't do it, but be aware......
  10. 0
    I worked night call for a couple do GIP for the same agency.

    With a usual home Pt census of about 300, we had 2 nurses for the midnight to 0830 shift. Sometimes one of those nurses would be from the home teams.

    We did TOD visits no matter where the Pt lived, unless the family or facility said "no."

    We offered a visit with any call during the midnight-0830 shift. The family/facility could say "no." If not, we went.

    Fortunately, we didn't have to do admissions, as they're just too time consuming.

    Some nights would be really slow, and others you could drive a couple hundred miles and make three or four visits....then find yourself 40 miles from home when you got relieved by the day team an hour after your shift supposedly ended. That left you with the dilema of getting enough caffeine to get home without wrecking, but not so much as to preclude sleep before the next shift that night.

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