Home Health Work

Depends on the client, family dynamics and atmosphere.

I looked into home health a while back and was finding that the LPNs were having to do 8 hour shifts with difficult patients, almost a one on one type of thing. That definitely wasn't for me so I didn't accept the job. This type of situation wouldn't be bad in a hospital where you have a lot of backup, but in a home setting it made me a bit uncomfortable.

There is a big difference between home health nursing and private duty nursing. I am a home health LPN and I love it. I work part time because I have a new baby at home and want to be with him as much as possible. I see on average 20 patients in my 3 days. The patients are all very different and require something different from me each visit. I do wound care, lab draws, LOTS of teaching, injections and other "nursing" duties. I spend an average of 30-60 minutes in each home. I think that it helps if you have had some hospital experience, since you are all alone. Of course, your office and an RN is a phone call away. It is very flexible with the hours and I get paid more than I did doing 3 12 hour night shift at a local hospital.

I can agree that home health pays much more than hospitals for the LPNs in my area. I made more in three days than I did in two weeks. The disadvantage was that there were no union, no medical benefits, no pension. It is a great job to have on the side.

I agree with pagan.

I think its very different from the hospital. I wouldn't say its easier. There is more of a chance for personality conflict because you are in someones home 40 hours a week. I love the one on one because I can focus on one patient and give them my full attention. I don't have to treat them like a number because of overstaffing. It can be hard when you have a family that doesn't care about the patient you are there for. People have such different lifestyles and cultures that there can easily be conflict even without meaning to.
In my experience, I've had families that like me so much they become "dependent" on me. Its good that they are happy with me and my work but, its not good if they feel like they can't function without me (even when competant in taking care of their famliy member). Then there are the families that don't care and you have to keep your opinion to yourself. Those families are more likely to pick up on the fact that you care and that makes them uncomfortable.
Because of personalities and family dynamics its not always easier. I do pediatrics and some of the parents have no sense of parenting. The kids can have some extreme behaviors. I've had kids hit, spit (from trachs too), bite, pinch, kick, etc. and the parents don't do a thing about it. I've had some kids even pull their trachs out to rebel. Luckily most of the things I mentioned are from the same 2 kids who I have not gone back to.
I wouldn't say its easier. But there are "easy" cases you come across occasionally. Most of those don't last long, as the patient is usually about ready for discharge when it gets to that point. I have some days that are busier than when I was in the hospital and I have other days that are so slow its painful. It really depends on the case.
Hope that helps a bit.

I had a pediatric trach patient that did plenty of the things you mentioned. Her mother was very good, though, but the situation was that this child was premature and had damage to her trach due to constant intubations, then, developed a stenosis. She had nursing care 7 days a week for 20 hours per day since her release from the hospital (5 years, now). While the family was great, they seemed to treat me more like a nanny than a nurse, and expected me to travel with them for their shopping, movie, party and outings. This made me uncomfortable after awhile because of the possible liabilities. While they were enjoying the scenery, I was always wondering where the closet hospital was in case of emergencies, had to keep other children from playing too close to her trach, and other things. I decided to leave the case because it was not worth it to me to keep traveling from place to place with these people to entertain this child. Due to that and a few other things, I decided to leave. Now, I would rather work with adults if the occasion ever came up again. The money is great, though, but you do have to concern yourself with family dynamics and culture. Some homes are really, really nasty. You cannot control situations like that, but seeing roaches and mice running close to your bags is not good for your nerves, either. I read a great deal, so, I enjoyed having the opportunity to do that when my patient was asleep.

How is your schedule? Do you normally have regular hours? Do they have enough work to keep you busy? If a case ends, do they find another one quickly?

I only worked on Saturdays, because I have a regular Monday through Friday job at a clinic. Again, it really depends on the agency. Sometimes, they get cases in droves, other times, it was a standstill-at least at my agency. It didn't matter to me, since I had a regular full time job. Most people sign for several agencies to keep themselves covered for situations like this, others sort of know the agencies and know of the 'seasons' when they are the busiest. I make plans to go to mine from October to December for flu season, where I administer flu shots at drug stores, companies and such. This was one that also had home cases, but after I left mine, I decided I would just go during that time of year (have been getting overtime at my own job).

Keep in mind, also, that not each job will be a great fit for you. It may be distance, or maybe the family does not care for you. It is not always personal, it can be for several reasons. When I was a home health aide, I had a Sunday client, but she didn't speak much English. She was able to comprehend what I said if I spoke slowly, and was able to make her needs known, but she eventually preferred someone that spoke Spanish. You may not feel comfortable with the atmosphere, or even like the client, yourself. The key thing to remember is that you are in their home, and are subject to whatever family drama, such as interfering relatives, bad habits (maybe they are smokers, and you have asthma, or they may have an unruly pet...). It may be a whole host of things that can make or break a permanent assignment.

One thing that affects how much you will be working (assuming that the agency has plenty of available work), is your willingness to put up with some of the negative aspects sometimes found with some cases. For example, if you are adamant about, say, no smoking, and the agency staff keeps referring you to cases where there is smoking, even though they are aware of your preferences, an attitude about you can develop in the office. Whether they offer you suitable work or not (here I mean that there was suitable work available, but the staffing person only offered you something they knew you wouldn't want) can eventually be influenced by the times you say no. Trying to put this in a more clear way: the more times you say no, the more times you give them a reason to stop sending work your way. Of course, common sense tells you that the staffing coordinator is most likely letting personal issues cloud their fairness in assigning work. This can really be to your detriment in places that have a firm policy in place about assigning cases. I once worked for a unionized agency that had a written policy stating that only people who were willing to work any type of case in any location would get preferential priority for work. As an individual, it is difficult for you to know whether you are being passed up for cases when work is available. This is another good reason why it is better to be signed up with more than one agency. When one agency doesn't keep you very busy, chances are you can make up the difference at your second agency.
Sometimes keeping oneself working can be quite a juggling act, unlike having a steady job at a hospital. Agencies, and patients (if they are the first to know), will occasionally keep you in the dark about the ending date of the case. Getting told at the end of your shift that you needn't come back the next day can be bad on your plans to pay your rent. Good reason to be with more than one agency.