Calling All HH Supervisors and Managers

[JennyHHRN]

I'm a clinical supervisor for a small hospital-based home health/hospice agency. I find myself having to absorb more and more duties every day and feel frustrated at the lack of resources available.

I love this website. I wanted to find out how many of you out there would be willing to share your knowledge or daily frustrations of trying to serve in the ranks of home care middle management.

Typical day for me:

6am-hit snooze for the 10th time, contemplate calling in sick

7am-hit the shower, think perhaps I can survive one more day

7:30am-what are my priorities today? How can I get out of wearing pantyhose?

8:00am-I am going to make a difference today, I have a great team, energy to fight the system,and I know there are 5 things I can complete on my "to do" list today, "Ain't No Mountain High Enough" plays in my head :nuke:

9:00am-bogged down in voice mails, e-mails and people holding for me, line of people outside my door wanting to case conference or have laptop fixed

10:00am-last of one of the crowd outside my door is gone and need to attend meeting regarding patient/employee satisfaction, add 10 more things to my "to do" list

11:00am-VP needs stat reports explained, why is volume up or down or stagnate, etc.....what is my action plan? CEO says I need to cut more out of budget somewhere. (only thing left to cut is toilet paper)must send memo: One square per employee.

12:00pm-no time for lunch, blend wt loss shake and slurp at my desk while pulling together acute care hospitalization rates for the month and making return phone calls

1:00pm-irate family of patient on the phone wanting to know why nurse cannot come to just draw blood for the rest of the patient's life, isn't that what they pay taxes for?

1:30pm-head to physician offices to drop off orders and "market":monkeydance:

2:00pm-scheduler notifies me that we have no on-call nurse for the night and not enough staff to cover all incoming admits needing to be done tommorow-fix it now

2:05pm-adm nurse calls from pt home, patient needs wound packed tid, no willing and able caregivers to teach, patient can't do, scheduler says we have no room for all these visits

2:15pm-kindergarten calls, my six year old has a belly-ache:barf01:

2:16pm-husband says his job more important, cannot leave to go pick up child:madface:

2:17pm-grandpa on the way to get belly-aching six year old

2:18pm-feel like a failure as a mom and clinical supervisor:bluecry1:

2:30pm - can't find desk under mountains of paperwork, clear space by creating several big, teetering piles, have mini strokes every 5 minutes knowing that chart reviews not getting done.

3:00pm-Upload Oasis data to state database, spend next hour figuring out why 3 files rejected

4:00pm-Found overworked but loyal nurse to cover on-call

4:15pm-VP calls, can i please present disease management program to physicians in two days (need powerpoint with stats and pathways, etc...)

4:30pm-Physician office calls late referral, wants patient admitted tonight. Peg tube was placed yesterday and patient sent home, no teaching, no tube feeding ordered or dme in home, if we can't do it, threatens to send referral to competitor agency.

4:40pm-call to family to say I'll be home late, don't wait up.

5:00pm-feeling stupid for being so positive this morning, want to quit and sell coconuts on a beach somewhere. "Take this Job and Shove it" plays in my head.

[CapeCodMermaid, RN]

Just a comment on your 2:05 three time a day wound packing.

Why didn't intake know the person needed 3 times a day visits so it wouldn't be a surprise? Most wounds only need to be packed once or twice and that person sounds like a great candidate for a wound vac!

[JennyHHRN]

My thoughts exactly. Intake states the d/c planner told her it was a daily dressing. D/C instructions sent home w/pt stated TID. Will explore wound vac option w/physician.

[Quietstorm1234]

Most visiting nurses/other staff members think that office staff members get to sit on their rear all day and relax. If only they knew. Great run down about how our day goes.

[joannep]

2:16pm-husband says his job more important, cannot leave to go pick up child

I hear you, I also have a hubby who earns more than me, so therefore his job is more important.

(only thing left to cut is toilet paper)must send memo: One square per employee.

We also had this type of memo; which led to a bit of a giggle, as we all sat on the throne and yelled out to each other "I am only using my allowed bit of paper". It died a natural death.

Otherwise, you have done a fantastic job of outlining a typical day,

[amesly15]

and I thought I was the only one experiencing all this. Add staff calling in and trying to cover their patients for the day, rehab staff's clerical asking numerous questions about coding and oasis, other supervisor calling me to ask questions, social worker from the hospital calls to ask how she can get a patient on care, little old lady calls and her ileostomy bag came off an hour ago and she can't get it back on (who can I send), lunch...at the desk (where else), meetings, orientation, chart reviews, stats, more stats (why the hell don't they hire a QA nurse?), emails from the DPS asking why something wasn't done yesterday, on-call nurse calls in (I am on a roll now I might as well take the on call - it will save me looking for someone)....time to go to a therapist and discuss coping mechanisms! My plan is to apply for the next Prevent position that comes up at my agency before I get an ulcer! They look like they have so much fun...funny stories from the STD clinics, visiting those cute little new babies, bat stories and rabies injections--OH YES I AM LEAVING CHHA!