Calling all HH Nurses, roll call

Specialties Home Health

Published

Hi, as a newly appointed moderator, I want to live this forum up a bit. I just resigned my position as a HH supervisor, to go back to the field.

I have been a nurse 20 years, 17 in critical care, mostly cardiac critical care, and the last 2.5 years in HH, or asthma disease management , which I also had to leave because I hated to be in a cube farm all day.

I still love HH, even though PPS is the pits, even though the OASIS would make good kindling for a massive bonfire, and even with all the rest of the paperwork, it is the most rewarding nursing I have ever done!!

PS, I went back to my former VNA who is now paying $30/hr, yes, you read that right, to work 3 out of 4 weekends. Since weekends work well for me, it's a good deal.

Let's hear from all the HH nurses out there. Out of all those registered members, there's got to be plenty of us on this BB!! :D

Thanks to all for the great info and insights into the world of HH nursing. I am considering jumping off the cliff of over twenty years of psych nursing into HH. These days in psych, we get plenty of basic med-surg, IVs wounds, G-tubes, diabetics etc., but I wonder if I really could learn fast enough to do a competent job being so long out of school and no recent experience on a med-surg unit. I love the idea of the autonomy and being in the community, but wonder if my resourcefulness will be enough. Any opinions or HH nurses who came from psych?

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Specializes in OB, HH, ADMIN, IC, ED, QI.
Thanks to all for the great info and insights into the world of HH nursing. I am considering jumping off the cliff of over twenty years of psych nursing into HH. These days in psych, we get plenty of basic med-surg, IVs wounds, G-tubes, diabetics etc., but I wonder if I really could learn fast enough to do a competent job being so long out of school and no recent experience on a med-surg unit. I love the idea of the autonomy and being in the community, but wonder if my resourcefulness will be enough. Any opinions or HH nurses who came from psych?

Hmmmmm, I've always thought the world in general is a psych unit, and your experience in that field can only be an asset in home care, as there are plenty of "unhinged" patients and family members you'll meet. I know you may have been joking, or half serious in the first sentence of your post, but please look at it seriously............. like why you're "jumping off", instead of augmenting your career...........

The worst part of HH is the paperwork, and in time that gets easier and faster. If only we used computers, with nurse friendly, pertinent software it would be better, but I'm always looking ahead.

Best wishes!:heartbeat

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Hi greenlotus

It can be frightening when you leave an area and jump into one like HH. I would hate to think about leaving HH after the 22 years I've spent here. We've had several psych nurses come to our agency and they do wonderfully. We have two with us now. They have brought their specialty with them and they are very welcome. We have several psych patients for whom they care. Come join the fun.

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Specializes in hospice, rehab, insurance CM.

Hi,

I'm an RN w/15 yrs of experience. we moved from the midwest to Louisiana almost a yr ago. I had to take a 20 % pay cut to work anywhere and am working home health. I feel burnt out already. I am driving a 50 mi radious and am doing 26 or more recerts/admissions a mo. I love the home health except for the filthy environments. The patients are wonderful and I like management and staff. I am still trying to get to know the outlying areas to be more efficient w/my road trips. I added an online map to Mapquest an GPS. Do you think my caseload is too large? What kind of tips can you offer?

Thanks,

Eileen

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Specializes in OB, HH, ADMIN, IC, ED, QI.
Hi,

I'm an RN w/15 yrs of experience. we moved from the midwest to Louisiana almost a yr ago. I had to take a 20 % pay cut to work anywhere and am working home health. I feel burnt out already. I am driving a 50 mi radious and am doing 26 or more recerts/admissions a mo. I love the home health except for the filthy environments. The patients are wonderful and I like management and staff. I am still trying to get to know the outlying areas to be more efficient w/my road trips. I added an online map to Mapquest an GPS. Do you think my caseload is too large? What kind of tips can you offer?

Thanks,

Eileen

Dear Eileen (and all HH nurses swamped by the needless repetitious paperwork our government requires of us):

It seems to me that 26 of the most paperwork oriented cases, appears to have nurses doing all the admissions. P.T. s can do them, but some agencies don't allow that. Try to find out if there is uneven assigning going on, and then get the ear of your preceptor (you do have one, don't you?).

When new personnel come on the scene, it's a great opportunity for those in high positions in the agency, to hear a fresh voice reflect what others keep saying is superfluous. Yet it's hard to start off as a complainer, and get anywhere (other than out the door). You've had some time now, to show your worth, so you can now voice your concerns, gradually.

First of all, there is software for completing those forms, that automatically fills in repeated questions' answers.......... how about Medicare providing that with their forms? It would certainly stop errors caused by boredom (like the wrong date, address, name).

It would be lovely also if the symptomatic information we provide, along with the medications ordered, automatically brought up the ICD-9s.........; and medication categories and side effects could be there, too which would save hours of time. Since books provide the information no one can retain in its entirety, let the forms do that!

As far as filthy environments are concerned, that can be called patients' inappropriate placement. If they're in dangerous circumstances (as well as healthcare visitors), Adult Protective Services may be required. If you're working anywhere near the flood locations, molds can harm you and the patient! There are diaster funds still available to rid buildings of that. Maybe a word to Oprah, too.....?

Best wishes. You can contribute positively to your and others' lives in a way others may not have tried. Go For It!!!!:yeah:

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Hello,

I just decided to accept a job as a HH RN with the VNA. All I have thought of since nursing school has been community health, it is my goal and my passion. I spent the first year of my career on a busy med-surg pediatric floor at a teaching hospital. Although afraid to leave the world of acute care so quickly, I feel like I need to seize this opportunity to enter HH. Thank you all for the posts and threads, they helped me land the job and decide to take it! I look forward to coming here again once I start, but until then I'll be checking those articles mentioned for HH rns in a previous thread. Any advice or tips to a newbie would be welcome. Thanks!

ps: out of curiosity, what is the average case load you all have? Mine will be 20-25 patients with 5 visits per day. Is this standard? I read in a hospice thread that more than 12 is alot, but maybe that is b/c of the high acuity of hospice pt's???

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Specializes in LTC/hospital, home health (VNA).

Welcome to HH Anna! You'll love it. You're right - there are numerous post on how to prepare for HH and what to expect, so look around then ask us a bunch of questions as they come up!

20-25 patients with 5 visits per day. Is this standard?

That is pretty average for my VNA. There are times where the census is higher and sometimes lower. I see anywhere from 4-6 a day ( with admissions counting as 2 visits due to the increase time of visit as well as charting). Seeing 7 is pushing it, but I live in a rural area and sometimes the travel time can add up. Hospice visits take more time - our hospice nurses only see 3-4 patients a day. Good luck to you. Let us know how it goes.

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Well I have been doing Home Health for 6 years here in Texas . I will tell you the paper work kills me , comming up with the teachings is hard.I work for a small company as the only feild LVN and I may see 8 - 11 people a day, so if you find out a better way for the paper work let me know , Thanks Vicky:redbeathe

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Specializes in OB, HH, ADMIN, IC, ED, QI.
Well I have been doing Home Health for 6 years here in Texas . I will tell you the paper work kills me , comming up with the teachings is hard.I work for a small company as the only feild LVN and I may see 8 - 11 people a day, so if you find out a better way for the paper work let me know , Thanks Vicky:redbeathe

Do LVNs in Texas do OASIS forms? They're the worst. There is software to help with them, but the HH agencies I've worked at, say that it's unaffordable.

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Specializes in Vents, Telemetry, Home Care, Home infusion.
Do LVNs in Texas do OASIS forms? They're the worst. There is software to help with them, but the HH agencies I've worked at, say that it's unaffordable.

Federal Medicare and state medicaid regulations permit only RN's to perform OASIS assessments.

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hi! I need advice. For almost 2 months I'm working in a government hospital as an OR Nurse, also my part time job is Home Health. I'm planning to give my work as an OR nurse and just be full time Homehealth nurse. Is that a good decision?? please advice..what are the advantages and disadvantages of working as a full time homehealth?

Tricia

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Specializes in OB, HH, ADMIN, IC, ED, QI.
Federal Medicare and state medicaid regulations permit only RN's to perform OASIS assessments.

That's what I thought, but the LPN in Texas wrote that she is swamped with paperwork, and I don't think regular charting of her services given are that copious, compared to that RNs have to do.......:confused:

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