Calling all HH Nurses, roll call

[hoolahan]

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!!

[LuLu2008]

that's when the job descriptioin you were given at hire comes in handy....... i'm sure that it doesn't state that records are done gratis!

just so we are all clear on our discussion--what paperwork/records are hh nurses thinking should be reimbursable? it was my understanding that whatever paperwork related to the patients i care for (e.g. faxes to doctors, writing discharge summaries, spending time revising medication lists, contacting and documenting communication with therapists and hha's) is considered part and parcel of my pay. in my agency, we are paid per patient encounter. if that encounter generates paperwork it is considered part of the visit. any guidance i should know about here?

[lamazeteacher]

just so we are all clear on our discussion--what paperwork/records are hh nurses thinking should be reimbursable? it was my understanding that whatever paperwork related to the patients i care for (e.g. faxes to doctors, writing discharge summaries, spending time revising medication lists, contacting and documenting communication with therapists and hha's) is considered part and parcel of my pay. in my agency, we are paid per patient encounter. if that encounter generates paperwork it is considered part of the visit. any guidance i should know about here?

you're right! all documentation resulting from home visits (hvs) needs to be considered part of the hv, and nurses' time doing that requires compensation. any referrals and office work required to accomplish that, including telephone calls, faxes, etc. are included.

you may contact the federal department of labor at dol.gov/compliance/topics/wages-other-breaks.htm

there are guidelines there, and all the laws affecting all the states are there.

congratulations on working for one of the only agencies that compensates their employees appropriately.

[LuLu2008]

you're right! all documentation resulting from home visits (hvs) needs to be considered part of the hv, and nurses' time doing that requires compensation. any referrals and office work required to accomplish that, including telephone calls, faxes, etc. are included.

you may contact the federal department of labor at dol.gov/compliance/topics/wages-other-breaks.htm

there are guidelines there, and all the laws affecting all the states are there.

congratulations on working for one of the only agencies that compensates their employees appropriately.

sorry, i think i was unclear. my agency pays only for the patient encounter. if i do additional documentation this is not compensated separately. i don't know (1) if i will be laughed out of town for asking for $ to do this documentation for my clients and to provide appropriate nursing care or (2) if i will be fired for insubordination or (3) be the subject of office gossip for having a "pushy" attitude. i would love to know how other agencies compensate for this sort of documentation, and thus be able to make a case for being underpaid. but then again, even if i am underpaid, there are no real nursing jobs in our town so they can thumb their nose goodbye at me.

[lamazeteacher]

sorry, i think i was unclear. my agency pays only for the patient encounter. if i do additional documentation this is not compensated separately. i don't know (1) if i will be laughed out of town for asking for $ to do this documentation for my clients and to provide appropriate nursing care or

most hh nurses agree that hvs + documentation needs to be compensated together, not separately; and have the same misgivings you have listed below.

(2) if i will be fired for insubordination or possibly, ask around to see if anyone had raised the question before, as long as you know whoever you ask, well enough to trust that your inquiry will be held confidentially.

(3) be the subject of office gossip for having a "pushy" attitude. i would love to know how other agencies compensate for this sort of documentation, and thus be able to make a case for being underpaid. but then again, even if i am underpaid, there are no real nursing jobs in our town so they can thumb their nose goodbye at me.

(3) only non nurses who don't get how long we work on extremely time consuming paperwork would do/think that, or if they had another nurse who tried to be fairly compensated.

you need to get in touch with the new national nurses' union for assistance. this "slave" labor situation has gone

on far too long, and should not be tolerated! you need support to do it, though. go to the thread about this new union, which is listed above, on the right, under "news".

best wishes for your success getting your agency to adhere to the fair labor laws! :grpwlcm:

[LuLu2008]

Sorry, didn't see a link above entitled NEWS.

[MBARN]

Hi, I am a new nurse just off of orientation for the last few months working in a step down unit, a cross between med surg and icu. I am going to start to work as a HH nurse for children parttime. My question is, if I decide to go full time and not work in a hospital anymore will that hurt my chances for getting into a FNP program in the next 2 years? I was thinking of doing home health for children and then med sur for adults for the experience. I want to have a bit slower pace so that I can learn better and more efficiently and give patients the time and attention they deserve. Any info would be appreciated, I am very new to nursing and to HH.

[lamazeteacher]

sorry, didn't see a link above entitled news.

hi!

it was hard to find, as the news had changed........ but here's what i think i wanted to share with you:

news release

whd news release: [11/19/2009]

contact name: dolline hatchett or joseph de wolk

phone number: [phone] or x4681

release number: 09-1452-nat

statement by us secretary of labor hilda l. solis on wage and hour division's increased enforcement and outreach efforts

washington-u.s. secretary of labor hilda l. solis today issued the following statement regarding the increased enforcement and outreach efforts of the department's wage and hour division:

"there is no excuse for employers who disregard federal labor standards - especially those that are designed to protect the most vulnerable in the workplace. the failure to comply with these basic labor standards means that workers are not receiving the money they have earned. it is both an economic issue and a fairness issue. america's workers should rest assured that protecting worker rights is a top priority at the department of labor. to make good on that promise, i have hired an additional 250 new wage and hour investigators, a staff increase of more than one third, to ensure that we promptly respond to complaints and can undertake more targeted enforcement.

"in the past three months alone, the department has had several significant enforcement cases, including collecting nearly $2 million in back wages for more than 500 workers.

"in early 2010, the department will launch a national public awareness campaign titled "we can help" to inform workers about their rights. the department will work closely with advocacy groups and other stakeholders to ensure that the materials developed for the campaign reach the workers who need them. we will not rest until the law is followed by every employer, and each worker is treated and compensated fairly."

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[RyanSofie]

One does not need to travel to South Africa to see children suffering in dire poverty and from neglect. I am a school nurse here in the USA who has seen children come to school im sub zero weather without coats or warm clothing. I have seen a child come to school so dirty and smelling so badly one could not get near him. He had to be showered and clean clothes given to him from the school closet ( donations made by teachers and administrators keep a limited supply of needed clothing/coats/shoes etc for these situations). Referrals are often made to help families struggling and in cases of neglect CPS contacted. We as a nation need to first look around us and help our children. There are millions right here who go to bed on Sat and Sun having had no food the entire weekend but who are fed breakfast and lunch Mondays at school.

[Diane L RN]

My first time in this forum! I'm a registered nurse currently Director of Operations for a proprietary home health care agency. As a working nurse with 34+ years, my focus is to provide support to all our agency nursing personnel! I'll always remember my early days in nursing, including the hospital, and the lack of true caring from our senior management. Now that I am in charge of our agency, the most important thing to me, is the welfare and professional satisfaction of the staff! I think I'm going to enjoy this site!

My best,

Diane L

[Diane L RN]

Our agency uses a specifically "nurse-intuitive" point of care laptop computer system. Although the nurses were pretty intimidated at first, even the more mature nursing staff, not so "computer-savvy" caught on quickly. Documentation is key to success, and our nurses literally form the basis for our home agency business. Our system uses specific teaching tools and check off boxes to streamline OASIS data gathering. I believe, since we left the paper behind, the documentation has improved dramatically! We all try to help each other out, but the government mandates the amount of data required. OASIS-C begins 2010~

[Diane L RN]

Hello! Sounds very ambitious and dedicated! Home health care is unique in the sense that you are providing direct care within the environment, and as a nurse, it is possible to assist clients to make important life style changes, achieve and maintain ability to manage diseases, but most importantly, allow a client to STAY HOME for care! Like old school public health nursing, home care is really the way of the future! As a nurse with previous experience in an institutional-based practice, nurses can be a lot more autonomous. It's really 1:1 nursing, and, although not for everyone, home care can provide immense satisfaction as patients recover - or, have their needs maintained in their homes! Good luck!

My best,

Diane L RN

[lamazeteacher]

My first time in this forum! I'm a registered nurse currently Director of Operations for a proprietary home health care agency. As a working nurse with 34+ years, my focus is to provide support to all our agency nursing personnel! I'll always remember my early days in nursing, including the hospital, and the lack of true caring from our senior management. Now that I am in charge of our agency, the most important thing to me, is the welfare and professional satisfaction of the staff! I think I'm going to enjoy this site!

My best,

Diane L

Keep that focus, Diane!