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hoolahan hoolahan (New Member)

Calling all HH Nurses, roll call

Home Health   (142,429 Views 579 Comments)
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Well best of luck to you and I hope you enjoy HH. I love it and often did not get down time but that has changed as I returned to per diem status. Trying to see 30 patients a week, do ROCs ,SOCs,case management and drive lab specimens to labs where I am asked to "wait in line"... was just toooo tooo much for this old bird. I wish you the best new HH nurse and I will attest to the fact that is a rewarding field of practice ( despite the monumental paper pushing)...

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HH the paperwork is all too time consuming and too much duplication of information. Being assigned one patient 45 miles east and another 60 miles north is plain insanity...especially when you must MAKE a daily productivity quota of 5-7 patients. It is not in the realm of consideration that driving 50 miles to see ONE pt and then 60 in another direction to see ONE patient then driving another 60 back back to see the remaining 5 ...is WORK. The time traveling is not considered at all. If it eats half a day then so be it...work another 8 hours to finish visits and then paperwork deep into the night. Insanity.

You are working for the wrong agency. My agency would never expect that of any nurse. That is ridiculous.

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I received my passing NCLEX (for the second time in my life) in May of last year. I applied at every hospital in my area. They wouldn't give me the time of day. I am now working home health pediatrics and I love it! Just signing in.

Vera

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You are working for the wrong agency. My agency would never expect that of any nurse. That is ridiculous.
:up: I have (since posting my comments ) went to a per diem position because I simply was unable to keep up that pace. I have some very talented administrative RNs working with me whom I have so much respect for as professionals, so I chose to remain with the company. I was per diem prior to accepting a FT position. The requirements are ridiculous for FT.The expectation is 30-32 visits per week ( Mon-Sat). That averages 5-6 daily and if a patient cancels a particular time we are to reschedule for that week which can lead to seeing more than 5-6 daily. There is no flexibility for emergencies or consideration for unexpected circumstances such as having to root around for the appropriate person to sign a consent. If a clinician is 50 miles east and an SOC referral comes in we are to " skedaddle" to that open which can be 50 miles in another direction. Yes..."skedaddle" is what I was told to do in one situation. Another situation was to go and draw a blood specimen 60 miles north then drive to another area 40 miles south and "find a lab" to drop of the blood ( an order given at 3pm in the afternoon ( an hour and a half drive to the patient) then another hour drive to the location to find a lab that typically closes at 5pm. Insanity is a mild definition for such expectations.:jester: In addition ...meeting deadlines for SOC's ROCs etc...attending "mandatory" meetings that can last 2 hours into an already crammed schedule. I am afraid that this nurse simply could not maintain that pace. It is quite obvious that not many can as the agency now has zero FT RNs on staff in that office with the exception of adminstrators who now must do the administrative work and go to the field. I love my profession, I am disappointed at what it has become in the years since I began my practice. Those left in the wake of the mad rush for profit are the patients who need our services desperately. :twocents::twocents: ( my 2 cents for all the difference it makes).:nurse:

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Thank you HH nurses for all the imput. I can see how this job can quickly become overwhelming. I had to leave the hospital because I couldn't stand on my feet for 12hours (doctors orders) , and it took a whole day to recover each time I worked. I guess I will stay per diem at the agency and if I get 15 regular visits in a week that will have to be good enough. Of course the agency wants more, like managing 25 - 30 pts plus all the extras. I don't see how it is possible. Keep posting your imput fellow nurses, I learn so much from all of you plus I don't feel like I am the only one who struggles.

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My name is Jamie, I have been working in home health since Aug 08. It has taken awhile but I have to say that I LOVE my job! I love my patients (the vast majority of them that is) and have never felt quite so "necessary" in any other job that I have performed. I of course don't love the paper work but have developed a "system" with my paperwork so that it is not so painstaking. It is a small price to pay for the freedom and enjoyment of the work that I do.

Would love to hear about your system

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would love to hear about your system
would love to hear about your system too....

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Uhhhhhhh...Wrong word...My meaning is double or more documentation of the same facts. Sorry...Need to go back to third grade and learn definitions of words...My brain said "double" sooooooooorrrrrrrrry....Of course any nurse understands repetition....documenting the same on reams of forms...:) (?sp) Tired nurse here....lolol
Repetition....over and over and over and over again. Writing a patients' name 50+ times on one open ( count em)...and the pts birthdate....cert dates blah blah blah...Ansewering the same question with different wording over and over....

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hello everyone, im new to home health nursing working here in houston. just posted a thread asking tips on how to write good summaries. very newbie to HHN and need mentoring. i like what i do in visiting the patients at home, it gives me fulfillment especially when patients express their gratitude after every visit. but i believe i need more improvement in my documentation skills. any tips you share would be greatly appreciated. thank you and God bless everyone.

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The focus is on the goals set in the POC. Each visit note should reflect your teaching,the patients response and the progress towards goals.Three weeks before end of cert period your patient should have met at least 80% or more of goals and your documentation should reflect that.If the goals have not been met then consider recerting if patient has proven to be competent in meeting goals and have not met functional potential according to your assessment. When writing your summary refer to your IDT plan and address the goals met . Also address any goals not met and why. Include in your final summary the followup plan and any materials you provided with teaching ( logging blood sugars,blood pressures ,diet etc) regarding pt management of disease process in the future. If wound care was your focus then document your teaching of wound care either to patient or caregivers, wound measurements and status of wounds throughout cert. In HH the teaching is the vital key to include in documentation.

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I agree with the previous synopsis of charting by Ryan Sophie!

Whatever you do, don't use previous notes in the chart as your guide, unless by some miracle they reflect that post.....

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