Can you have a life AND do HH?

NurseFries, BSN, RN · Nov 10, 2013

I think it maybe all 3. Home health visits are not for everyone. I worked as a HH visiting nurse and quit after 3 weeks because I was so tired of seeing patients and then coming home and charting late into the night. I started off with 10 patients a week, but I knew my patient load would increase soon and that caused me a lot of anxiety. I loved the flexibility at first, but then I felt like I never had time to take care of myself and my family. I loved the autonomy but I also missed the social aspect and the support I received from colleagues. I also felt like I was doing the job of 3 people. I had a lot of anxiety and was scared my license would be taken away if I forgot the littlest detail.

You may want to look into private duty HH nursing. The pay may not be the same, but you would take care of 1 patient per shift, chart, and go home. The nurse manager/supervisor would also do the case management for the patient which equals less stress for you :). I personally do not like case management.

I recently took a private duty HH nurse job which does not pay much, but it is less stressful. I will continue to look for another job while working. HH jobs are a dime a dozen. Many nurses do not like working HH b/c of the constant change in the environment and driving all over the place.

I suggest you look for another job STAT b/c it will probably not get any better.

Good luck :)

Guest505077 · Nov 10, 2013

Hi there..after >25yrs as a hospital nurse started HH..it's been over a year now..I thought I was the only one finding it difficult finding a balance between work and home life. I had worked 12hr shifts in the hospital, looked forward to working 2 or 3 and then having some days off. Gotta say as much as I like many aspects of HH, I really am disliking all the extra time spent making phone calls or all the paperwork..never really knowing when I'll finish my day...looking into doing something different...

FieryPsychRN, BSN · Nov 11, 2013

This is discouraging since I am starting home health nursing soon. I don't know what to expect but everyone I know that does home health say that they love it! :yawn:

KelRN215, BSN, RN · Nov 12, 2013

I don't have any problems managing my life. I never chart at home/after hours.

IndianaHH · Nov 12, 2013

I have been in HH for 10 years. This last week was when the line was drawn into the sand, and I said enough was enough.

The agency I work for is private owner/family run agency. Not such a bad idea, however there is never a let up on the demands. SOC and ROC complete.. and I mean the EVERYTHING in 24 turn around. Meeting following meeting following meeting...which naturally cuts into my time to be a nurse in the home, performing MY JOB! I regularly drive 75 miles daily, often just to see one patient. The management totally does not understand correlation between 3 hrs of drive time subtracts from charting.

The stress at the office is effecting everyone. I , who has never had BP issues, is now on meds. The DON started smoking, and one of our schedulers landed in the hospital with BP 220/120!! Is home health a great field? Yep. However there MUST be a balance between job and one's life. I chose my life. I gave notice.

I have other things to accomplish besides an early grave. I dont have another job lined up, other than work on building a HT client base. If I can work 12-16 hr days/ 6 days a wk for someone else, than I should be doing the same for myself

Home health is a great field.. if there are boundaries.

CharleeFoxtrot, BSN, RN · Nov 13, 2013

Tagging on here, I just started home health after being in the hospital environment.

:sarcastic: maybe we should start a "new to home health and need support"club.

turningred15 · Nov 14, 2013

I have trouble with setting limits. Once I learned to set limits everything became easier. You either need to see less patients per day or work a longer day - which it doesn't sound like you want to do. Have a talk with your supervisor to see that if there are ways to help reduce your time working. Make sure you inform your supervisor that the current hours you are working is too much. This would set reasonable limits for the hours you are willing to work. Maybe home health agencies will finally understand that they can't continue to work us the way that they do if we all wouldn't stand for it.

Hinnahwill · Nov 15, 2013

Not all Home Health agencies are created equal. If one doesn't fit, try another one. I worked in HH 8 years ago and loved the flexibility. I was a salaried case manager and rarely spent extra time charting into the evening. The HH agency that I worked for went out of business and I have spent he past 7 years as a ADON of a large nursing home & assisted living. This week I accepted a Director position within the same company's HH. It has already proven to be the best decision I cold have made! The pressure and hours spent being in a nursing home were relentless. I'm hoping this job will continue to be as great as it already has proven to be and I can work here the next 15 years until retirement!

redfoxglove · Nov 15, 2013

Here's my perspective, after one year of working in home health. I was a new grad just 2 years ago, spent my first year in a nursing home. When we graduated the eight positions open in our rural hospital were given to the young grads in their 20s. Us more mature grads got jobs in other than the hospital. After a year in the nursing home, my DON took a chance to hire an inexperienced nurse into home health. I have had a steep learning curve. Her famous phrase is, no matter what your background, no matter how much experience you have, it takes 3 years to grow a good home health nurse.

I spend an average of 1.5 hours in the patient home doing SOC, ROC, and recerts. In that time I am able to get through the entire assessment tool. It takes 90 minutes to do the clinical note, phoning the doctor, completing the orders, and other followups.

If you were an excellent hospital nurse does not guarantee easy street in home health. The challenges are there. It is not transitioning to an easier job. It takes about a year to get comfortable just with the basics. Then it's going to be another 2 years before you are really good at it. That's what my DON teaches, and so far as I can tell, her version is accurate.

What people love about home health, that I can tell, is you have more autonomy. Which means you have more responsibility.

The big challenge with home health is that it is largely funded by Medicare and Medicaid. So the agencies have smaller profit margins. So there is more demand on the field clinicians to produce. I am not a salaried full time nurse, but a part time nurse. The salaried ones, as far as I can tell, are very stressed about the workload and appear to me to be expected to do 1.5 jobs. Maybe that's throughout nursing. My work schedule is Fri-Mon, so 4 days, and I am pretty worn out at the end of those 4 days. Another challenge with home health is that due to changes in politics, more budget cuts are going to be made very soon. How is that going to affect the employing agencies? Unknown at this time.

Bottom line, don't get into home health thinking it's a free ride or an easy job. It is not.

NissaNurse · Nov 19, 2013

I have been doing home helath since 2008 It's not easy.. Documentation an the many miles an endless phone calls. Once you get your own routine down its fine but after

DavidDudley · Nov 19, 2013

I am a previous hospital nurse who has been doing home health for about 2 months. So far it has been a nightmare! I am charting every night after I finish seeing patients and most of the weekend. We do computer charting which I am thankful for... but even so, it takes so much time! I am salary and it is a decent salary... unless you are working 12 hours Monday through Friday and all weekend. I have gotten faster since I started, but I just don't see how it is possible to see patients and get charting completed in a 40 hour week. As an RN I am primarily doing admissions, recerts, and ROCs all of which take some time at the patients home AND even more time charting. I am computer savvy and I type fast...so I don't know. They are always pushing you to stay caught up with your documentation and the only way I can do this is to document ALL THE TIME. Is this just the nature of home health?
I love the patients and I love the teaching aspect of the job. But I hate the endless hours. I also dislike the constantly changing schedule. I will think I have my day planned and then I will get a call that a someone has been added to my schedule.
Is this the way HH is...... or it is just me... or the agency? Any thoughts are appreciated.

Unfortunately, this is the way HH is. Ive been doing it for 2 years and I always drown in the paperwork and getting behind. It's a nightmare. And that's coming from someone who only does it per diem, never full time. I suggest having a full time hospital job and only doing HH 1-2 days per week max.