Caseload of 70 active patients

caliotter3 · Feb 18, 2012

There is an easy answer to this, especially if you live in an employment at will state. Just find another job and resign from this one.

merlee · Feb 18, 2012

Find out what the avg is in your agency. Is this home health, or in-house?

DixieRedHead, ASN, RN · Feb 18, 2012

Go to McDonalds and put in your application. It should tide you over until you find another job. You license is on the line NOW. Get out.

netglow, ASN, RN · Feb 18, 2012

Let me guess, you received no clinical orientation just orientation to the EMR... gotta get that cash. That's all you are hired to do is submit charting for billing.

bella44 · Feb 18, 2012

WOW.

If you feel overwheled, find another place to work. The same thing happened to me. My job was so stressful that it began to affect not only my private life....but also my health (high BP & heart palpitations.)

I'm currently unemployed for the exact same reason.

I wanted to regain relationships c my children & myself.

Currently seeking another place to work...

I wish the best for you.

Home Health Columnist / Guide · Feb 19, 2012

Home care agency's doing skilled intermittent nursing visits RN national average is 25-30 patients per caseload.

This includes a mixture of new patients seen 2-3x/w, daily wound care and chronic care: monthly foley catheter maintenance, monthly B12, patients seen 1xwk for management + eval of care plan due to frequent rehospitalizations, etc.

One RN can manage higher amount patients if teamed with an LPN who does daily wound care with RN weekly assessment visit.

Agencies that specialize in private pay/medicaid where RN only supervising HHA every 2weeks or monthly, case load of 50-70 patients doable, especially in a city where multiple clients may live in Senior apartment complex.

Please discuss this assignment with your manager as 70 skilled patients = case load of 2-3 RN's and only leads to burnout.

AKRAZYRN · Feb 19, 2012

Of my 70 patients, 1 requires bi-weekly injections, approx 20 require 2-3 visits weekly for instruction and monitoring, 1 requires daily wound care and the remaining require 3 days a week for extensive wound care requiring an additional amount of time to perform.

The largest setback in productivity is the immense amount of computer time requires to create documents. A SOC with wounds (which require photographing) and have 20 plus medications can take near 2-3 ours to input. This includes MD orders, the 485, ordering supplies, researching insurance deductibles, Then reiterating the findings again on another set of documents to request additional visits d/t Managed care policies. I am given patients with no working phones, have do do drive by's to locate patient and am often given incorrect info on referral. There are no in office schedulers. The nurse is required to keep count of visits and re submit new requests for authorization of additional visits.

If a patient is referred and not found I am responsible to make the calls to locate the patient.

Bottom line is the agency cares more about having the notes completed in 1 day.

This is almost always impossible as the homes or in poor sanitary condition, and find it impossible to see 7 people daily, complete the for-mentioned and return home unharmed and uninfested.

I have contacted my Union Friday but they were closed.

AKRAZYRN · Feb 19, 2012

Of my 70 patients, 1 requires bi-weekly injections, approx 20 require 2-3 visits weekly for instruction and monitoring, 1 requires daily wound care and the remaining require 3 days a week for extensive wound care requiring an additional amount of time to perform.

The largest setback in productivity is the immense amount of computer time requires to create documents. A SOC with wounds (which require photographing) and have 20 plus medications can take near 2-3 ours to input. This includes MD orders, the 485, ordering supplies, researching insurance deductibles, Then reiterating the findings again on another set of documents to request additional visits d/t Managed care policies. I am given patients with no working phones, have do do drive by's to locate patient and am often given incorrect info on referral. There are no in office schedulers. The nurse is required to keep count of visits and re submit new requests for authorization of additional visits.

If a patient is referred and not found I am responsible to make the calls to locate the patient.

Bottom line is the agency cares more about having the notes completed in 1 day.

This is almost always impossible as the homes or in poor sanitary condition, and find it impossible to see 7 people daily, complete the for-mentioned and return home unharmed and uninfested.

I have contacted my Union Friday but they were closed.

annaedRN, RN · Feb 19, 2012

I would not and could not work in those circumstances. How many other nurses are helping you see these patients? I do not understand how you could effectively manage 70 patients - it is a near impossible task!! I have often seen 7 patients in a day (prefer 5-6) but I am only managing 20-30. Personally, I would find something else if at all possible. This job is leaving you wide open for something to come back and bite you in the butt....besides just leading to total burnout!! Good luck to you

AKRAZYRN · Feb 19, 2012

Thank you for your feedback. That is exactly what I thought. There were no issues with my nursing care. Just had 38 notes to type. So instead of taking the weekend to catch up, they took my laptop and said rest up.

Nursecathy123ca · Feb 22, 2012

The maximum number of home health patients I could effectively manage was 30...and that was a stretch. We were paper-based, so paperwork took the most time, then top with other case management duties, and the visits; it was much more than 40 hours/week.

Hope you can talk to your supervisor and tell her the caseload is too big to care for safely. Have you ever figured out how many hours per week you are really working! Might help to estimate that. Then you can find out what you are really making per hour.