Director of Nursing Home Health Agency! HELP!

nurseby07 · Sep 19, 2008

Have you done HH nursing or are you coming in blind?

kwagner_51 · Sep 19, 2008

Hi nurseby07,

I have been in HH for over a yr. I also did home visits with children r/t Head Start for a year. so I have over 2 yrs collective experience.

I don't have experience with OASIS but as far as being in compliance with Fed rules I had to get an entire program within Federal requirements within 6 weeks. It was so far behind and had papers missing when I took over. The program passed with no problems or errors.

nurseby07 · Sep 19, 2008

I'm curious what the experienced hh nurses have to say.

I didn't know you could do HH without oasis, because I am so new. If I were you I would start studying it intensely on-line.

Good luck, and again, I'm curious!

annaedRN, RN · Sep 19, 2008

You will have to use OASIS if you have Medicare patients. I would be uncomfortable being in a position of supervision and not knowing/understanding OASIS and being responsible for helping other staff with it. While some people are wonderful at reading and being in tune to situations...if you aren't really familiar with HH you may have difficulty adjusting to the job. On the other hand, if you study up and get trained on the P&P and OASIS it may be a fun challenge! Good luck and let us know how it goes!

jnurse19 · Sep 25, 2008

I was a HH DON before ( 2 years ) and was really so stressed! always wanted to pull my hair! Then I left the company because of some indifferences with my boss. Now, I am a case manager, and I'm okay, really enjoying my job:yeah:......

I will never accept a DON position again, NEVER!!! :no:

nursechris1 · Sep 27, 2008

You will have a lot to learn. There are state regs, and if they are accredited by Joint Commission, or another accrediting body, you will have those standards to learn. I am a manager of a small home health and hospice department of a hospital. I am responsible for budget, attending several committee meetings a week, and other administrative/business responsibilities, along with all of the quality issues. I do have a clinical coordinator who is repsonsible for supervising staff. It is not terrible, but I'm definitely not paid enough for all of the responsibility I have.

I don't mean to scare you, but be prepared to work hard.

CapeCodMermaid, RN · Sep 28, 2008

I don't mean to be fresh but what ever possessed you to take a job when you didn't have a clear understanding of what the requirements were?

As for the OASIS, it's no more difficult than the MDS used in long term care. Someone posted a really wonderful website ...start reading the other posts here to get a good idea of what you'll be doing and what you'll be up against.

Good luck.

CseMgr1, ASN, RN · Sep 28, 2008

Here are some links which I found helpful, during my last stint in Home Health:

http://www.oasistraining.org/oasis11/upfront/U1.asp

http://www.cms.hhs.gov/Manuals/PBM/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=ascending&itemID=CMS021914&intNumPerPage=10

Good luck!

Home Health Columnist / Guide · Sep 29, 2008

By your own admission, you do not have the skill set necessary for a DON position. I would be VERY leery of any company hiring someone who does not have experience and intimate knowledge of intricate homecare regulations. If this is a start up company and you don't know OASIS nor state regulations, have never worked per visit homecare caring for Medicare patients, you will be eaten alive by owners when you are unable to guide staff, have no coding knowledge so the OASIS questions answered improperly and $$$$ is lost or agency fined on audit.

As staff, I'd be mighty upset if you are unable to answer questions regarding homecare regs/OASIS and have no experience as homecare Case manager/supervisor.Please seek experience in non-profit homecare agency doing multiple daily visits, pick brains of coder and QI staff, become nursing supervisor then look for DON position.

I've posted the regulations for homecare at top of forum...please start reading if you plan to follow through with this position.

kwagner_51 · Sep 29, 2008

I came on here looking for advice. I didn't ask to be judged and left wanting in other nurses eyes.

1.) I have met the OWNER and he is very comfortable with me taking the position as DON

2.) He is willing to TEACH me and so is the Administrator. I have met the nurses in the field and they are very well versed on OASIS.

3.) I wanted information on what to study so that I would have a leg up when I take over.

4.) The requirements for the DON position are: At least 2 yrs experience as an RN, one of which must be in HH. Willingness to LEARN and take some of the pressure off the Adm. I have been an RN for almost 3 yrs and have worked in HH for over a yr.

5.) I will also keep my other job and will be working 7 days a week caring for pts and working as DON.

6.) I asked for help, so I can provide the best care I am able to. Instead I have been told that I have no business taking this position. I didn't ask if I was qualified for the job, I already KNOW i am. I wanted to share in my good news about the position. Instead, I have been told that the employees will hate me and that I should quit before I even start. :argue:

shelly304 · Sep 29, 2008

I find a lot of companies hire nurses that perhaps don't have the background that some people think would be necessary. When you hire someone that has been with a company plus years they are bringing mega baggage with them. Hiring "fresh" can be a bonus for the company, the staff. and in the end...THE PATIENT!

You will be trained the way the company wants. Not the way the 30 year plus veteran says it should be. I see sooo many ads for positions. They have tough requirements for the potential candidate. The job ad gets filled and guess what? Six weeks later it is posted again. Because the new-hired nurse marches in with a "Been there, done that" attitude. Not good.

I think the company that hired the OP is right on track! Most of us would just be too nervous to step out of our safe space and take a chance! Wishing the OP much luck and thanks for putting yourself out there for so many who stuck just complaining everyday about their job!