Do you rotate patients? HELP

[pnkgirl25]

I work for 2 different agencies. One of those agencies rotates patients, meaning you are hardly ever assigned the same patient. We typically don't receive our schedules until 6 or 7pm the night before the visit. I have been with the company for a little over 6 months but the way they do scheduling is really starting to drive me nuts.

My nights are pretty much a mess. I don't get my patients until sometimes 7pm at night, then I have to route them, read the 485 and then try to call them all to schedule visits. Then I cross my fingers and hope everyone answers. If not I am up calling in the morning to try to reach them. If I can't reach them I have to make the call as to if I want to do a "drive by" to see if they are home or skip them and cross my fingers they don't call me later in the day now wanting to be seen and thus throwing off my entire schedule. Sometimes I am up till 9pm scheduling patients EVERY DAY.

Another issue is supplies. Since I don't see the same patients every day it's always a mystery as to what supplies i am going to need. I cross my fingers that the nurse that saw them before has done their charting so I know what they last did or at least respond to my e-mail or phone call when I call for endorsements. My car looks like I robbed a medical supply store. It's a HOT mess.

My other agency I work with does it different. When we are assigned a patient they are ours until they are D/C or we request a change. This is totally stress free and I love it. The only down side is I don't get as many patients and 99% of them are once a week patients so i typically only average 12-14 visits a week.

The agency with the crazy scheduling I typically have 7-9 patients a day (7 days a week if I want but I choose to only work 5 days). I love the patient load but the scheduling is driving me INSANE.

I'm thinking of dumping this agency and then signing with 3 or 4 other agencies so I can have my own patients even if that means working 3-4 agencies just to get in my 30 to 40 visits per week.

For those that work home health how many agencies are you working with. Also can/do you tell them the patients you won't take. i.e., being a single mom I would rather not take daily patients.

[Libby1987]

With every new post I see how my work experience is very similar to Chrissy's.

Our satisfaction surveys are consistently above the average. I think patients are more confident in staff who are both strong and patient oriented.

[msteeleart]

I am an RN case manager doing psych home health. I don't call my patients ahead of time because they expect someone to come everyday to give them their meds. A lot of them have lock boxes we keep their med planners in. Our goal is med monitoring to keep them healthy mentally and medically. Each RN case manager has a certain territory and I have 3 full-time lpns working under me. I have been there 3 weeks and I love it so far. I would stick with an agency you like because life is to short to stick with something because you think you have to.

[pnkgirl25]

I am an RN case manager doing psych home health. I don't call my patients ahead of time because they expect someone to come everyday to give them their meds. A lot of them have lock boxes we keep their med planners in. Our goal is med monitoring to keep them healthy mentally and medically. Each RN case manager has a certain territory and I have 3 full-time lpns working under me. I have been there 3 weeks and I love it so far. I would stick with an agency you like because life is to short to stick with something because you think you have to.

This sounds great! I worked in adolescent psych right out of nursing school and LOVED it!

[KelRN215, BSN, RN]

I put the vast majority of my patients on a standing schedule and for those for whom a standing schedule doesn't work, I set up their next visit at the current visit. I rarely call people before unless it's an admission or I need to change the time because they already know when I'm coming. I visit children, most of whom have cancer, and they do not have to be homebound to get home nursing. Many of them go to school. I am willing to accommodate them for that because they SHOULD go to school as often as possible but for people who are just being difficult, I'm not bending. For example, we have a patient who cannot go to school because she is s/p stem cell transplant. Her Mom will often agree to visits and then when the nurse arrives say "oh she's still sleeping, I don't want to wake her up." Too bad. This is the agreed upon time and there is no other time available. She seriously asked me to go to my next patient and come back the last time I was over there because she didn't want to wake the kid up. The kid is 11 and it was 9am, she should have been up anyway. I said no. If she doesn't like it, she can bring the kid to the Oncology clinic. When I offered her that as an option all of a sudden she was willing to wake the kid up. If you give an inch some people will take a mile and the more you bend the more they will take advantage. Be firm.

[pnkgirl25]

I have been taking everyone's advice and I have to say, it's working. I no longer say "is it okay if I come between 10-11. I say I will be there between 10-11. I have had a few people push back and that when I say, I understand you have a busy scheduled, If you like I can d/c your home health and you can go to the wound care clinic at a time that works best for you. Would that work better for you? Magically between 10-11 sounds GREAT!!! lol

Thanks guys!