First Job in Home Health

renerian, BSN, RN · May 9, 2005

Your employer failed YOU not the other way around. If someone comes to home health they need to train staff about the regulations which are many. As for coding, they also should not have asked you if you have never done that. It is a billing duty and many nurses pick it up (after a while)but unless you know what your doing/have been trained/don't do it. Your supervisor is accountable to set up that training. If the company did not have a training program to meet to your needs they probably should have hired a person who needed little training. The company set you up for failure.

I am sorry. They were unfair. I had a similar experience when I started home care in 91, except I had 4 hours orientation. NOne on paperwork LOL. For the first year I got stickies/yellow on everything!

renerian

SWRN84 · May 22, 2005

Tanna, I have 19 years experience in home care, and I can tell you, your orientation was not typical at all! It sounds like you have been hired with this ground level company that really is "ground level" in all aspects. If they only gave you one day of orientation it tells me that they really have no idea what they are doing and how to take care of patients in the home. Home care is a very different aspect of nursing. You learn to use nursing skills that may have fell by the wayside in a more high paced technical atmosphere. You will fine tune different types of assessment skills and rely so much more on your nursing judgement. It takes a long time to learn the nuances of home care....the Medicare requirements and rules...the documentation requirements...it changes all the time. It's not an easy job to learn. You are learning how to use your skills along with learning a whole new way of documentation. Home care can be so rewarding, but you have to have the basic orientation first....how to do the visits, how to communicate with patients in their own home on their own terms...then how to put it all together.

I'm sorry your first experience in home care has been so frustrating, but I can tell you, all home care agencies are not like that. If you are committed to learning home care and providing great home health nursing to your patients, I would seriously consider trying to find another agency to work for. It can be such a rewarding experience.

I am very discouraged because I have not had a very positive first experience in home health. I come with an ICU background of 18 years, but, have left that field due to the stress.
I was hired at a ground level home health agency just getting started in our community. I was sort of oriented on my first day and was on my own after that. There was an LVN in the office who was titled Patient Care Coordinator. All calls went through her and she handled calling all the doctors, patient complaints, etc. So, I was responsible for all these patients, but, never knew what was going on with them because the LVN didn't share any of the information.
My boss kept telling me I was doing a good job. Then, on Friday, I was called in to the office and it seems the LVN had written me up about 5 times for breaking all kinds of rules I didn't even know existed! I was told I was slow and hadn't even started coding, yet. When I asked why no one had started me coding I was told that they had a gut feeling I couldn't do it.
I was also told about a patient reporting me for changing a dressing without gloves. It was a dressing without any drainage, I maintained sterile technique and washed my hands before and after. I had no idea I was violating medicare regulations until I was called into that office...and fired! This was about 3 days after I was told I was doing such a good job!
I have moved, from the East, to San Angelo, TX because of family. It seems that everything is different here and I am having such a hard time. I have lost a lot of confidence and wondering if I still even want to be a nurse.

tripleblessed · May 22, 2005

Tanna, I have 19 years experience in home care, and I can tell you, your orientation was not typical at all! It sounds like you have been hired with this ground level company that really is "ground level" in all aspects. If they only gave you one day of orientation it tells me that they really have no idea what they are doing and how to take care of patients in the home. Home care is a very different aspect of nursing. You learn to use nursing skills that may have fell by the wayside in a more high paced technical atmosphere. You will fine tune different types of assessment skills and rely so much more on your nursing judgement. It takes a long time to learn the nuances of home care....the Medicare requirements and rules...the documentation requirements...it changes all the time. It's not an easy job to learn. You are learning how to use your skills along with learning a whole new way of documentation. Home care can be so rewarding, but you have to have the basic orientation first....how to do the visits, how to communicate with patients in their own home on their own terms...then how to put it all together.
I'm sorry your first experience in home care has been so frustrating, but I can tell you, all home care agencies are not like that. If you are committed to learning home care and providing great home health nursing to your patients, I would seriously consider trying to find another agency to work for. It can be such a rewarding experience.

I worked in home care for 5 years and truly loved it , I ended up leaving due to the birth of my triplets and all of the paperwork. It was probably the most rewarding job in my 11 year nursing career. It is truly overwhelming if you do not get a good orientation.