Is home health care for you?

sphinx, BSN, RN · Feb 15, 2003

Been in homecare 2 years, love many, many aspects of it. However, I recently left the field and took an in-office RN position. Why? because I was tired of working all day, then coming home and finishing my paperwork, often taking till 9-10pm, interspered with a dinner break. Sure, it's partly because I'm pretty much a perfectionist......spent a lot of time with each patient, and even though I charted in the home, I always had charting to do at night too, as I am very particular about accurate chartng. Not to mention the case management, which is very time consuming and takes a good portion of your day. However, it was very rewarding, much more so than hospital work. But I got where I couldn't work the long hours, and no matter how I tried, I couldn't seem to scale back.Our caseloads kept growing, and as nurses leave, their positions are not filled (yes, the shortage is felt everywhere). Not to mention, only getting paid for 8 hours no matter how long I took to complete my day. Now I go in at a set time and leave at a set time. I miss the patient interaction, but am still working in a nursing capacity, and for now, it is what I need. I can't even imagine going back into the hospital setting, even now. No way.

hoolahan, ASN, RN · Feb 16, 2003

I am with you sphinx. Not to mention being placed in unsafe situations daily. I am doing per diem visits and not case managing until I start my new job as a case ,manager for an insurance co. Yes I will miss the flexible hours, but I will NOT miss doing ridiculous unsafe admissions b/c my agency is money hungry. They should not accept 25 % of the visits they do.

Also, there are not enough case managers right now. One nurse has been out w a TKR for THREE WEEKS, they have been assigning her cases randomly as per the computer schedule, and are only now starting to think about how they will divvy up hercaseload. I am sorry but these pt's have rec'd less than optimal care while no one is case managing. My agency uses a bandaid philosophy. They refuse to see the problems, and slap a bandaid on when they finally have to instead of finding permanent solutions. Even our w/e sup was ragging that with the snow storm you would think some of the nurses would have tried not to turf their pt's to the weekend.

Weekend visits are all almost city visits in bad areas b/c the case managers don't like those visits, so they dump on the w/e. I woud not support the supervisor, if I didn't know this to be a fact and have heard them joke about it in the office.

I also think HH can be the most rewarding nursing around, unfortunately it just isn't wonderful anymore as my agency continues to circle the drain and disrepect nurses.

Teresa S., DNP · Feb 16, 2003

Stellar,

I have been in home care a little over 15 years, I work with maternal/child patients. I work for a VNA and have loved my job most of the time....The paper work for maternal/child is not a much as we do not have to do the Oasis. This is form that those caring for the adult population have to fill out every admit, and every recert - 60 days. Those visits have to be in a 5 day window, there are like 80 computer screens of questions, rediculous....medicare requirement. I have loved the freedeom and independence of my job, the help I am able to give to my patients in their own environments. I am paid pretty well, salaried, some days I work longer, some days I am done a little early - it all works out. However, I am also on call every 4th weekend - not always busy with my population, but still a day I can't really plan for much else, plus on call 1 night a week. There are 4 of us who care of maternal/child so we work that all out together and support each other. We work as a team and do well. Currently however we are all about 1 foot out the door as they are considering - well they have, we are fighting it - adding more to our expected visits a day. I really like it, but am really considering making a change because of the increased and ongoing demands that are placed on us. If you would like any more information for your research, please pm me.

bravegirlamy · Feb 16, 2003

Hi, I have been in home care for almost 2 yrs now, & I love it! I am paid a good hourly wage, good mileage, paid for my travel & office time. Not to mention on call pay is an extra $900 a month...& I very seldom get a call. Home health can be great if you get the right company. Good Luck with what ever you choose..

CraftyLPN · Feb 16, 2003

actually I am going back to HHC and can't wait.....

sphinx, BSN, RN · Feb 16, 2003

Teresa,

You are lucky, I also did materal child health and high risk OB (half the county, for a while the whole county) but always, always had CHHA patients too. Also, when I was on call, I usually did CHHA patients. While I was one of 2 OB nurses who worked full time days, there were one or two who worked weekend/evenings, and they'd get those patients first, and I'd be opening a case for a patient with multiple health problems that I know much less about. (I do have med surg experience, which helps in that respect, but less med than surg, haha). Plus, our agency uses software, that while the non-oasis forms are slightly easier, they are nearly as long (wasn't always this way, but with the advent of the new software, the non-oasis forms mushroomed incredibly). We also follow the same guidelines for all our patients (time-wise), even non-oasis patients......only difference is, if we are late for a recert, we don't get as freaked out!

The one thing I like about our agency, is our call system is better than some in town. We get a call schedule for 3 months, and have to sign up for around 4 evening calls, maybe 1 weekend call and 1-2 weekend back-ups (where you are 99% likely to get an assignment). We have evening and weekend staff, so we don't always get called, except when things are very busy (at the moment we have a lot of BID's, so our nurses are getting a lot of calls). The agency my mom works for does not have a weekend staff, so are required to work set number of weekends, with assignments, etc. Evenings they are on call. If they have a BID patient, they do the am visit and the pm visit.

Also, I find our agency to be very responsive to the nurses needs. They actually listen, and do their best to try to fix things. They have their problems (the no overtime thing is a big one), but much better than hospital politics.

Eventually, I imagine I'll be back in the field. Maybe when the new software has the bugs worked out. Or when my job is obsolete (it is only "temporary"). Who knows. But...I am babbling again.

all in all, I'd take home care over hospital any day, but the paperwork is killer. And to think, I always was the weird one who *liked* paperwork! haha!!!