how is it to go from private duty to hourly visits

[smartnurse1982]

i have done only shift work in the home but was wondering how would things be if i switched over. Would the clients be sicker in hh vs private duty? would their be more paperwork? anyone that did both types of Home care could tell me any adjustments i would need to do?

[HmarieD]

I have only worked directly in intermittent HH (hourly), but our agency does have a few PD shift cases. Regarding whether intermittent pts or PD pts are "sicker", I would say that PD patients are typically those with chronic conditions that are stable but require a slightly different skill set, more technical in some ways (lots of vents, trachs, etc). Intermittent HH pts are typically in a more acute stage of illness, seen after hospitalization for assessment and pt teaching for meds, disease process, home safety, etc. There is also a lot of wound care, IV abx, central line care. There are a some chronic intermittent HH pts, with monthly foley cath changes or monthly B12 injections.

There is more paperwork in intermittent HH, especially if you are an RN. Not too bad if you're an LPN.

[caliotter3]

You would have to be mentally prepared for the increase in paperwork and driving duties. A good read of some of the hectic schedules on the hh forum would be in line. I've no desire to do intermittent visits, one reason being, that the compensation offered does not make up for the added wear and tear on my car or the expected added time to do my job. With extended visit work, I rarely do any paperwork at home and do not care to do so. I am fine with being paid for the eight or 12 hours that I devote to my client. I find the time to do my paperwork during the shift.