Happening again

AMN74 · Apr 12, 2012

I don't know if you're cut out for the job or not, only you can decide that.

I feel like you are a very consciousnesses nurse by calling CHF patients to check weights etc... but there is something to "enabling" the patient. I have been in home health for 20 years, and one thing I've learned is to make the patient responsible for their own care. After all, we are not going to be in there forever. So, for CHF patients, for example, it's best to front load visits and get in there and teach as much as possible. Teach your patient about weight gain, diet, signs of chf to report to md, help them make a wt chart, make a med calendar so they know their meds and can be compliant, and make sure they know consequences of noncompliance. Once they verbalize that stuff back off on visits seeing them weekly or q other week through out the rest of the cert period to eval if they are actually being compliant. They have to weigh q day, so they know the weight if their weight is up and they are exhibiting other signs of chf make them responsible to call the MD. Because once you discharge who does it for them anyway? Home health is about teaching so that the patient understands their disease process, meds, signs to report and making them independent to be at home. My CHF patient visits are like 3 w 1, 2 w 1, 1 q other week....till the end of the cert period....I don't call them and keep checking that is what I teach them to do, make them responsible to call the MD on their own. LONG gone are the days of keeping patients forever just to check on them...

I wish you the best!

emilysmom,RN · Apr 13, 2012

Thank you for the info about CHF patients but my company started a protocol and have to follow it until discharge and have to document that you are calling the patient to see how there wt is. ANd I am the one nurse that has 5 CHF pts since I am so familiar with the protocol I get all CHF pts. I know I have to stop complaining and just do my job.

Does anyone else work this much? Seeing 6 to 10 pts a day some are 40 min away. Some I have to see 3x/wk due to CHF issues, have to take labs etc. Last two weekends saw 3 pts on sat and still doing charting on sunday to catch up and get ready for next week. I left this company over the summer because of the constant issues. THey did hire a LPN to help with visits but still going crazy. I do not see the other nurses in my company doing this much. Full timers taking time off, having time to babysit grandchildren. I am always calling on my CHF pts to check wts, on weekends, picking up meds for pts who have no family. Maybe I am not cut out for this?

RN1263 · Apr 13, 2012

I know I have to stop complaining and just do my job.

Not necessarily, a realized the more and more I complained that I was not wanting and not happy with my job anymore! I tried to make it work and it just no longer fit what I wanted for my career and happiness. I refused to be miserable the rest of my career. Self evaluation is the only way you're going to know if you are happy and satisfied or not. Good luck to you.

IndianaHH · Apr 18, 2012

HH agencies were/are the targets of Medicare cutbacks. Which trickled down to cut backs in nursing staff. The HH agency I worked for had its THIRD lay off in 6 years.. every 2 yrs the staff was cut. Finally, this past February the last 3 standing nurses was reduced to two nurses. These gals are working 14-16 hr days, charting every waking moment. HH use to be a blessing for patients and their nurses. 1:1 ratio. Time to teach. Time to listen . Now its all about scores and donating one's life to a company who only looks at a bottom line. What ever happened to PATIENT CARE? I miss my work. I miss my patients. However when I read posts like this Im grateful I was the one let go. I'm the "older" nurse, and will admit the long hrs plus being on call was catching up to me. As someone mentioned...life is too short to be frustrated so much of the time.