Hello, everyone, and in advance, let me say any advice offered will be greatly appreciated.
Brief history...22 years in nursing, with about 12 in ICU/ER, followed by about 10 as a Work Comp Case Manager including supervision. Total burnout. Decided to try HHN. Well!
The good parts...I absolutely love it and feel like I am really "A Nurse" for the first time ever. I have a wonderful territory, great patients. My manager is fantastic. In 22 years, the one of the two best and kindest people I've ever worked for. And she thinks I'm wonderful, too, for a newbie to the field.
The problem? I'm going broke doing this and working harder than I recall working in YEARS! I am per diem, and the rate isn't bad, however...no reimbursement for cell phone usage and that adds up - as I'm sure you all know. I get paid "per visit" yet there is tons of paperwork to be done at home - all part of "the visit." Then...the pre-visit phone calls, having to call some docs 3-4 times before getting a response, etc.
Part of it is my organizational skills, I'm sure. However, I'm just not the type to zip in and zip out. For a routine visit, it takes me at least an hour. And you know...some of these little old people...it takes them 30 minutes to walk from the chair to the bed! For example, today I did one admit OASIS and 2 reg visits. And granted - they were spread out with considerable driving time between #2 and #3, but still, I spent a good 6 hours in the day for just those 3 visits and I STILL have paperwork to do!
And running back and forth between home and office! Non-reimbursable in terms of time or mileage, but gosh! It really adds up in a flash. So the bottom line...I absolutely love it, love my manager, love the challenges, but I can't keep on doing this if it's going to COST me money.
I really enjoyed the work, and as said before, felt like I was really doing something to make a difference in the lives of some patients. However, after I sat down and put pen to paper, I decided it just wasn't worth it. I spent too much money on my education and too many years gathering practical experience and knowledge to work for what ultimately boiled down to an average of $10 - $15 dollars and hour. If that, even, when all things were factored it. The wear and tear on my car, running back and forth to the office to drop paperwork, pick up supplies, adjusting my schedule (resulting in having to call patients to reschedule, etc.) to allow me to do the sudden admit, cell phone bills (huge!), often trying in vain to contact a doctor via every method known - phone, fax, pidgeon birds (lol)...fax, fax, fax, call, call, call...over and over sometimes. Not getting any info to speak of on a patient and having to walk in blindly - scarey! And then, to find "significant" findings and not have anyone even show you the courtesy of a callback? And, yeah...you can always say that as long as you put it in writing, you are 'covered' legally, but that isn't true. As a R.N., I have a legal obligation to follow through if I don't get a response. But who? When? How? It's a private patient. Whose head do I "go over" to get an answer. In just my short time, I had two MAJOR incidents where I could not get a response. At one point, I even told my manager that I would just go to the docs office, but oh, no...can't do that. Might upset him and of course, we need our referrals. Huh?
For me, the worst of the worst was constantly being told, "Well, this is just the way it is in home health." I detest that sort of attitude. That is the way it is because you let it be that way. If we all took that attitude about everything, we'd still be living in caves or something. People have to be pro-active to make changes. So, I'm one person and I have to support myself. I wish I could find the time/money to effect changes, but since most HHA's take that very attitude, I'd be fighting an uphill battle forever and it just isn't worth it. Not to me. Not at this stage of my career and life. Much like the nursing shortages we've all seen over the years...when they find themselves without nurses, the changes will come about. But not as long as any of us continue to work for practically minimum wages.
I may be different, but for me, nursing is, was, and always has been a profession I chose for the primary purpose of supporting myself on a long term basis. Sure, I like people and want to help people, but I am the person I like first. And part of that leads to wanting to support myself and be valued for my skills and knowledge. I hate to be so crass as to reduce things to the almighty dollar, but fact is, I have bills to pay just like everyone else. Like most nurses, my standard of living isn't real high and there isn't too terribly much I can "cut back" on. It may not be too significant to you, Mr. Administrator of the Agency, that I am paying $3.00/day to run up and down the tollroad to the office, but that is $15.00/week for me, and $780/year. Based on what you are paying me, it IS significant. I was told by Admin to get a new cell phone plan...something for $59.00 for 3000 minutes per month. That wasn't my point. My cell phone was being used exclusively to do the business of the agency. Therefore, in my mind, the agency should provide the cell phone. Seems reasonable to me, but who am I? So OK...now I've got the toll fees added onto the cell phone bill for a total of roughly $1500/year - non-reimbursable - but yet I have to pay taxes on the income they are paying me....and then, I came to the conclusion. I'm backing up.
There you have it. I decided I'd rather clean houses for a living if I had to. It would be more financially rewarding and leave me at least SOME time to call my own.
Kudos to those of you that have managed to figure out how to do this home health stuff. And I sincerely mean that. Perhaps had I joined with a different agency, things would have been different. However, I adamantly refuse to devalue myself in this profession. To my way of thinking, as skewed as it sometimes is, it merely devalues every RN out there.
Good for you. You work to live...and NOT the other way around, as these agencies want to make you do. I've BEEN there, DONE that, too...and it's time to get out, when the job starts costing you more than what you make emotionally, physically AND financially! :angryfire
Specializes in private duty/home health, med/surg.
Good for you, DallasRN. I'm sorry you had such a lousy experience.
I must admit, I am surprised to see all the negative comments about the HH companies. I realize that nursing is not as well respected of a profession as it should be, but after reading some of your experiences, I agree with the poster who said the treatment is hateful.
Until a few weeks ago, I was a home health LPN, and I am about to take the NCLEX-RN. I was interested in exploring the home health-RN field after a few years of acute care experience in no small part because of my 2 clinical days working with a HH RN. She absolutely loved her job--loved the pay, hours, benefits, patients, flexibility, etc. All of my classmates came away with the same impression after their experiences riding along with HH nurses.
I'm thinking this must be a rather well-run agency. When scheduling us student nurses, the agency found out where we lived & then assigned us to the RN who took clients in our geographic area so we wouldn't have to drive as far. The RN I was with had her cell phone & pager reimbursed, mileage, free laptop--it seems that this agency took very good care of their nurses. Too bad they are the exception.
Specializes in ICU/ER/Med-Surg/Case Management/Manageme.
I think like everything else, it is the specific companies as well as the region. The job itself is great - wonderful patients. I met some truly remarkable people. As for flexibility, I don't know about that. With a full case load, you're on the road early and often not home until late. I don't call that flexibility exactly, but that wasn't a problem, either. It was simply the lack of pay and reimbursement.
Right now concentrate on obtaining your RN and maybe by the time you're ready for the independence of HHN, pay scales will be worth working as hard as you will find yourself working. It's pleasurable work for the most part, but it isn't a piece of cake, as some seem to think (and I used to be one of those that thought that!).
I hate to be discouraging, and remember, this was only MY experience. Others have had wonderful experiences. Good luck on your RN.
Sorry to hear the HHC did not work out for you. I have just quit that field after 4-5 years, and am concentrating more on my music - I am learning to play the piano- with all of my free time. I loved my patients - some of them were with me from the time that I started but financially it made no sense. The last straw for me was when my car got into an accident in September and was written off. There is no way that I will abuse another car in that manner. So stay cool, and look around for another job that pays a little better without so many demands.
CseMgr1, ASN, RN
1,287 Posts
Good for you. You work to live...and NOT the other way around, as these agencies want to make you do. I've BEEN there, DONE that, too...and it's time to get out, when the job starts costing you more than what you make emotionally, physically AND financially! :angryfire