HH Case Manager: What Is It Like?

ididitrn · Oct 15, 2008

I've been doing HH for a couple of years now and would not go back to the hospital for anything. As an RN/case manager I generally see 5-6 patient per day. An average visit is 30-45 min. I occasionally get an admission and they usually take me 1 1/2hrs. I mainly drive 25-30 miles/day and how long that takes depends on traffic. Phone calls and paperwork can take about 2 hrs. I start at 8am. Some days I'm done by 2-2:30 but some days I don't finish until after 5:30-6. Those late days are pretty rare.

Like: the autonomy, the chance to see do what I need to do with one patient before moving on to the next one, the relationships you can build by spending more time with each patient, the chance to decompress in my car between visits.

Don't like: last minute changes to my schedule from the office, streets without street signs/houses without numbers, being the go-to person for all issues from the various disciplines for follow-up (lots of messages on my voice mail that must be dealt with daily).

I'll be honest, there are days I hate my job but the days I love my job far outweigh the bad days. Good luck with your interview. HH isn't for everyone but it can be a great job.

annaedRN, RN · Oct 15, 2008

My response is pretty much word for word what ididitrn wrote ( actually freaked me out...it was like I wrote it!) I say a bad day in HH would be a good day in a hospital. I am usually responsible from 15-25 patients. Some I admit and some others admit for me. I make the schedules for all my patients and if I cannot see them there are LPNs that help us with the revisits. Weekend and holiday schedules the clinical mgr makes up - I just let her know the patient needs seen and then leave a voicemail report for the clinical staff.

I like making my schedule, but there is unfortunaly often changes made to the schedule last minute ( sick calls, new admits, extra visits for IV, catheter, wound VAC problems).

The biggest thing is to have good communication with everyone involved with patient - PT, OT, HHA, MSW, LPN, team manager, HHA scheduler, MDs. Because while everyone is seeing the patient, it always seems to come back to you. SO make sure all involved are kept updated and leave report as needed.

I enjoy the autonomy and flexibility immensely! It is less strenuous than a 12 hr shift at a facility but some homes can be an adventure in of themselves! You get a chance to still perform med-surg skills without the crazy pace. I don't work weekends but take on-call every 5 weekends or so. Hope you give HH a try - let us know how it turns out

DDRN4me · Oct 15, 2008

Marla, the two pps have said a lot; and given you a good picture.

Be sure you have a reliable vehicle; as the worse the weather the more pts seem to need you! I loved the variety; no two days are alike. I used to see anyone from the 16 year old gun shot wound to the 90 year old with a fx hip. from the beautiful big home on the cul de sac to the projects; from those with multiple medical issues to a simple post op check.

The one on one attention you are able to give your pts; the teaching (rmember that ) that you are able to do are fantastic.

Cons: sometimes there are lomng distances between patients; some areas are not the best to be in; the paperwork ; like everything in nursing is out of control at times. I actually enjoyed the interaction between disciplines because it meant you were giving good holistic care.

hope this helps..good luck!!!!mary

utrocks84 · Oct 16, 2008

I'm new ti HH, I'm an RN case manager and all I do is SOC, ROC, D/C and Recert...also HHA sup visits. I coordinate the care of all the diciplince also. My agency is trying to rebuild pt load after staff left do to take over. I'm told I could manager up to 50-60 pts. You may want to clarify what type of case management. LPN's do the revisits and report to me.