HH Nurse Survey

medicrnohio, RN · Jun 3, 2006

I am new to home health myself and I love it.

1. How many patients are you required to see a day for full productivity? 5 -6

2. How much mileage do you average, and at what point does mileage get factored in with respect to the visits you are required to make? They try to schedule patients within a few miles of each other. We do get paid excess travel time for anything over 20 miles.

3. How much time is spent on an "average" visit? 40 - 60 minutes

4. Are you frequently "hassled" about productivity? No

5. Do you spend time on paperwork off the clock? Yes If so, how much? an hour

6. Do you accrue overtime hours? No If so, How much on average?

7. Are you required to do chart audits in addition to your visits? No Is time alloted for this or are you just expected to "fit it in?"

8. What is a typical case load for you? I have about 15 - 20 patients.

9. Is your paperwork all written or do you have a palm pilot or laptop to make it easier? Written for now. They will provide laptop and training after 4 - 6 months.

10. Have you ever been denied overtime your earned because you were not "productive" enough according to administration? NA

jenrninmi, MSN, RN · Jun 3, 2006

Hi, June 13 I will be in HH for 3 months. I love it.

1. How many patients are you required to see a day for full productivity? 5

2. How much mileage do you average, and at what point does mileage get factored in with respect to the visits you are required to make? They try to give me patients near my home, but the average I would say would be about 50 miles a day, and it is all paid.

3. How much time is spent on an "average" visit? 30 to 60 minutes

4. Are you frequently "hassled" about productivity? No

5. Do you spend time on paperwork off the clock? If so, how much? No

6. Do you accrue overtime hours? No If so, How much on average?

7. Are you required to do chart audits in addition to your visits? No Is time alloted for this or are you just expected to "fit it in?"

8. What is a typical case load for you? Right now I have less than 10

9. Is your paperwork all written or do you have a palm pilot or laptop to make it easier? All on laptop.

10. Have you ever been denied overtime your earned because you were not "productive" enough according to administration? N/A

Jo Dirt · Jun 4, 2006

Cs58, I'm new to home health (on the job 5 weeks) and am still trying to adjust. I have heard nothing but praise sung for HH for the most part, and I'm not giving up hope yet. There are still things that take getting used to. For one thing, unlike a job at a hospital or nursing home, you don't leave your responsibilities at the door, so to speak. At the agency where I work, we have two full-time visiting RN's and the other RN wanted to "split call", which means I cover my counties and he covers his, so we are "on call" all the time and split the on call pay (which means $75 each per week). So far every call has been in my area, and this weekend has been particularly bad, as I had a complicated patient d/c'ed from the hospital Friday evening with complicated orders, so I basically will have spent 36 of 48 weekend hrs. on this case...for $75... This is why I am sitting here at 5:30am on Sunday morning. I have to leave soon to go draw labs on this patient, sit with him two hours while his ABO's run through his PICC line, make a 100 mile round trip to drop them off at the only hospital that will accept his Medicaid, be back every 8 hrs. around the clock to sit with him two hours while his ABO's run. All because LPN's are not allowed to do PICC lines for some beaurocratic reason. And people can't tell me it is because touching a PICC line requires some kind of high skill, because when his sister was caring for him she was taught to give his meds/flush his line/change his dressing etc. by the HH nurses and she took care of this.

But back to the office manager...she acts like the RN's drive around all day and basically live a life of leisure while she is at the office every morning and is there from 8am-5pm. She is on vacation this next week and before leaving she made sure to let us know that if we wanted to do her job for her while she was gone we could expect to be there every morning at 8am ready to WORK....I'm getting really tired of this.

If it was up to the office manager we would be at the office doing chart audits sun up to sun down

The only flack we really catch about productivity is from the office manager. The DON seems to have more mercy for us. She was hired two days ago and she has just been working out in the HH field so I think she has more mercy for us. But the office manager thinks the RN's drive around at their leisure and come and go as they please. Like I said, the way I feel right now I'd like to call her up and compare weekends.

My last pay period I had almost 1500 miles (and I wasn't even counting mileage to and from the office, which is a 60 mile round trip.) That added up to amost $500 in mileage. I know you wear your car out in HH, but I can't believe 1500 miles in ten days.

Also, I'm salaried so this means no overtime. THey pay based on 40 hr weeks. I started at $22.50 and it was supposed to go up to $25/hr after 30 days, but it has been 5 weeks and I still have the same pay rate. I don't know why, but if it is up to the office manager I'll get a pay cut instead of a raise...ugh.

The patients have been okay for the most part, but it seems I get a lot of people wanting to put me off. On days they are scheduled I will call to let them know I'm coming and a lot of them tell me to come back tomorrow, or Tuesday, or can't you just interview us over the phone?....some of the patients act happy to see me, others don't. But I refrain from asking them why they accept HH services but then don't want to be bothered with the necessary formalities so they can keep it.

I just don't know...I'm not a quitter, so I'm going to give this a while longer. I did not take this HH job with the intention of keeping it forever, I'm using it more as a stepping stone (I want to go to NP school). Maybe I will feel different in a couple of weeks. Maybe it will get better.

cs58 · Jun 4, 2006

Thanks to those who responded. MM, hang in there. I'm new too---started FT in Home Health a few months ago, and, like most HH nurses, I love my patients--- and every time I walk in the door I forget, momentarily, about the tsunami of paperwork that awaits me back at the office.

But I began to get concerned when I saw how stressed out my new coworkers were/are and, as my caseload has grown, I soon learned why. I work for a for-profit hospital affiliated agency, and it just doesn't seem possible to get the job done in 40 hrs week. Yet we are TOLD there will be no overtime. We also have to do chart audits, but most days I see 6 patients a day and average about 40 miles/day.

Last week one of my coworkers had the OT she submitted taken away from her. I am told this is not the first time this has happened. Another nurse had a fairly light caseload over the weekend, so she came in to the office, finished up about 6 chart audits, and was so pleased that she had finally caught up--------UNTIL the director reamed her out for her lack of productivity over the weekend. Apparently chart audits are not a productive use of time so we are somehow supposed to fit them in along with our patient visits.

I hope we get more responses to this survey. Being new to home health, I am in the dark about what it is like at other agencies. Even my coworkers---some of whom have been HH nurses for many years---aren't sure what it's like at other agencies. THat's why I am so interested in all your responses. Thanks again!

renerian, BSN, RN · Jun 9, 2006

Hi. I am a new HH nurse, after having spent my entire career in hospital nursing---mostly med-surg--with a little L&D thrown in. I LOVE HH nursing, but have become discouraged over the paperwork and the morale in my unit.
First thing I want to know before we decide on a course of action is what is typical today in HH nursing, as even my coworkers who have been here awhile are not clear on what other agencies require of their HH nurses. I would GREATLY appreciate it if we could all compare notes and see what is expected of the typical HH nurse today.
Thanks!
1. How many patients are you required to see a day for full productivity? was 6 to 8
2. How much mileage do you average, and at what point does mileage get factored in with respect to the visits you are required to make? unlimited no service area
3. How much time is spent on an "average" visit? varied
4. Are you frequently "hassled" about productivity? VERY much so
5. Do you spend time on paperwork off the clock? If so, how much? varied but alot
6. Do you accrue overtime hours? If so, How much on average? No othertime/was salaried
7. Are you required to do chart audits in addition to your visits? Is time alloted for this or are you just expected to "fit it in?" no time alloted and yes expected to do them
8. What is a typical case load for you? up to 50 or more
9. Is your paperwork all written or do you have a palm pilot or laptop to make it easier? hand documentation
10. Have you ever been denied overtime your earned because you were not "productive" enough according to administration? no overtime paid in years
Thanks to all who respond. Our home health nurses are considering going to our director about what appears to us to be an overwhelming workload but we'd like to know what other HH nurses face first. I'm sure this info will be helpful to all of us.

renerian

ISITFRIDAYYET · Jun 14, 2006

Hi. I am a new HH nurse, after having spent my entire career in hospital nursing---mostly med-surg--with a little L&D thrown in. I LOVE HH nursing, but have become discouraged over the paperwork and the morale in my unit.
First thing I want to know before we decide on a course of action is what is typical today in HH nursing, as even my coworkers who have been here awhile are not clear on what other agencies require of their HH nurses. I would GREATLY appreciate it if we could all compare notes and see what is expected of the typical HH nurse today.
Thanks!
1. How many patients are you required to see a day for full productivity? 7
2. How much mileage do you average, and at what point does mileage get factored in with respect to the visits you are required to make? 30-70 depends,,,i charge another hour for out of county patients
3. How much time is spent on an "average" visit? 25-50 min
4. Are you frequently "hassled" about productivity? Nope,,,get paid by visit
5. Do you spend time on paperwork off the clock? If so, how much? yes, about 4 hours each week
6. Do you accrue overtime hours? If so, How much on average? no ot, but get extra pay for eveniings and weekends
7. Are you required to do chart audits in addition to your visits? Is time alloted for this or are you just expected to "fit it in?" No audits, hell no!!
8. What is a typical case load for you? depends on the season 10-15
9. Is your paperwork all written or do you have a palm pilot or laptop to make it easier? written
10. Have you ever been denied overtime your earned because you were not "productive" enough according to administration? No ot,,paid by visit
Thanks to all who respond. Our home health nurses are considering going to our director about what appears to us to be an overwhelming workload but we'd like to know what other HH nurses face first. I'm sure this info will be helpful to all of us.

Hope this helps

renerian, BSN, RN · Jun 15, 2006

Cs58 how are things going?

renerian

DutchgirlRN, ASN, RN · Jun 16, 2006

1. How many patients are you required to see a day for full productivity? I am PRN so I choose. Full time is 6 a day or 30 a week. Admits = 2 patients.

2. How much mileage do you average, and at what point does mileage get factored in with respect to the visits you are required to make? 150 miles per week. Some full timers 300-600

3. How much time is spent on an "average" visit? 30 min

4. Are you frequently "hassled" about productivity? Never

5. Do you spend time on paperwork off the clock? If so, how much? 3-4 hours per week

6. Do you accrue overtime hours? If so, How much on average? No we get paid per visit.

7. Are you required to do chart audits in addition to your visits? Is time alloted for this or are you just expected to "fit it in?" we get paid to do chart audits. We are expected to put in at least 2 hours per week.

8. What is a typical case load for you? 2-3 per day

9. Is your paperwork all written or do you have a palm pilot or laptop to make it easier? All written.

10. Have you ever been denied overtime your earned because you were not "productive" enough according to administration?

NA

*Pepper* · Jun 16, 2006

Could I ask another newbie question?

What is the typical uniform worn during visits?

Do you carry a tool kit with you and what would it contain?

How do you resolve cross contamination concerns when visiting multiple patients in a day? A new uniform for each?

Are there any good web resources you would suggest?

Sorry for the dumb questions, I am just breaking in.....

AnnemRN · Jun 17, 2006

1. How many patients are you required to see a day for full productivity? 5-6

2. How much mileage do you average, and at what point does mileage get factored in with respect to the visits you are required to make? 30 - 50 miles a day

3. How much time is spent on an "average" visit? 20 - 40 minutes

4. Are you frequently "hassled" about productivity? No, but others are.

5. Do you spend time on paperwork off the clock? If so, how much? No

6. Do you accrue overtime hours? If so, How much on average? No OT

7. Are you required to do chart audits in addition to your visits? Is time alloted for this or are you just expected to "fit it in?" Time is allotted for chart audits.

8. What is a typical case load for you? 16 ( I am part time)

9. Is your paperwork all written or do you have a palm pilot or laptop to make it easier? handwritten

10. Have you ever been denied overtime your earned because you were not "productive" enough according to administration? No, and I don't think that's legal

Thanks to all who respond. Our home health nurses are considering going to our director about what appears to us to be an overwhelming workload but we'd like to know what other HH nurses face first. I'm sure this info will be helpful to all of us.

DutchgirlRN, ASN, RN · Jun 17, 2006

What is the typical uniform worn during visits?
Do you carry a tool kit with you and what would it contain?
How do you resolve cross contamination concerns when visiting multiple patients in a day? A new uniform for each?..

You wear scrubs to HH visits and you don't change clothes just as you wouldn't change between patients in the hospital. Universal Precautions are observed at all times just like in the hospital, number 1 defense GOOD

HANDWASHING. I carry a bag with a BP cuff, stethoscope, thermometer, pens, gloves, note pad, hand sanitizer. I carry red bags to dispose of soiled dressings. I have a tackle-like box in which I keep items to draw blood, change huber needles, start IV's, alcohol swabs, skin protectant, masks, etc. These items are all supplies by the company other than the bag and the tackle box. I also have a plastic portable filing box for extra forms and to file forms which are finished, ready to turn in, and a notebook where I file away useful information. I'm sure I'm forgetting something but I'm oh so tired and ready to go to bed.

P.S. The only dumb questions are the ones not asked. Look through the HH

forum and you'll find loads of info for newbie of HH.