Home Health Help..Considering change from acute care to Home health

riern · Jan 11, 2005

Hello All,
I am a 34 year old guy new to nursing (less then 1 year RN) but not to the medical field. I have 15 yrs experience in related areas : PT Aide, EMT, LMT, Burn Unit, Ortho, Wound care.
Currently employed Acute Care Orthopedics considering a change to home health for a little more money but primarily for a better schedule. I have a 10 old child and need more flixibility.
Is home health a good option for me?
Is the pay better?
Is the schedule better?
Does the amount of paper work make the other advantages null and void?

I have recently, as in last week, left HH to return to the hospital. I went to HH because I was a single mom and needed the flexibility at the time.

It all depends on your employer. Some HH agencies require the nurses to return to the office after seeing their patients to do paperwork, make phone calls etc.. that cuts out the flexibility somewhat. The pay was a little more but where I worked there was no insurance or benefits so I ended up making less because I had to obtain private insurance. I'll just be honest with you .....THE PAPER WORK IS HORRIBLE!! I would see patients all day and spend at least 3 hours at night doing paperwork. We were still all on paper ......some agencies are using laptops now and they say that's easier and quicker, if the laptop behaves.

I left home health because I was getting burned out on the paperwork and the constant feeling of being responsible for these people even when I was on vacation. You know you're too involved in your job when your cell phone rings while you're on the beach and it's a pt wanting to know when you'll be back.....LOL. I also began feeling like I wasn't using all of my skills.....hadn't started an IV in at least 2 years. It was time for me to go back to what I loved and that's OB.

Only you can decide what's best for you at this time. My suggestion would be to ride with one of the nurses there one day and see what the typical HH day is like for them. Each agency just like each hospital is different.

Good luck to you.

Home Health Columnist / Guide · Jan 12, 2005

Your just beginning to get organized as an RN and comfortable in that role.

In home care you are on your own in a patients home, with little backup in how to handle a situation. Paperwork is overwhelming to many experienced RNs. Average admision requires minimum of 20 pages documentation (due to OASIS form) , often 25 pages is usual.

Instead of leaving your hospital position, see if you can go perdiem in homecare to get your feet wet with doing followup or wound care visits, buddying with a FT homecare RN.

Homecare was very flexible for me with young kids. I only worked 3 days week when young, voluteered at school s lunch mom/nurse, helped out in classrooms one day a week. I could help in class from 8-10AM, then be on my way to see patients. Needed to fit in teacher visit, could see patients, meet with teacher 1PM, back out to finish case load or attand school event.

About every three weeks, I'd set aside Wednesday mornings just for physician calls and insurance updates (seemed best time to reach my docs). Because we needed to see average 25-30 visits per week, I might have seen 7-9 patients day before/after, instead of usual 5-6. Since I Case Managed a large number of Chronic care/ Recerted clients with wounds, foleys, trach's, IV's, I'd start my OASIS/ Plan of treatment/ insurance update forms for coming week---or be completing any late ones I missed ...in between phone calls. Of course those days plans could be shot to pieces if a client had a serious problem, needed STAT visit or new admit just HAD to be seen, but most of the time I was able to juggle my time.

Pay in my area was GREAT in 1980's, but now behind what hospitals are offering in Philly area. If you can fly by the seat of your pants, accept that you are in the patient's home and have to abide by THEIR RULES when you can come + what they will permit you to do, and are flexable as a rubber band, then homecare may be for you.