DESPERATELY seeking for an advice!

Specialties Home Health

Published

I just accepted a skilled home health care job a month ago from a small privately owned company. The orientation is through online which lasted 1.5 hours and that's all about the training I received. I wasn't paid for that training either. I felt unsafe not having a real orientation and just accepting patients like that.

My background is years 5 of nursing RN-BSN. I have worked 1.5 years adult and pediatric non- skilled nursing, long- term, sub- acute and acute care hospital for 2.5 years.

I got tired of hospital setting, now currently working at home health and back to sub- acute unit at the same time, and also going back for my FNP.

I have been desperate looking for information as I do not know any home health nurse or have friends that are home health nurses.

Few questions...

1. How long is the orientation should be for new skilled home health nurse with no experience?

2. I live in Central NJ. My pay rate is $50.00 for everything, SOC, reg. nurse visits, DC etc.

No mileage reimbursements, no phones, no laptops. Is that a fair pay?

3. I really like homecare but I feel like I am in the wrong agency, should in case I apply for a different skilled nursing home health agency. What are my chances of being hired? Is there a big demand for skilled home health nurses?

Any answers or advices is greatly appreciated.

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P.S. The more I researched about home care the more I discovered about OASIS etc the more I realize how much I don't know anything at all about home care and how unsafe it is sending me to see patients and start intakes and plan of care after 1.5 hours of orientation. I feel soooooo unsafe and paranoid that I might have made a mistake and will face lawsuits. :( :( :(

I am preparing my resignation letter now... Guys I need your input.

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I went into homecare as an experienced nurse with no homecare experience. My orientation period for that was three months. I was given a phone, laptop and mileage in addition to a generous salary. Your orientation sound woefully inadequate to say the least. I may have been very comfortable with my assessment skills, but the charting is different and takes a while to master. I agree, try another agency. I am very happy making the switch but you need more support.

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You have three months for orientation? Omg that's long. I only have 1.5 hours and then I started to see patients. When I started working for this agency, then I realized they have no other nurses other than me. I am the ONLY nurse they have, just ONE. If I resign then I will leave 8 patients behind with no other nurse seeing them. I pray to God that they will find someone to find a replacement.

If I leave the agency and God forbid something happens to the patient e.g. wounds got infected etc. would I be liable because I left or would it be the agency because they couldn't find a replacement? I'm so confused. I am a nurse with 5 years experience, yet I feel so naive.

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I started to see patients sooner, but started by shadowing another nurse, then seeing patients with my educator observing, then seeing one patient alone and someone reviewing my charting, etc. Three months to gradually increase me to a full patient load on my own. If you properly care for patients while you are there and properly give resignation it is on them to replace you. I cannot believe they have NO other nurse, that is crazy! I would start looking elsewhere for sure. What is their plan if you are ill, hurt, etc?

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Specializes in Pediatrics Retired.

I have no idea about NJ job needs but I do know a company offering 1 1/2 hour for homecare training is NOT the company to work for. It would take you a full day just to start to grasp the framework of medicare documentation requirements.

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I've been a visiting nurse x4 years, my best advice? Run fast & far. There is so much to home care that you are setting yourself for some major problems. The pay structure is also atrocious. I am pretty sure mileage has too be paid for this position but that could also vary state to state. Without proper OASIS training you run the risk of accidentally creating Medicare fraud and would be liable since you're doing the work. Run! Work a VNA with a big hospital that offers adequate training. Mine does 6 weeks for seasoned VNA and 12 weeks for newbie's to VNA. Best of luck!

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Basically if they do not pay mileage you can deduct it as a business expense, my company pays .50/mile but because it is less than federal rate (which last I saw was .54/mile) you can deduct the difference between what they reimburse and federal rate on taxes. I do not think any state actually requires them to pay, but almost every company does.

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Not all home health jobs require multiple visits. I do home health with one patient, which I like. Only problem is you can get bored with same routine but then I guess you could request another assignment.

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Our orientation is 5 weeks long. I still struggled even after 5 weeks, just with all of the charting. That pay is VERY low. I live in Florida where the pay rates are much lower than NJ, and even we pay more than that for a SOC. Run fast...find another, more reputable company. Try searching on glassdoor.com for company reviews. Best of luck to you.

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I've worked for a few different agencies both as an employee and as a traveler, even the travel agency gave me a short orientation with another nurse. At all agencies I've had a nurse bag, trunk kit, agency provided phone (one didnt provide a phone but gave a stipend), laptop, and necessary forms, admit, dc, 48hr, etc.

I was expected to see 6 patients/day although the odd patient sometimes required a 2hr visit.

OP, what does the agency plan if you are assigned a patient with a device or equipment you've never seen? For me even as an experienced nurse, I sometimes saw things that I was not familar with and if I asked my manager would send someone to familarize me with no questions asked.

I have heard of some national chain skilled agencies that provide a 2 day or less orientation- turnover at those places tend to be high, and in my area they also seem low on the referral list.

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You have three months for orientation? Omg that's long. I only have 1.5 hours and then I started to see patients. When I started working for this agency, then I realized they have no other nurses other than me. I am the ONLY nurse they have, just ONE. If I resign then I will leave 8 patients behind with no other nurse seeing them. I pray to God that they will find someone to find a replacement.

If I leave the agency and God forbid something happens to the patient e.g. wounds got infected etc. would I be liable because I left or would it be the agency because they couldn't find a replacement? I'm so confused. I am a nurse with 5 years experience, yet I feel so naive.

I think you might need to speak to a lawyer regarding or asking BON, what happens if you leave and they have no other nurses. Obviously theres a reason they have no other nurses, but legally you may have some responsibilities to the patients you currently have, find out and protect yourself legally.

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