How do I get out of the home?

  1. Hello.

    I started my new job as a home health nurse 2 weeks ago. I am totally loving it. I feel like this is what I was born to do and am so grateful to be allowed to do it.

    When I was working on med/surg as a new grad, my preceptor said "you have to learn to get out of that room". What she meant was that I spent a lot of time just talking to my patient. I only worked med/surg for a very short time, but I did learn to get out of the room. I hated not having the time with patients because I don't think many things are more important than listening to the patient. I have made many "saves" just by being alert to what I am being told and following through when something plucks that "oh oh - this is important" string that I believe all good nurses have or develop.

    Notwithstanding, there is a point, especially with the lonely and the housebound, where I really must go.

    How do you experienced home care nurses, or anyone else for that matter, with finite time and energy, move that meeting to a close while at the same time, expressing to the patient that you are interested, they matter, and in a perfect world, you would have that cup of tea?
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  2. Visit Kaisu profile page

    About Kaisu, ADN

    Joined: Aug '13; Posts: 56; Likes: 197

    17 Comments

  3. by   caliotter3
    "Well, I must be moving along. My next patient is waiting for me now ......."
  4. by   Kaisu
    Quote from caliotter3
    "Well, I must be moving along. My next patient is waiting for me now ......."
    Thank you for that. I guess I am still carrying over from the hospital, where we were NEVER to tell a patient that the reason their ice cream was late was the respiratory arrest in the next room. I over-state, but essentially we were never to blame patient load for our failure to meet expectations.

    This is a different thing.
  5. by   meanmaryjean
    Quote from Kaisu
    Thank you for that. I guess I am still carrying over from the hospital, where we were NEVER to tell a patient that the reason their ice cream was late was the respiratory arrest in the next room. I over-state, but essentially we were never to blame patient load for our failure to meet expectations.

    This is a different thing.

    Changed my mind
  6. by   Libby1987
    If you aren't already, and granted there are visits that are difficult to keep on track, try setting up front what the patient can expect from the visit. AIDET is a tool but this is the general information you can give to patient at start of visit, even in part with the phone call to schedule the visit.
  7. by   Elfriede
    A buzzer or a "keyfinder" in your pocket will do it.
    You press it and a ringtone "calls" you to an "emerency use".
    "I´m too sorry. But if you have a urgent problem, my other patients has to wait as well."
  8. by   Oldmahubbard
    So simple. "Mr Jones is waiting for me a few miles up the road."

    It is actually much simpler in HH than most other fields.

    Never tell your patients that your territory is a small area, even if it is true.

    You cover the entire county.

    Don't hang out at the home on a slow day. You don't want to give the wrong impression.
  9. by   LadysSolo
    Quote from caliotter3
    "Well, I must be moving along. My next patient is waiting for me now ......."
    I agree with this or some variation - "I'd love to have tea with you, but I have to get 6 more visits done before 5 o'clock today," "So sorry, but I have a timed IV I have to get hung, it HAS to be done on time," etc. In home health you are ABSOLUTELY allowed to say such things to keep on schedule. Also, you may want to look into your local Passport or whatever they have in your area, they may have people who are willing to visit the lonely (or a local church group, or whatever.)
  10. by   KelRN215
    Set reasonable expectations with the patient as to what the visit will be. "I am coming to admit you to our services." "I am coming to make sure you understand how to use your new feeding pump." "I am coming to change your central line dressing and draw labs." I was pretty good at keeping my visits to 30 min or less when I worked in home health. Sometimes there is nothing you can do- your patient's mother should have brought him to the ER last night but waited because she knew you were coming and now it's an emergency- but don't plan on staying for tea or anything like that. It's important to keep boundaries. I never drank tea with any of my patients (or their parents since this was pediatrics) in 3 years as a visiting nurse.
  11. by   Oldmahubbard
    Definitely refuse offers of any food. Eat before you come to work.

    In today's world, you may possibly, on rare occasion, accept a cold glass of water.
  12. by   Kaisu
    Quote from Oldmahubbard
    Definitely refuse offers of any food. Eat before you come to work.

    In today's world, you may possibly, on rare occasion, accept a cold glass of water.
    For sure. I'm a nurse. We don't eat, drink, pee or sleep. ;-)
  13. by   Elfriede
    Quote from Kaisu
    For sure. I'm a nurse. We don't eat, drink, pee or sleep. ;-)
    How do you manage the electrical charge?
  14. by   Eleven011
    When I was working HH and it was getting time to leave, I'd say something like "Well, Mrs. Jones, your meds are all set up for this week, I have the refills you need written down so I can bring them next time, your blood sugars are looking good today and your dr. appt is set up for thursday. Is there anything else I can do for you before I leave?" Amazingly, after listing what we did like that, they normally replied, No, there wasn't anything else they needed and that was my cue to leave and move on.

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