I need to vent!! :

Specialties Home Health

Published

I just need to get this off my chest... Am trying to schedule my visits for tomorrow. Note I drive approximately 100 miles per day in 3 counties. I have been told the following by my patients

1. I don't like to get out of bed by 9:00am - can you come later, like after 11:00 but before lunch?

2. I'm going be kind of busy at 2:00. Can you come after 5:00? I want to go to the movies.

3. I don't like you to come until after 1:00 but before 4:00. This person does not even move from his chair, never mind leave the house during the day.

4. No, you can't come. My cleaning lady will be here.

5. No, you can't come. I am volunteering at the assisted living facility down the street from 9 until 12:00. This after she just plain didn't show up at our scheduled appt the day before. She was shopping. ( I reported this one to my supervisor. Homebound??

These are just a few examples. I am going crazy in this job. The sense of entitlement absolutely drives me nuts. I think it's because it's Florida and there are a million agencies competing for business. I remember when my Mom was on hospice. The nurse would call and say I'll be over at 1:00. I would rearrange my morning so I'd be free when she came, and I was glad to do it, too.

Thanks for listening....

mc3

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Specializes in LTC/hospital, home health (VNA).

i know!!! lately we have been so busy that i have been a little "firmer" with my patients...saying that i know you'd prefer that but in order for me to see you/change your dressing/do your IV...I'm gonna have to come between such and such...I have ___ other patients to see..just stay in bed, dont dress up, stay in pj's, etc. While they are often not extremely happy, they USUALLY let me come. Sometimes I just say, if I cant come in the AM, then I'm not sure who will come or when they can come. I feel bad about being so adamant, but in order to get done...sometimes you just gotta do it. I always thank them when I come for "helping me" and then move on to what they need done. BTW, my patients typically love me :)

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Your patients do NOT sound homebound at all. Movies?? Volunteering at the AL facility? What do they need nursing for then? Or is the family members that you are talking about?

I'm not an early person myself, so I rarely go to someone's house before at least 9, unless a DM patient. And, I need the flexibility of HH nursing. But when someone request late in afternoon, or some unagreeable time, I will see if someone else can cover the visit. I'm PRN so this might not be an option for you.

Luckily, I don't have the problem that you have. And the few times that I have had someone "request" a special time, I will say, "I'm sorry. The office has me in your area at this time of day" MOST pt's will be happy to arrange their schedule to suit yours. They are homebound, so why wouldn't they? Just like you did with your mom. And if the family member is the one making the request, after they meet me and are comfortable with me, I will say, "I can call you after the visit and give you report on that wound, assessment, etc."

Are you possibly just too nice?

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Yes, Yes, Yes! That's my days too!

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I am trying to be firm, but the agency is so concerned about making the patients happy so it's a fine line, I guess. I do like the suggestion of saying "my office scheduled me at such and such a time" although I wouldn't be surprised if they called and complained. Like I said, the area I'm dealing with seems to have an air of entitlement to it; it drives me nuts. And yes, it was a patient that wanted to go to the movies, and I reported it in my team meeting. No response from the supervisor, except I feel like I'm getting a reputation as a troublemaker!

Thanks, everyone, for listening and for your suggestions! :paw:

mc3

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Trouble maker? I think NOT!! When they get audited and it's found out that the patient is NOT homebound, the office will be in big trouble. Bottom line, if they can go to the movies, they can go to the MD's office. Of course I don't have all the information in front of me, but that's what it sounds like. And do we sometimes have to "bend the homebound status rules...", yes. Only you know. With the info you have written, I would say, write a missed visit, and on the reason, put patient at the movies NOT HOME.

Remeber, you are also liable for the homebound status on patients. Just my:twocents:

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Specializes in COS-C, Risk Management.

MC3, I could've written your post! I'm also in FL and my agency insists that we call patients at least the day before to "make an appointment" to see them, but can't understand the havoc it wreaks when they throw additional visits on my already full plate. I refuse to call patients until I know who all I'm going to see in a day. I will let them know the week before what day I am planning on, make sure that rhey don't have dr visits or whatever and will work around that, but I refuse to "make an appointment" that I am then bound to keep. I will be there when I get there. I'm more than happy to call as I'm leaving the previous pt's home to give the next one a heads up that I'm on my way, but I'm not going to criss-cross town five times in a day because two or three patients want to be seen in between the Today Show and their soaps!

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Specializes in oncology, trauma, home health.

Oh this is the most annoying part about home health.

I call at 9, get this groaning, slow...."heloooo" No I don't want to see you before noon. I was up all night watching tv. I hate the new gal's hair, but I am legally blind.

Or the ones who are in the ALFs and you have to schedule around their bingo/ meetings/ lunch from 11-1, then a nap. Ugggh.

Or the annoying foster care owners. No! You can't that flu shot, she never wants one.

But the worst....the VERY WORST...are the annoying family members who hover, say "that's not how so and so did it in the hospital" get mad when you call at 8:30 for an appointment, hover some more and covet your supplies in the back bedroom you're not allowed in. They BRING you two gloves to use. Oh God. It has been a rough couple of weeks.

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ALF's are the toughest to schedule around,,and then there is the wonderful Price is Right, i think it is a requirement to be a HH patient and watch that show, so many of my pts don't want a visit at that time!!! i do my best to accomodate all the requests as i know that alot of them are so lonely and we are the only one they may see all day , but i can"t criss/cross all day long or i will never finish!

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ALF's are the toughest to schedule around,,and then there is the wonderful Price is Right, i think it is a requirement to be a HH patient and watch that show, so many of my pts don't want a visit at that time!!! i do my best to accomodate all the requests as i know that alot of them are so lonely and we are the only one they may see all day , but i can"t criss/cross all day long or i will never finish!

gee, I thought it was Who wants to be a Millionaire!

mc3

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ALF's are the toughest to schedule around,,and then there is the wonderful Price is Right, i think it is a requirement to be a HH patient and watch that show, so many of my pts don't want a visit at that time!!! i do my best to accomodate all the requests as i know that alot of them are so lonely and we are the only one they may see all day , but i can"t criss/cross all day long or i will never finish!

LOL! I once had a pt who sat two feet in front of her TV when TPIR was on with a pen and notepad, she wrote down the prices of everything on the show! You could forget getting a visit accomplished when Bob Barker was on.

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Specializes in COS-C, Risk Management.

The week that Guiding Light went off the air was a doozey. That's all I'm saying.

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