1. Out of curiosity, what is your average daily mileage that you report on your DAR? We have to report mileage and count it as time, as well (so 30 miles is considered an hour of time on the DAR, for instance).

    I've been running an average of 30 to 60 miles per day, as I am the low bwana on the totem pole and don't have a one town case load. In this area (New England) that is substantial, but I imagine it's a lot lower than in other areas where things are more rural or farther apart.
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    About RoAbreu

    Joined: Sep '02; Posts: 27
    Visiting Nurse, Case Manager


  3. by   sunnygirl272
    I have a company car, on which i am taxed...but i do anywhere from 45-210 miles per day, 5-8 clients/ day.
  4. by   RoAbreu
    Wowsa... where do you live, that you'd do 200 miles to see that many patients? I am seeing from 5-7, usually.

  5. by   sunnygirl272
    Central new yourk state...we are a (fairly) rural county...the higher mileage days for me are usually when i get forked on weekends with BID dressings that are on far ends of the county...Oswego County Vital Statistics
  6. by   RoAbreu
    I haven't been at this long, so I've only worked one weekend (we work a weekend every six weeks). My next weekend is the w/e before Christmas, and I work that this year, so I expect a strange week as the hospitals dump everyone out for the holiday.

    I guess I'm grousing about it because in our agency, there are several teams that work a single town/area (such as just Haverhill, or just Lowell, etc) but I'm on a team that is spread out, so I am starting to luck out with the dailies that are about 25 miles away from my next client out. At the same time, the bosses are making noises about productivity, which is nigh on impossible to maintain without overtime if you're seeing the same number of patients as someone whose patients are all in a five mile radius of each other, more or less.

    As winter approaches, I'm wondering how to approach said bosses with the reality check... I got paged the other day to do a PRN visit ASAP that was a good half hour drive from where I was, and it meant skipping the patients around where I was and driving back to them after.

    I'm not looking forward to snow in those rural areas. How long have you been doing your route?
  7. by   sunnygirl272
    been a nurse for over a decade, in home care for 5 yrs....when i first started i did qo w/e..then it went to q we hired another nurse, just barely before our horrible hiring freeze, and we are q4thweekend...
    the 4 of us are lpns who rotate assigned visits on w/es..there are other nurses who work w/e s to fill in as needed, theyare assigned to work, but may only work part of the weekend...and there are oncall nurses also...
    we are soooooo short staffed now...we have noticed all along that theyare being sent home sooner and sicker, but it is more so now...our agency is opening ave of 4 cases/day...occ more than that!!! and mannnn are they sickies...i have seen my first exposed epiglottis...that was freaky!!

    sounds like you will be busy at the holiday...
    we are split into east team/west team (based on population) during the week... and the oncall beeper is split all the time..but on the w/e, the assigned visit nurses may be all over hells half acre, depending on staffin and location of visits...the east team of our county has a larger territory. because the west team is more population dense...

    in our agency i have found that teamwork kicks in better during the winter...swapping visits so there arent 3 nurses going to phoenix, for example...
    also not uncommon for our clients to decline/refuse visits when the weatehr is'll call to set it up and they will say"sweetie, i am fine...the roads are bad..i dont want to worry about you coming to seee me...let's try later inthe week"..and they do have the right to refuse, so why push it, ya know? or they will fungle through and do their own pm dressing change so a nurse isnt out on theora d to see them..they dont do a great job, not good enough to really decrease the frequency, but ok enough for a

    i would check and see if your agency has an official policy on weather and visits...ours is quite vague...unfortunately...
    sometimes, very rarely, when it is bad, although they won't "close" the building..they do unofficially pull us from the roads...put extra padding on the bid dressings and tell them no one will be back til the am...they hafta bear in mind the legal liability if a nurse is killed on duty...that never looks good on paper...

    actually we had a HHA who was killed on duty... was on her way to her first client, (in a county vehicle, so she was considered on duty, although her day had not started yet) some @$$hole ran a stopsign and killed her....
  8. by   RoAbreu
    I think there is a foul weather policy, and I'll need to look it up. I have already run into what you are talking about, with the patients trying to defer me on yucky days... it'll probably increase when the weather is worse.

    I know they typically try to get us to move our regulars off holidays and just leave the dailies, and we have baylors for w/e in addition to the rotating staff and admit nurses... but as an RN what I usually end up doing is labs and new admits as they come in, they give the baylors the dailies.

    I really do like what I'm doing, I'm just not looking forward to driving in bad weather. One of these days I'm going to have to convince the hubby to move me back South
  9. by   LoisJean
    Ro: Are you being paid, then, for mileage time and mileage miles both? Just curious.

    Lois Jean
  10. by   RoAbreu
    They have us put it in our DAR; I'm a full time person, rather than per case, so I guess, yes, it works out that way. They count my road time as part of my eight hours, to a degree... as I said, 30 miles is considered an hour; sometimes that may not take an hour, but sometimes it might take more, I guess they figure it as an average. For per cases, they don't get paid that way, it's per visit and mileage. I get paid hourly and mileage, and I'm compensated for my cell phone calls. I have to turn in a voucher for the cell phone thing, but they get my miles from my DAR and pay me monthly.

    The per visits get paid more per visit than I get paid per hour, and somehow they get flat compensation for their travel time, but I haven't explored that, as it doesn't apply to me.

    At least, that's what I've noticed so far (G) I've only been doing this since late August, so I've only been on the road a little over a month now.
    Last edit by RoAbreu on Nov 17, '02
  11. by   rnhomeind
    Our agency will give you less visits for the day if you have to travel further than the in town nurses...
  12. by   Traveler
    I average about 80 miles a day. Some days as low as 30 and some days as much as 200.

    Weekends are tough as patients are certainly being home much sicker. Our coverage area extends 3 hours apart at the furthest points so weekends can get sticky especially if you have several q8 hour iv's. Our nurses work really well together so if we get into a sticky spot on the weekend someone will usually step in and help out that lives closer.

  13. by   luvbeinganurse
    I am working with the private side of home health right now (most of the time - occasionally they throw me back to Medicare when the Medicare side is horribly busy) so I am not running around on nursing visits as much. Most of my visits are the sign-ups and supervisories. But I also do the scheduling for all the aides and homemakers. The girls are paid by the hour and not by the visit. I calculate their drive time basically by multiplying the number of miles by 3. It's usually pretty accurate unless they are held up by an accident, etc. But we are in town and the traffic is almost bumper to bumper constantly.

    On the Medicare side, they have started taking into consideration the distance patients are from each other when they have to go out in the country. They initiated an acuity system which takes that into accountability now. The nurses that are driving in town may have 6 or 7 patients, but the ones going to timbuktu may have only 3 or 4. It seems to work pretty well that way.
  14. by   renerian
    After my last home health job I put no less than 100 miles per day on my car. Most of the time 150 miles per day. We were not paid for drive time and sometimes half my day was in my car.