Offered HH position, have some questions

Specialties Home Health

Published

I have considered home health nursing for a while. Was offered a position with VNA and am excited about it. Orientation will be at least 6 wks, longer if needed. They said four 10 hr work days is not a problem. I currently work in ambulatory care, mostly office work. I'm looking forward to direct pt care, teaching, independence and especially flexiblitiy in work schedule. I currently work M-F so four days/wk would be great.

Concerns: Talked with a coworker who hated HH b/c of the condition of pt's homes. I shadowed a HH nurse in nursing school and don't remember such horror. Of course I'd expect to have some uncomfortable homes but are most homes all that bad?? Also the charting, have read horror stories here. How many hrs a day do you work? Does an 8 hr day turn into 9, 10 hrs?? Is your mind off work once you've completed charting or do you start thinking about tomorrow's schedule. I currently work long hrs at my job and a big reason for moving on is to have more time for myself and with family. Oh, and the major concern... it's a huge cut in pay. But I figured I'll be working less (only 4 days) so less pay. Doesn't really add up but really need a change. Any input would be appreciated.

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Specializes in oncology, trauma, home health.

Hi there,

I'm about 4 months into my first HH job and don't see myself ever going back to a hospital. What really concerns me is this "cut in pay" that I often hear nurses say when they go from the hospital to HH. I make more in HH than I would on dayshift in the hospital.

About the pt's homes, some are dirty, decrepid, and some are amazingly beautiful. Yesterday I went from a public housing apartment above the homeless shelter, drove 1 mile uptown and was in the penthouse of a highrise.

If you read (I'm sure you have) the posts on a typical day for a HH nurse you'll find many of your q's answered. Where I work, we are really short staffed and I find that because I have a different kind of relationship with the patients in their homes, I will step up and go see them on a Sunday if I know they need that dressing changed and there is no one to do it. It is hard to just turn it off when I am at home.

There is a lot of charting..But my typical day is: In the office at 8 (I like to start there) home by 2pm, chart 1-3 hrs depending on the day. But I am charting in sweats, with the kids home, hanging out. I can chart when I get home, or at 10 at night. I love that freedom. I also love the freedom of not having to go into the office, or be there at a certain time. I'm an early riser, but if you're not you can get your day started at your own pace (generally).

I was worried about giving up those 12 hr shifts and all of the days off, but still now I have NEVER dreaded or even disliked going to work. I enjoy it and the freedom so much and I hope you do too

I read (and have written) all of these posts about nursing burn-out and wish that nurses would consider HH. I talk to friends who work in the hospital and they hate their jobs, I beg them to think about HH. I cannot fathom why people wouldn't want this job.

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Specializes in Home Care, Hospice, OB.

hh is something you love or hate--pretty clear where i stand from my user name.:yeah:

you will see all kinds of homes...i have visited filth and clutter in a "mcmansion", and clean, tidy homes in the projects. many elderly cannot do housework anymore, some patients are mentally ill. the joy is getting to help them cope with their illness or injury on their terms, in their homes, and it does require being flexible and accepting (which is not the same as approving) of the human condition in all its forms.:rolleyes:

best of luck--i started in vna and now am the clinical director of a small agency. pm if you need me!

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thanks for the reply. Truly want to do more pt care, one pt at a time. Spoke with the recruiter one week ago, had some questions about benefits and weekend pay. She mentioned a shadow day. let her know I would love to shadow and that I was still interested in the position. Also let her know wanted to be sure b/c this would be a cut in pay for me. She said the manager would be getting back with me. Am still waiting to hear back from them. Left a msg a couple of days ago, still no reply. What happened??? Losing hope.

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I followed the HH nurse for part of today. She was on call for that evening. She received a call from the office with 2 new visits for the evening that were being added since she was on call - one was a new admission. This was in addition to her regular scheduled visits. Is this right? One of her scheduled visits for the day was a pt she case managed. She saw him for first time today - to discharge him. The nurse said it's just the way it was scheduled. does that sound right?

I want to do home health nursing so think I'm going to take the plunge. Want to do real nursing and get to know the pt. Any input on the on call situation and scheduling of pts would be appreciated. thanks

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It is not unusual to have additional visits if you are the on-call nurse. I have worked 15 hours straight on days/weekends when I had call. That is nowhere near typical but it can happen. Ironically, the call visits were often the most satisfying because (unless it's an admit) there is a specific focus for the visit and the pt is usually very grateful that you have come to help, keeping them out of the ER or hospital.

I have worked in HH for seven years. Doing performance improvement in the office now, but really loved being out in the field. You are able to really focus on your patient, and you get a much more realistic view of their life and how they are handling their medical issues. Sometimes the HH nurse is the only "company" these people get and they really look forward to your visit. They will want to show you photo albums, feed you coffee and homemade pie, and play that song they wrote 40 years ago for you on the piano (although this can add some time to your day, it always made me feel good to take the extra time when I could and give these people some companionship and human validation).

As someone said earlier, I too have been in some really nasty homes and also in some incredibly beautiful places. For the nasty places, take shoe covers, use your newspapers as a bag barrier (like we're supposed to every time LOL), and be careful where you sit! :eek:

The documentation demands are usually what run people out of HH. Do as much as you can in the home, try not to end up with a back-log, and remember it will get easier with time. But DO document well - remember, it's only you, the pt, and their family or friends present, the only witness you will have if needed is your own documentation, so make it good. Good luck, I hope you love it as much as I do!

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They will want to show you photo albums, feed you coffee and homemade pie, and play that song they wrote 40 years ago for you on the piano (although this can add some time to your day, it always made me feel good to take the extra time when I could and give these people some companionship and human validation).

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This sounds like the reason I'm entering the field of nursing.

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