Wow... thirteen patients... that surely IS way too many !!!
As for the above.. I do start at the office BUT... I get there by 0700 before any of the others get in except a few admin here and there. This way I can pull my charts, get what teaching materials I need, have the copy machine all to myself to make what ever copies I need for the day, etc.
Can glance over my notes one last time before turning them in, and make changes in the MARs as needed from the day before.No one else there to talk to or distract me.
I can get out of there in half hour and be on the road. I try to be at my first patient's home no later than 0800... often quite a bit earlier, depending on the patient and what time they will let me show up.
I do have several who let me come as early as I want. I see one regularly at 0645.
Catch her on my way IN to the office.. same as my lab draws if they are enroute to the agency.
We get our schedules on intranet the noc before, so I already know whom I must see the next day, and can call them from home that evening already to let them know. Also know what labs I will have to draw and where, so that helps, too.
I average 6-7 pts./day and my area of travel averages about 25-30 miles/day. Often less than that.
So on average, I get home by one pm .. sometimes later if I have 7 pts. and several of those being tedious wound care. Rarely get home later than two, and often have been home by noon. All depends on the patient, and the care needed.
I, too, try to get my notes done IN the home before leaving, as they are chit chatting with you. Helps a lot, that way the remainder of the day is MINE. (except we ARE still considered "on the clock" until 4:30 pm.. meaning if they need you to do a PRN visit somewhere or somthing like that, they can still call you back out.) Happens only once in a blue moon, though.
Sometimes I just can't get my notes done in the home if I have a heavy load or things are crazy that day. I do as many as I can, sometimes I have done none and will have to do them later at home, which I don't like. But... gotta take each day as it comes and do the best with each one.
We're still hoping to get up to date with laptops or PDAs in the future.. wish it was sooner than later. *sigh* That would be a HUGE help and timesaver!
I don't understand why your agency doesn't want you to see patients before 1030 am. ????
Ours requires us to be on the road and on the way to our first patient no later than 0830-0900 at the LATEST. Most of the nurses come in to the office by 0800- 0830. I'm already long gone by then.