Typical Day For A Home Health Nurse - page 13

Not a bad day today... started back per diem today. 6 cases, all in the same township. Not my usual zip codes though, so I did waste some time and scheduled visits akimbo, instead of in a line... Read More

  1. by   ruseenmetoo RN
    Quote from Geordi486
    Hi, I am a SN, I currently work as a HHA and absolutly love this job. I am interested in becoming a HH nurse but am wondering what the best course of action would be. I graduate in Aug with a BSN degree. I am thinking of applying for a Critical Care internship at a local hsp. Am I correct in thinking about getting as much experience as I can before becoming a HH nurse. Also the other thing I hear is they are only willing to train a GN once. Any advice would be appreciated.
    Going to the hospital first is a GREAT idea, ICU is a great way to get very comfortable with your assessment skills. In HH you need good skills, you are the only medical eyes in the home...good luck!
  2. by   ruseenmetoo RN
    Quote from luzababy
    I've been doing Home health for a few years now and going back to the hospital. Benami313, if you're seriously thinking about working for a HH agency, you really need to look into an agency that pays mileage because you are going to be using your car A LOT. Don't forget car maintenance. Instead of needing an oil change every 3 months, you're looking at every month and a half. Also, think about gas...with prices going up, it can get pretty pricey.
    I'm leaving because of the paperwork. The pay may be a little better, but when it comes down to it, you're actually getting paid less because you're CONSTANTLY working. And as soon as you think you're back on track, the cycle starts all over again. Not only that, but it's the constant phone calls...the office will call you ALL DAY LONG, racking up your phone bill. My last phone bill was >200.00 -- a huge ouch on my pocketbook!
    The good thing is you can set your own schedule; you're not stuck inside a hospital all day long; and you can run errands in between patients.
    Good luck and hope everything works for you!
    Any agency that does not provide cars or pay mileage for the use of the SN car is for the birds................
  3. by   CapeCodMermaid
    Quote from ruseenmetoo RN
    Oasis is a killer but once you get it you will be so proud of yourself!! Don't get frustrated, hang in......
    I've done both the OASIS for home care and the MDS for long term care and I can say without hesitation the OASIS is MUCH easier! My supervisors had my orientation class all stressed about the OASIS. Then we actually looked at it...not hard at all. It takes time, of course, to do it acurately but that's it.
  4. by   Nursecathy123ca
    Quote from CapeCodMermaid
    I also bought a GPS and I'm using it as a tax deduction next year. The joke in my family is when they were handing out senses of direction in Heaven, I couldn't find the line!
    My company gives all the nurses a cell phone so at least the phone bill isn't an issue and they have a mileage reimbursement, but I know what you mean about the wear and tear on the car....and my poor body trying to maneuver through some of the yards and houses is like being on Fear Factor!
    Would it be rude to ask what all y'all make per hour or per visit?
    I asked my husband about getting a GPS and he is thrilled! (He is, of course, a big-time geek.) Even though I do most of my home health nursing in an assisted living facility, I do occasionally go out into the community. And out there I am constantly betrayed by my imaginary sense of direction!

    Great idea.
  5. by   EirinRN
    Hi to All,
    I'm new here and just wanted to thank all of you for sharing your experiences on this thread. I have worked in the hospital for 14 yrs. and have been in cardiac medicine for the last 9 yrs. Reading all of this has helped me with my decision to switch to home health nursing and helped me learn what to expect when I did a recent ride-along. I was really impressed with what I saw on the ride-along, the people I've met and I believe that I have found what will be my niche. I was offered a position with this company that I regretfully was unable to start this summer d/t personal family issues but I am hoping that I will be able to take a position with this company in the fall. In fact, I am preparing to give an advanced noticed (through the next new schedule) or step down to an extremely casual contingency with my current employer.
    Any words of wisdom on how to prepare for this type of job change? I must admit that this magnitude of change seems a little daunting.:spin:
  6. by   WoWChick
    Quote from LoriAnnRN
    I can't go into details about my daily routines, but I did home health for about 8 years and I really enjoyed it. It has it's negatives but remeber this: your worst day in home health is still 5 times better than your worst day in the hospital setting!
    Really? I am looking for a change. Even with gas prices being nasty - I think this is worth it.

    My Mom was a HH RN the whole time I was growing up. I've done my year in med surge. I'm ready to actually have time to take care of my patients. Any advice to me while I sit on the fence, so to speak, and peer into your world?:spin:

    The hospital that I work at now has an IV team and lab techs come to the floor to draw blood. I have never drawn blood. I've started *maybe*10 IVs but always got in on the first try. (I was holding my tongue right.) Is that inexperience too bit of a disadvantage for me? My mom is a phenomenal RN and would teach me in a heart beat if I could find somewhere to buy phleb. supplies. I know she and my husband would "donate" their arms to my cause.

    I want a normal schedule - I work 12 hour nights. I want time with my patients...quality time where I get to be a nurse to them. I want time to stop and use the restroom. I want my health back - lots of sickness since I started working nights. I want my sanity back - stress/anxiety increased since began at hospital. No matter how much team work is at the hospital there is never enough to make up for the lack of *quality* nursing care.

    Cross your fingers for me. I'm going to call Mom in the AM (oops, I mean in a few hours!) and ask her what the pay scale was when she was working as a Super. in HH.

    I suspect this is the path that God has been nudging me towards. I remember wanting to do HH since I was a little girl, riding around with Mom on call, before HIPPA. I would go and camp out in the car while she went in. Sometimes people would spot me and insist that she bring me in. I remember smells from people's houses, I remember patients Mom had who loved her. I want to be able to help people the way Mom did....by having the time to spend, teach, care, heal.

    OMG I am rambeling. Time to go lay down and rest until I think Mom is awake. Then.....I call her.

    Thank you all for your stories. I think I have been inspired by you, as well.
    Last edit by WoWChick on Jun 5, '07 : Reason: Felt the need to elaborate on my thought process. :)
  7. by   lc177985
    I just graduated in December with a certificate lpn and am doing home health nursing. Right now I have just one client who I work with on a full shift. I like it in the sense that I have time to evaluate the patient and get to know them so that some of the "problems" are not always medical but psychosocial and can be resolved in a different way. My concern is that I am losing all of my skills (more so since I just learned them) that do not involve this patient. But the pay is great and so is the schedule, I can pick my days to work on a set schedule and have off whenever I want (without pay because I'm part-time) as long as I give 30 days notice. Does anyone else have this concern? Also, since I am there all day I do a lot of lifting and transfers that I wouldn't do in a hospital and I am concerned about long term effects on my back as well. Just wanted to know if you have the same concerns. Thanks, L
  8. by   WoWChick
    Quote from lc177985
    Also, since I am there all day I do a lot of lifting and transfers that I wouldn't do in a hospital
    I would say lifting and transferring one person - learning how to work with them and establishing a rapport - is much better for your back than hospital lifting and transfers. Of course, this is case specific and so I am wondering if your patient is a total or can they do some/most of the work?
    Well I think I've changed my mind. In the hospital you have lifts (if your floor is lucky) and there is always someone around to help you boost someone up in bed (if your floor has good teamwork.) Lots of factors are involved. Hmm....now I can't decide but I hope that I gave you something to "chew" on. Above all else guard your back. Injuries are cumulative and can show up years after the insult. Once you back is gone - you are facing limited options.
  9. by   lc177985
    Yea, I am with you on the "not quite sure which way to go" thing. I do like the rapport, have a hoyer but NO collaborative assistance from PT. I have help in the late morn. but in the early am no one and I can't even turn the pt alone. They are easily 2 1/2 times my weight. But I like the rapport to an extent, finding that I feel guilty for going away, they complain about me taking off, etc. Oh well, I will plug along for a while. Thanks for the advice. L
  10. by   jh479352

    Can anyone give me the hourly rate for HH or rate per visit? How many hours are spent after you get home on paper/computer work?

  11. by   bembcar
    hello all,
    thank you for your interesting posts. I will be graduating soon with my BSN in nursing and would like to get into home health. How long would would I have to be orientated before being on my own? Are you all making your own schedules, how does that go??
    Any input would be greatly appreciated.

  12. by   CapeCodMermaid
    Quote from bembcar
    hello all,
    thank you for your interesting posts. I will be graduating soon with my BSN in nursing and would like to get into home health. How long would would I have to be orientated before being on my own? Are you all making your own schedules, how does that go??
    Any input would be greatly appreciated.

    None of the agencies around here would hire a new grad. You really should have at least a year of med-surg to work for a HH agency.
  13. by   steelcityrn
    Sounds like there are some private duty nurses and home health nurses here. Thats cool, just to let you know as a home health nurse, I have done very little lifting. Most patients that need asst. with transfers will have a family member or caregiver to help with that. As far as hourly wages, most nurses I know make around 25 per hour plus mileage. If your getting paid per visit, its around 40 for a visit, maybe as high as 70 for a admission, or other oasis paperwork.