Typical Day For A Home Health Nurse - page 16

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   Silverblitzen
    Quote from nurseby07
    That sounds awful!! You don't have to stand for that! Aren't you in Canada? Not ok..I wish I could help..

    Yes, Ontario. I do think home health is the way to go, but there has to be some consideration to the amount of work one can do in one day. I'm past wanting to do 60 hour weeks anymore and that is what full time (anything over 22 hours a week!) had turned into. They'd continue taking cases, wanting to get to 100% acceptance (i.e., take any cases given to our group). That's a fine concept in principle, but if you don't have the field staff with which to do it, it's insanity!

  2. by   nurseby07
    Quote from Silverblitzen

    Yes, Ontario. I do think home health is the way to go, but there has to be some consideration to the amount of work one can do in one day. I'm past wanting to do 60 hour weeks anymore and that is what full time (anything over 22 hours a week!) had turned into. They'd continue taking cases, wanting to get to 100% acceptance (i.e., take any cases given to our group). That's a fine concept in principle, but if you don't have the field staff with which to do it, it's insanity!

    Yeah, that's what I don't get either, not having enough field staff. If the RNs have to do all of the opens, recerts, closes, post-hospitals & supervisory visits and as a case manager you are responsible for 25-40 cases some who have to be seen three times a week and some just weekly, I don't see how they expect us to continue to admit, admit, admit.
    I will agree that a typical day is never 8 hrs. An open for me is (not including drive time) is 1-2 hrs in the home, 1-2 hrs charting, calling for approval, making calender, ordering supplies, and at least 1 hour in the office sorting it all out with the manager and the scheduler and the PT, OT, MSW. And that is just for one open.
    I will say that to me the overtime that I do at home is a huge, the biggest, compensation for me. But what you are being asked to do is ridiculous.
    Today I have 2 opens, 1 regular. One of the opens is 60 miles away (it's the weekend so I am admitting for someone else) so my day will be completely full but I will be home by 3, I hope.
    Are there other agencies in your area? There has to be, Ontario is huge. Good luck..
  3. by   QueenAngie
    Hello, new friends!

    Old hospital RN turns into new home health RN....as of this month.

    Am hoping that it will be my dream job.
    So far the patients are all making the job special.

    Paid per visit....that entails calls, faxes, paperwork.

    Still in orientation and on the learning curve.

    Appreciate all your pointers & tips!
  4. by   irishnoreenRN
    Hi there:
    Wow...sounds like a great HH position. The best of luck to you. I loved HH and was recently hired but it's Hospice. I will start next week after the drug screen, background search yada yada. I've been checked and rechecked this year three times. Once for the course at UD then board of nursing and now for this employer.

    Anyway, I'll be starting with Hospice through a local hospital. I don't know if I will adapt to this as my experience is in critical care but of course that was a few years ago. After being away from the bedside for a period of ten years, it's very, very, hard to get a position anywhere. I'ts like you're old news. No one is interested. I thought I'd do my very best and see if it's good for me as well as my patients.
  5. by   irishnurse68
    I am so thankful for this thread!!! I was just hired at an HH agency, I went in to talk to them about doing some part time visits thru the week as I work weekends only at my hospital job. They were so nice, and the job sounded so great that I hired on full time, which is a minimum 25 visits per week. I have only been a nurse for 2 yrs, and that time has been in a level 2 nursery and postpartum/gyn surg unit, so there is a lot I am going to have to learn! I am nervous about that, and nervous about giving up my current job (I have been at this hospital 11 yrs, first as a microbiologist before becoming an RN), but I am beyond ready to get out of the hospital. It is helpful to see what REAL days are like for REAL HH nurses!!! Thanks for all the great info!
  6. by   whidbey nurse
    OK, I am a retired OR nurse and am thinking about going back to work in the home health care field of nursing. It is something I have no training in, but I would think the personal contact would be so much more fulfilling than the OR field. Any opinions from a home health nurse? Thank you.
  7. by   whidbey nurse
    Hi, I am a retired OR nurse thinking about going back to nursing, only this time trying a new career in Homehealth care nursing. Any thoughts from all the nurses who have experience in the homehealth field?
  8. by   whidbey nurse
    Hi, I am a retired OR nurse who is thinking about gong back to work, only this time, in the home healthcare field. Any ideas from those who are experienced in this field? Thank you.
  9. by   Quiskeya
    Very good since I just got hired for HHC. I am an LPN and this would be my first HHC experience.
  10. by   Tazdoc1
    As a level I Practical Nursing student, I just wanted to say thank you to all of the wonderful HH Nurses who has contributed to this forum. Not only have you given me a deeper insight into the field that inspired my desire to become a Nurse in the first place, but you've also haphazardly helped me to complete my professional development essay on HH Nursing!! I can't believe this thread has been faithfully rolling on since 2003! It literally reads like a book that I just can't put down!! As a past/current client of HH Nursing (for my son), I say keep up the good work, keep striving forward - you are deeply appreciated!!

    Eleven years ago my son was Dx w/Hema A severe. It was a HH Nurse that came into my home with gentle hands and enduring patience that taught me sterile technique and how to access a port-a-catheter to infuse a 1 1/2 yr. old child - my child; who taught me how to run an IV machine at home around the clock by myself when his line became infected; who was there for me when I just needed respite. When my son came home from the hospital at age 4 after recovering from a systemic fungal/bacterial infection from his port, it was a HH Nurse that taught me how to palpate and access a peripheral vein. And she didn't rush me or make me feel as though there was some impending deadline by which I had to learn the procedure. And even though my first stick was successful, she continued to stand be my side week to week until my confidence matched my success rate (for I thought it was always a fluke that I got in & didn't blow it).

    It was all of the wonderful HomeCare Nurses that complimented me and told that I would make a good Nurse one day. They educated me, and uplifted me so high too the point that I had a most profound epiphany. And now I can't see myself as being anything else but a Nurse! My heart is giddy with anticipation of the day that I can offer expert care, kind words, and a gentle touch to an individual in need (and I don't CARE how mushy that sounds!).

    Anyway, just wanted to say Thanks and PLEASE KEEP THIS FORUM GOING!!!heartbeat
  11. by   Kayekayrn45
    I've worked in HH as a Staff Relief Nurse. I see patients when a nurse is sick or on vacation, or just when the office is booming... needless to say this is a fulltime job with all the benefits. About the OASIS... thank goodness we have Coders at our office who fill in the OASIS code stuff.. we tell them what we think is the primary diagnosis and so on, and they fill in the code #'s for us (thank God...we just dont have time for this). Also, when it comes to the insurance, Medicare, Medicaid stuff... do like I do... ask which OASIS to use. After 4 years of HH nursing, this gets my goat. Fortunately, I work at a company who has staff that calls the insurance co's and Medicaid so they can tell us how many visits we can make. I used to work for an agency that the HH nurse had to do all of this...I got burned out and quit. With my co. we have wonderful LPN's who have desk jobs to help out the RN's in the field. If we need to contact a doctor, we call the PCC (LPN), give them all our info on the pt, they contact the MD and get orders for us and let us know. This is great because we can make our call to the PCC, leave and go see another pt.....no waiting around on HOLD for an MD's nurse to run down the MD and get orders....our PCC's do that for us.... It is awesome and it saves us HH nurses so much time. I am spoiled. Since I don't have my own case load... I usually have no info on the pt except diagnosis and meds... the LPN's are up to speed with the pt's and really help me out quite a lot. I must say that I actually LIKE my job, and that's a first for me after 11 years of nursing.

    About the OASIS... people make it out to be harder than it really is. Just read the question and go with what mostly fits the patient. If there is a gray area I usually pick the "most worse" answer and hope that on discharge or recert that the same question would show some improvement.

    On a last note... with the OASIS, just do the best you can and if you have a good QA person, they will help you correct any mistakes... don't take offense at QA... they have taught me so much just by all the mistakes I've made on HH paperwork. Your QA person is a good resource along with your Clinical Supervisor.

    Home Health is very rewarding and most patients are greatful for what you do for them.
  12. by   honeykrown
    Worked home care right out of nursing school and i have been doing fro a year and half. I could say it has been kind to me so far. It has its best and worst days but i can say that the best days are more than the bad days. I dont do visiting care. I work for an agency and take care of just one patient. I do only one family and they are so nice. The best thing i can say that homecare has done for me is to improve my commnication skills which was at a low even after nursing schools. The nursing skills are not that much so i know i lost most of them
  13. by   scrappygirl123
    I am new to HH. I have been in the O.R. for over 25 years, and have decided to change the course of my life. Anyone know of any online teaching for newbies? I have been winging it for 2 weeks now, but am still still very uncomfortable in my skills. I have been thrown a few curve balls all ready, trying to do things that I have never done. I feel somewhat shaky on assesements. Haven't done admisssions yet, just visits. HELP please!