What Would You Do?......thanks for input in advance

  1. I have been orienting with a small rural home care agency for 8 days. I have no home care experience, but I have been a nurse almost 30 years. Last week when I started there was one full time RN and an RN that has been there 6 weeks and a Per diem RN that is doing very little patient care. The clinical supervisor has been seeing patients since she had to let someone go right before I started because she couldn't turn in the dreaded paperwork anywhere close to when she is supposed to. I knew this going in, but on monday my first day to go with my clinical supervisor to see some of the patients that she is giving me, she tells me the one full time RN that has a big patient load gave her two week notice. That had me concerned but I hoped that the clinical supervisor would let me get a bit more orientation and at least feel more comfortable seeing patients before giving me something I am not familiar with and have not had proper orientation on. WRONG.....today i went with the clinical supervisor to open this case as I had not seen that done, and he has a complex wound that is actually a failed skin graft that the doc wants wound vacced...well the clinical supervisor isn't even sure if this can be done and consults the kci wound vac specialist......well the patient is upset with his situation and not happy we can't give him a definite answer.....he also said I hurt him doing his dresssing and so i told my supervisor i would not do this patient.....she asked on the way back ...."haven't u been instructed on wound vac's?" and i again told her no and she says u need the training.....U THINK???:trout:
    also she is wanting to divide the patients of the busy full time RN between us and the nurse that has been there only 6-7 weeks is already feeling pressured and frustrated as well......when i verbalized my concerns over this the other day her response was......"well another nurse is going to be starting soon for prn or part time........the going to be starting soon was my clue that she doesn't count as of yet......(am i wrong?)
    until today i was determined to learn as much and as quickly as i could to help and Monday is my first solo gig with some of the patients she has given me.........Also, i get no pay UNTIL i make my first patient visit alone....and she failed to mention this in the interview and said numerous times during the interview, "you can make as much money as you want."
    I knew she was needy when she hired me without any home care experience. but now she is just desperate and that scares me. The icing on the cake is that when i have questions she is either on the phone, doing her work in her office or when we are one on one talking about her social life and how she needs to get more social......also she is going to be getting a divorce soon........... I am sorry about her personal life, but don't we all have things outside of work that cause us stress? I recently was treated unfairly at the place i have worked at over 29 years and was hoping to make a fresh start and was ready for the adventure........I am so confused now.......Please assure me that all agencies aren't this way?
    Am i wrong to refuse and protect my license?

    Sorry for the long post......
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    About blue49

    Joined: Apr '06; Posts: 23; Likes: 3
    Specialty: med/surg, Icu/Ccu. ER, PACU, HHC, LTC


  3. by   cookie102
    WOW!!! i will try and give you my take on things, i also have been a nurse for 30 years, the last 18-19 i have spent in home health. i will be honest with you when i say the paperwork can be a nightmare, and it will just take you time to learn it, no one can learn it over night, so don't worry too much about that. once you get a grasp on the paperwork it really isn't bad. becaue you are starting with no homehealth exp. it will take a good 6 mos to learn the goings on of home health, rest with the fact that you are a good nurse and the visits will be easy, there is always something that each and every one of us has to learn for the first time, no one could have done or seen it all....what i am most concerned about is the lack of support this agency has for you or anyone....the agency i am employeed at currently allows the nurse to start out slowly esp if she has no home health exp. , we too, feel the nursing crunch but would much rather the nurses get some what comforrtable with what they are doing. (some would want orientation to go on forever). and NOT paying you until you "go solo" is , i believe against the law. the first day you started there you were an employee, they need to pay you "orientaion" pay. for our prn nurses we have a hourly rate they are paid for while on orientation....sorry if this is soooooo long, and hope that you see that not all agencies are the same....i say find another one and get out of this one. keep us posted