Home health

[Dakota Metz]

I just accepted a new job with home health and start Monday. I know there is a lot of charting but I’m really scared because everyone says I will hate it and that I will be charting so late. It’s a Monday through Friday 8-430 every 4th weekend and two on calls a month. Any tips? And any way to not be charting past at least 530 every night?

[NRSKarenRN, BSN, RN]

Numerous discussions on this topic in our Home Health forum.

Expect for it to take 6 months to fully grasp all aspects of Home Health Medicare and insurance regulations affecting charting, especially Medicare OASIS assessment. You will be exchanging call bells, staff arriving late, hospital politics for the patients home autonomy, professional independence and ability to self schedule your day -- paperwork will get better, especially if your agency has EMR. After 30yrs, I still love this niche specialty,

[ImissScrubs]

I am with my second home health company. They advertised the same hours you mentioned. My best advice is to ask for help as soon as you think you need it. Honestly I have trouble with staying organized and focused some days and it's been pretty rough for me. I've been here 3 months and have given my notice because I feel like more of a burden than anything else. I love my patients and the flexibility some days. I pray your company isn't using the charting program we have. That has been my other big issue. It is so complicated and makes me fall even farther behind. But if you are great with time management and staying organized you'll be just fine. Best of luck!

[Roslyn Waller RN]

I wrked in health facilities for 39 years, so home health has been

like learning to crawl. In the morning I call doctor offices and patients to set times for visits.

I have started giving the office FAX number when I call a doctor office for orders. I have learned I have to make sure pts. have accucheck machines, medicare might pay for it. That's another phone call. Making sure pts. have their meds. and if they don't call the pharmacy, doctor office and chart the facts.

The responsibility on the nurse to call doctors, and put the orders in and chart on SOC, ROC, 60 day conferences, resumption of care and that is just some of the job.

I went on YouTube to learn about HH nursing and none of the of the nurses told about the items states above. I can't type fast so those of you raised in the PC times hang in their.

HH nursing is like all other jobs, prioritize, organize and use your resources. It will become easier the more you practice your skills.

[Svit, BSN, LPN, RN]

Welcome to HH!

Try to chart as much as you can during the visit.

[Roslyn Waller RN]

The ADL/FUNCTION/grooming, M1800-1845, GG0110, GG0170, GG0100 and there is a fine line in the description of a patients abilities to transfer from toilet to chair, etc. It is a new skill to learn on charting for home health, MCS.

Thank you for your help.

[Roslyn Waller RN]

I have gone on YouTube for Oasis-D information to understand the charting to do it right the 1st time. But it is still a challenge.

[LuisHH]

3 years in HH and once you get the hang of it its not bad at all, especially if you chart as much as you can at pt’s home and able to be organized. Being efficient in your routes helps you save time to chart at the end of the day.

[Roslyn Waller RN]

Thank you LuisHH. PT,physical therapist, called to tell me my patient did not have 1 of his meds, so now what is my role when a patient doesn't have or is not taking medications? The patient is alert and oriented, family present for medications reviewed. Do I call the doctor and tell him/her?

Thank you, RozHH

[Svit, BSN, LPN, RN]

All you can do is educate the patient about the medicine, why he needs to take it, what happen if he will not take it. Call MD and report and than chart all you've done. You can't make patient take meds but you can educate.

[Roslyn Waller RN]

Thanks, HH so much to learn.

[LuisHH]

Exactly. Because of patient autonomy best you can to is provide patient education. If able to convince to take the meds follow protocols of missed doses depending what it is (blood thinners or epileptic meds). Always do your communication notes that include all parties. Record refusal on MAR chart. Make phone call to GP. Other clinicians might have done this but it’s better to cover yourself.