Homecare

username44 · May 3, 2008

Is it possible to work regular hours doing home health care? Can you get full time if you want it? Can you count on having enough work from week to week?

I'm curious about private duty lpn work also.

pagandeva2000, LPN · May 3, 2008

Does any of you LPNs do homecare? I did that back in the 80's and enjoyed it alot. I think I might like doing that as an LPN when I graduate. Can anyone tell me about that?

Is it possible to work regular hours doing home health care? Can you get full time if you want it? Can you count on having enough work from week to week?
I'm curious about private duty lpn work also.

From my brief experience, it depends on what the agencies have available. I have seen situations where they receive a new case for say; 20 hours of nursing care 7 days a week, and then, it is offered to nurses, some are available Mon-Fri 7am to 7pm, others are available only weekends for the same, or maybe someone else may take the sleep in for the entire week/end. Or, there are some that just offer home visits for a specific purpose, such as dressings, teaching, treatments, or whatever else. They try to cluster areas close together, but there is no guarentee. I had a pediatric trach case offered to me for Saturday and Sunday 10 hours. I went to see the case before I accepted and found that the girl, while she is cute as a button, she was a pure hellraiser and I didn't have the energy for two days, and just took Saturday, so that I can have a day off to myself. They may have per diem, some nurses sort of share jobs, where if she can't make it, she or the family may call a agency buddy that they trust (some people try to upsurp jobs by influencing either the family or the agency) will not 'steal' the job.

Great points are that you are more autonomous, it is one on one, flexible, you give the patient all of the care and attention you want. Some families are really great and appreciative. Negatives are that if there should be an emergency, you are ALONE. Make sure when you go there that all emergency equipment is there, that you have the number to the physician, the pharmacy and the location of the nearest hospital. Wise to have a cell phone in case the family does not have a phone or uses it all the time. Also, it is best to have your own, because if you have to call the agency, the conversation is more private. Make sure that the MAR is there and you know what meds the patient is on.

Also, find out what has to be done if a new script such as an antibiotic is ordered, and how the agency wants you to handle it. Mine would say that if the prescription states the patient's name, that the date is within the time you are there, that you can just add it to the MAR, and then call the nurse at the agency to let them know, others may have another situation. The mother used to make a copy of the prescription for us as well, so, I would fax it to the agency to cover myself. Try not to be tempted to give things that are not ordered. Some people want to add ointments or home remedies to their treatment. Do not do it!! You really don't know what is in those tubes of meds, and they may counteract with the current meds you are administering! I would tell them that *I* will not administer it, but cannot force them not to; but I will document what the patient/family said that they are administering and will also inform the agency to cover my butt. Some families will get mad, but that is your license.

Negatives can be some of the above, such as the home treatments, and FAMILY DYNAMICS AND CULTURE. They may do things that are totally abnormal to you, but you are in their home. I remember once, I asked my agency if I could be oriented to a person on a home ventilator. I felt that once I saw what the other nurse did, and she taught me, I would take the case if I were comfortable. I was to meet the nurse that was normally assigned to that patient at the house during treatment time. Well, I went there, and the nurse didn't arrive. I waited for 1/2 hour and meantime, the mother of this adult quadraplegic did not show me the emergency equipment, nor the MAR or care plan (mind you, she is a respiratory therapist); she just opened the door, let me in to the patient's room, where it was dark (in fact, the entire house was dark) and went to her bedroom. I see a catheter, did not know if it was a Texas or Foley, I am hearing this ventilator going on, don't know what to do for this patient. I called the agency and they told me to leave. I am walking in this dark house, quietly calling for someone's attention to let me out, and I walk into a room where I see a bunch of guys counting up cocaine! One of them was surprized to see me and was about to pull out a gun, and I raised my hands and said "I am the nurse, I just want to leave" and then, the mother runs out of her bedroom asking "Why do you want to leave...I told you that the other nurse was coming!!!" Suddenly, I am more angry than anything and I said to her that I cannot legally or properly care for her son because I have no information on him, and this is not safe for him (or ME, but I was careful NOT to say THAT), and I told her that I was leaving. Of course, I never went back. When I got to the agency that Monday, I told them what happened, and when the RN came in, she took me to the side and told me that these were drug dealers, and the patient was paralyzed because of a drug deal that went awry.

I am not saying this to scare anyone, in fact, I laugh at it, now (this happened a few months ago), but, this is why I say to go see your case before you accept. This was an unfamiliar neighborhood to me, so there was not much to go by in terms of geograhics alone. And, if this mother didn't take the time to show me what to do, and what if something happened to this guy while I was there?? Would they shoot me out of revenge? I don't know how the regular nurse deals with that situation. She may be used to it, or she may even sell herself, but it was not worth my life or my license to be there.

Funny enough, I would still do home care, and I plan to get back to it. But, I plan to see my case first, see if I can deal with the neighborhood, the illness, the patient and their familes before I jump and accept.

username44 · May 4, 2008

Thanks so much for your nice long reply. It confirms what I remember from my past experience. That is, you never know what you are walking into. Still I enjoyed it a lot. My only complaint was a lack of regular hours. I have to work when my kid's daycare is open, weekdays 6 to 6, so I don't know if a homecare company can schedule me for enough hours.

pagandeva2000, LPN · May 4, 2008

Thanks so much for your nice long reply. It confirms what I remember from my past experience. That is, you never know what you are walking into. Still I enjoyed it a lot. My only complaint was a lack of regular hours. I have to work when my kid's daycare is open, weekdays 6 to 6, so I don't know if a homecare company can schedule me for enough hours.

Yeah, I looked at my post and said "Goodness, that is LONG":lol2: :lol2:

I enjoy it, also, and plan to get back to it at some point in my life. But, I am more responsible as a nurse, and choose to be a bit more careful of what sort of cases I would take. :nurse:

caliotter3 · May 4, 2008

Agree with everything previously said. Also wanted to add that you can expect staffing coordinators to give you a hard sell and attempt to manipulate you with the pity story in order to get you to work sometimes. My thoughts on this, "why aren't other nurses scarfing up the hours on this case?" If there is something about a case that does not make it a good fit for you, then you need to be firm about not working on that case. One of the benefits of working in home health is OUR ability to be just as choosy about our work circumstances as those for whom we work. Don't let anyone walk over you in this respect. If your agency won't provide you with work that you can live with, another agency will.

As for the hours that you are available: sooner or later, the agency will be able to accommodate you if they are trying hard enough. They have the option of getting a patient's family to work with your availability. This is more likely to work out when there are family members who are normally at home, without outside commitments. They can often adjust the hours of the shift(s) to coincide with the nurse. If your agency can't work with you on this, then sign up with other agencies. At some time one of the agencies will get a case that will work out for you.

JenRN03 · May 10, 2008

:nurse:I work for 2 seperate home care agencies with 2 different clients... with those 2 i get full time hours..one agency requires block scheduling.. the other is pick and choose.. i love the flexibility of home care.. i rarely have to work holidays (family wants to be alone )... I have encountered a few issues with home care nursing (over bearing mother & boundary issues) but for the most part i love it...

username44 · May 10, 2008

Are there any benefits with home health care?

caliotter3 · May 11, 2008

Are you talking about employee benefits like paid vacation and health insurance? It depends on the agency. Most agencies have benefits available for those that work a minimum number of hours per week. One of my agencies required 28 hours per week. This one allowed the individual to pay out of pocket to make up for weeks when they didn't work the minimum for some reason. My other agencies have required 32 hours per week. This is a question that you should bring up during interviews with prospective employers.

UNFORGETABLE2667 · Jun 5, 2008

i do home care and i love it. I do medicare visits where i am in the patients home for about one hour doing wound care, cardiovascular checks, catheter care/changes. I see anywhere from 4 to 8 patients per day. i can decide how much i want to work or not work. some agencies offer benefits and some dont. you will have to look around for that. they also have shifts at nursing homes, hospitals, doctors offices and the county jail. the county jail was the easiest job i have ever done, but i cannot do the 12 hour shifts here because of my child care issues. but other than that, i make my own schedules..