HomeHealth stress! New and feel like crying

[chenoaspirit, ASN, RN]

I think I COULD love HH, but the stress is keeping my nerves tore up to the point I cant stand it. Nurses are giving me some of their patients. One was a new SOC, nurse told me that it was a q week PICC drsg change. So I went weekly to do the dressing. Once I got the 485 to sign, I noticed that it was 2w2, 1w7. Well, I had only seen this man once per week. I flipped out, just knew I was going to be in trouble. Luckily, I was able to correct the 485, then sign the corrected one and that was that :grn: . On another occassion, I was putting all my recert dates into my calendar, went over it 3 times to make sure all dates were correct, to later find out the date I had placed in my calendar for one patient was wrong (I was going by the ROC date, rather than the SOC date). So, there was another mistake. :grn: grrrrrrr. I am not sure I am ever going to be able to keep up with all my patients info. One of my patients fell at home the other day, was admitted into the hospital with a broken leg, now Im stressing over having to do a ROC because Ive NEVER DONE ONE. I have studied the orientation packet so much I dont ever want to see it again. I dont want to quit. I gave up my seniority at the hospital to take this job and now I feel like quitting because I feel like Im letting everyone down. Anyone else feel this way when they first started HH?

[caliotter3]

Home health shift care is the least stressful. One patient, one note, done for day.

[berube]

I think I COULD love HH, but the stress is keeping my nerves tore up to the point I cant stand it. Nurses are giving me some of their patients. One was a new SOC, nurse told me that it was a q week PICC drsg change. So I went weekly to do the dressing. Once I got the 485 to sign, I noticed that it was 2w2, 1w7. Well, I had only seen this man once per week. I flipped out, just knew I was going to be in trouble. first it doesnt sound like the nurse gave you a complete report, all she told you was the freq of the task that needed to be done not the freq of the visits, you can learn from this when getting report, ask for the frequency,

Luckily, I was able to correct the 485, then sign the corrected one and that was that :grn: . On another occassion, I was putting all my recert dates into my calendar, went over it 3 times to make sure all dates were correct, to later find out the date I had placed in my calendar for one patient was wrong (I was going by the ROC date, rather than the SOC date). So, there was another mistake. :grn: grrrrrrr. don't be so hard on yourself mistakes with dates can happen

I am not sure I am ever going to be able to keep up with all my patients info. when you get a new patient,get the frequency and plot it out right then and there on a 60 day calander, even tho it may change you will have a place to start

One of my patients fell at home the other day, was admitted into the hospital with a broken leg, now Im stressing over having to do a ROC because Ive NEVER DONE ONE. I have studied the orientation packet so much I dont ever want to see it again. dont worry over a ROC, it is like a soc but without alot of the signature pages

I dont want to quit. I gave up my seniority at the hospital to take this job and now I feel like quitting because I feel like Im letting everyone down. HH takes a good 6 months to get a handle on all the paperwork, dont worry, hang in there, stay organized and you will be fine, even now after doing HH for over 20 yrs there are times that i get overwhelmed and frustrated, i just take the extra time and organize myself and i am fine, you will be too! Anyone else feel this way when they first started HH?

best of luck and hang in there

[chenoaspirit, ASN, RN]

Thank you soooooo much for your response. ok, 6 months. I just hope my boss understands and has patience. I dread tomorrow. Im hanging in there, but only by a tread. lol

[berube]

here is how i would face monday---regroup, dont take on any extra visits, spend a couple of hours organizing your patients and their papers,,,it will get easier, believe me!!!

[annaedRN, RN]

Hang in there chenoa! It is like berube said...it does take awhile to really get the hang of HH. The paperwork and all the OASIS stuff is complex. Have you checked out the fazzi.com website or the links to the OASIS stuff at the start of the HH forum? It helped me once I got my RN (started as an LPN) and was trying to understand all the OASIS and Medicare stuff. As far as dates...just remember ROC is a continuation of original cert period so use original end date. And with recerts, remember new cert period starts the day after the old cert period ends..no matter wahr day in the 5 day window you perform the recert assessment.

The assessments themselves are very similar whether its SOC, ROC or recert. Hopefully you have a "go to" person to ask all your questions, because it is very overwhelming...but don't give up, eventually you'll be able to ask the questions in your sleep. As you get familiar with the questions, you'll go much faster. You will also be able to ask one question and realize it answers a few, because you are familiar with what questions are ahead. Or watch them answer the door and know what all ADL questions it answers, etc. You can do it!!

[berube]

oh i so agree, once you know what questions are on that oasis you will breeze thru it!!!! i actually start my assessment when they open the door, you can tell alot from how they are walking etc....honestly it does get easier!!!!! stay organized is the best advise i could give you.

[SilverRain]

Since I am too late to offer advice on ROC, i will chime in on the other part of your post. I have many years of experience working in HH (from field nurse to sup to QA). It is important to remember that other clinicians can also get confused and give you wrong info. Hence, don't take anyone's word, see for yourself. Read those MD orders, compare to your HH policy on PICC line changes (order could've been written in error to begin with), if you are short on time - use your QAs, ask what your HH's guidlines. Most of us love to educate clinicians and we know CoPs and our company's rules and regulations by heart.

Also, if you feel that you need more time to learn, talk to your sup. It's your license and your patient's safety. Look around your agency, find organized nurses and ask then how they do it. It's our human nature to brag - they will show you how they do it. There are a LOT of shortcuts you can take (without jeopardizing Pt's safety of quality of your paperwork). Good luck.

[HmarieD]

Seven years ago I could have been you. It takes a little time, but you will get it. Once I did, I couldn't imagine leaving HH. Now I'm the PI person for my company. Hang in there!

[chenoaspirit, ASN, RN]

Thanks everyone! I am getting better/faster on the SOC's. I have yet to do a resumption (I have one coming up once my pt is discharged from inpatient). I hope it isnt hard to do. But you guys have given me alot of GREAT advice! I love this website, you guys are great. There is so much support here and I truely appreciate you!:tku: And hugs to all of you for helping me.

[ILBCNU]

I feel your pain! I VERY recently transferred to HH after 14 years of med/surg. I feel so overwhelmed and am just beginning orientation. I have been sitting through a week of Oasis explanation and computer charting instruction, and grasp the information at the time, but the next day when reviewing it seems it has all been erased from my brain! I have been out in the field with my preceptor for about 5 total days observing, and she is basically a walking-talking medical/nursing encyclopedia, and it makes me doubt I will ever be as efficient or knowledgeable at this job as she is. I often wonder if I made the right decision and I'm not even out on my own yet! My husband, who always complained about the fact I worked nights and was gone all night, now says I am putting too much time into this new job by spending home time trying to go over information and learn what I will need to know.