Hospital owned HH experiences

[Kitty Hawk, ADN, RN]

I am still weighing my options thus far. I have the opportunity for a HH that is owned by one of the mega hospitals in my area. They are all about profit, I worked for them in the past in the hospital setting and anyway they have nearly monopolized all areas of health care around here, that's how big they are.

I was told it would be salary (what they don't know) holidays are time and half. SOC's are 75.00 recerts 35.00 and 56 cents for miles. It's a 5 day work week with 3 on calls per 6 weeks and working approx q 3rd weekend, though she said it's not really every third bc you can request timeframes you want vs don't want etc...

The area that I would be assigned to which is fine, is in the suburbs about 37 miles from my house to the area. (I'm thinking my car will get very beat up) The major problem is there is a very bad area in our territory. Although not "my" territory, it would be for the on call and the event of call offs, and let's face it that happens far more than they will say.

This really bad area she mentioned that you can ask for an armed guard to go with you/meet you if say, you have to do something at 1030p. Now not being stupid, I'm sure it costs to have this armed guard, so again there not going to say it's discouraged on the interview, but if they're concerned about a profit it would be no?

Honestly I'm not comfortable going to bad areas in daylight let alone at night, so that's likely my answer. I would love the teaching aspects and the 1 on 1 but the two negatives would seem to over rule that. (miles and bad areas)

The charting is OASIS and since it's a 6 patient minimum is that still "mounds" of paperwork nightly? There are assistants in the office that schedule your day. It's put up on the computer a week in advance. There's an 8x yearly office requirement plus 2x year for certs. They're offering 8 weeks of orientation plus 6 mos probation that they will try to get you to see things you didn't get to see before. All in all they sound like they run things decently. You get a cell phone, laptop, bag with supplies and other supplies sent to your home. Just curious your take on this, would it likely be 45-50+ hours? The set hours are 830-430P Thanks

Also it's case management for 20 patients since the LPN sees some of those does that mean 7 visits still need to be maintained by the RN?

[startofcare]

Organizationally it sounds like a great opportunity. Im working per diem, M-W-F (5-6 pts, mostly wound vacs), T-TH (2 QD, recerts/soc/dcs) Sa, Sun 2 pts , documetation catch up. Your pay rate looks great, I get half what you mention for SOC. and I dont get paid mileage.

As far as bad area, I have to go into a few often. I usually try to go between 9-3, word on the street is "dont be around here after 4pm". I usually do an assessment of the area, if it look ok I park, if I see people hanging around, I greet everyone loudly and say "Im here to see so/so , he/she needs a nurse visit. 9 times out of 10, someone will acknowledge you and tell everyone your here to see so/so. This helps me develop trust and that Im there to help , not make life difficult. Also use assertive body language, get out of my car quick, leave quick. This is just my experience. After a few visits people will recognize you. But never let your guard down, in one bad area, I became a bit comfortable doing some documentation, and a guy out of no where lunged into my driver window and asked me what did I have, told him I was nurse and needed to a sick patient, he asked me if I had anything good in my car, I pulled out my bp cuff , needless to say he wasnt interested. Moral to my story, I zip in and zip out, and find a starbuck or dunkin donut to do any notes.

[kiszi, RN]

I worked in a similar situation. I case managed over 20 pts and if I was low, the office would add extra visits. 5 to 6 was the average, with a SOC counting as two visits. I was salary which was nice since I knew I could count on my pay even if there were cancels, low census, etc. 7 visits would make for a difficult day, and I refused to do 8 or more. I second the above poster on the advice about bad areas. Always be aware of your surroundings and project a confidence about you. I never had a problem, even though some of my visits were in very rough areas. Oh, I also carried pepper spray. I only used a security escort once in 3 years and that was because of a volatile family member, lol. I did know nurses who used it for late on-call visits. The agency never made a fuss. That's what it is there for!

[kiszi, RN]

As far as the hours, if you manage your time well, you are better off. We had computer charting but it still would be easy to fall behind on charting. Best to do as much as possible in the patient's home, and finish up the last bit of charting in their driveway or down the block before moving on. My formula was to stop somewhere safe at the end of visits for the day and wrap up charting, orders, etc. then call any pts for the next day that I hadn' t already scheduled. That way home time felt more like my own time. I saw my first pt around 8:30 and was usually home by 3:30 or 4. You will still get an occasional return call from an MD at dinnertime, which can be annoying. Nature of the job.